A workers comp attorney, also known as, a personal injury lawyer, concentrates on helping workers collect workers comp insurance from a work related accident that sustained injuries on the job. The work injury attorney begins by looking at the workers compensation policies and then checks to see if there’s a conflict between the employee and the employer, in this case, the attorney will negotiate with the workers comp insurance companies to ensure that a fair workers comp settlement is agreed upon.
A workers compensation lawyer is also referred as an employment attorney, injury lawyer, or accident attorney.
Throughout Pasadena, the biggest and the best law firms may have a personal injury lawyer or two, they not only work with workers comp claims, but also personal injuries. Not to reiterate the point, but a workers comp lawyer can also specialize as a car accident attorney that can represent victims of a car accident who sustained injuries.
Going back to work related injuries.
While the worker is seeking medical treatment for their injuries and in the state of recovery, a workers’ compensation attorney can help you figure out if you may receive benefits from a workers’ comp insurance claim. In the most difficult claims, a workers compensation board may be called in to help settle the claim.
Workers’ compensation is a type of insurance that most employers are required to provide for their workers in Texas. Workers’ employment attorneys are well versed in the “ins and outs” of workers compensation insurance and may help employees get workers comp settlements that are fair.
The Rights of Injured Workers To Have Workmans Comp Insurance
In Texas, a worker has certain rights when they have sustained an injury at work, in according to the Texas workers’ compensation system.
These are the rights as follows:
1. The right that at any time during the workers’ comp claims process, the injured worker can be assisted by a workers’ comp attorney;
2. The right to get help from the Office of Injured Employee Counsel in the event that an injured worker does not have a workers comp lawyer;
3. If one is eligible and notwithstanding of fault, the injured worker may have the ability to gain financial and medical benefits through workers’ compensation (limited exceptions), and any surviving family members, have to option and right to burial benefits if the eligible injured employee were to pass way due to the work related injury.
4. The right to medical treatment for the workplace injury or illness for as long as the treatment is required;
5. The right to gain benefits for any work-related injuries of illnesses;
6. The right to disagree resolution regard claim in concern to death or income benefits.
7. The right to pick a doctor within the Workers’ Compensation Health Care Network; and
8. The right to make sure that all of the workers’ compensation claim information kept private and confidential.
The Responsibilities of Injured Workers
In Texas, due to workers comp laws, injured workers have certain responsibilities. Texas state laws say that an employee must fulfill the following responsibilities before they are eligible for workers’ compensation benefits:
1. The responsibility of reporting your work-related sickness or accident injury to your boss within 30 days of the sickness or injury;
2. The responsibility of determining whether or not the employee is a part of the Workers’ Compensation Health Care Network;
3. The responsibility of finding out how to get medical attention if the worker belongs to a political subdivision, such as a school district, a city, or a county;
4. The responsibility of discussing with a trained physician about the injury or illness and it’s relatedness to work;
5. The responsibility of carrying out and submitting an Employee’s Claim for Compensation for a Work-Related Injury or Occupational Claim Form to the Texas Division of Workers’ Compensation;
6. The responsibility of providing recent contact information to the Texas Division of Workers’ Compensation;
7. The responsibility of notifying the workers’ comp insurance provider and the Texas Division of Workers’ Compensation, in the case that the workers’ employment status changes;
8. If the injured worker dies due to the work-related accident or illness, the surviving members of their family now have the responsibility to complete and submit a Beneficiary Claim for Death Benefits to the Texas Division of Workers’ Compensation within the one year from the death of the worker; and
9.The responsibility of not making a frivolous and fraudulent claim.
Types of Workmans Comp Insurance Benefits
In Texas, workers’ compensation is available in four different kinds of benefits:
- Medical Benefits. Medical benefits allow injured workers to be able to pay for their medical care needed to treat the work-related injury or sickness. Some restrictions are designed when obtaining medical benefits, which include gaining medical treatment under the workers’ compensation insurance provider’s service facility or you may have to choose a doctor from a list of prescribed network care providers (if however, the worker needs immediate treatment with a life threatening injury or illness, the work can go to an emergency care hospital.)
- Income Benefits. In Texas, workers with a work-related injury are eligible for four different kinds of “income” benefits.
- Temporary Income Benefits (TIBs).In the case that a worker has missed seven or more days of work, Temporary income benefits will be compensated because of the work related injury or sickness. An injured worker can be eligible for temporary income benefits as soon as they have missed eight days of work. 70 perfect of the difference between the average weekly wage and any other wages that the injured worker can earn after their work related injury is the total amount paid for TIBs. Benefits can be paid in the event that the worker has returned to work, but this is shown in a modified position that would accommodate their injury. If the worker is in a modified position and receives a reduced wage, TIBs can continue. TIBs, as a general rule, will stop after 104 weeks of payment, or as soon as the injured worker has hit their maximum medical improvement, as deemed by the employee’s health care provider. TIBs are also known as replacement benefits.
- Impairment Income Benefits (IIBs). When an injured worker has concurred a permanent impairment due to their work-related injury in Texas, the injured worker may receive impairment income benefits. After an injured employee has hit their maximum medical improvement, or the greatest level of recovery that is able to be made, then a health care provider will check the injured employee to see what the impairment rating may be. The eligibility for IIBs is determined by the worker’s impairment rating. Three weeks of IIB compensations are paid dependent of the percentage of the impairment rating. IIBs are paid under the following two options: Having 70 percentage of the worker’s weekly wage or the state average weekly wage (while the state wage acts at the cap on IIBs.)
- Supplemental Income Benefits (SIBs). In some cases, a worker with an impairment rating of 15% or more, did not go back to work because of the impairment, went back, but couldn’t make any more than 80% of their pre-work injury average payment, is looking for work, and did not receive the IIBs in a lump sum type of payment, the injured worker may be capable of gaining supplemental income benefits. An SIB will compensate 80% of the total difference between the employee’s pre-injury average weekly wage and the employee’s post-injury average weekly wage. Once the IIBs have been closed, it the worker’s responsibility to apply for the SIBs each quarter, at which they will be paid monthly. SIBs will be closed 401 weeks (estimated 7.5 years) after the employee suffered the injury.
- Lifetime Income Benefits (LIBs). Certain injuries could allow an injured worker to lifetime income benefits. For instance:
- A loss of both feet above the ankle, or both hands above the wrist, or any combination;
- A combination of paralysis between two limbs;
- In the event of a traumatic brain injury that could produce insanity or a mental disability; or
- In the case of third degree burns that either cover 40 percent of the body and require grafting, or covering both hands and the face.
Each of these injuries could enable a worker to be eligible for LIBs. Paid at 75% of an injured worker’s weekly salary, LIBs are subject to a 3% raise, or increase, after each year. A written request must be made with the workers’ comp insurance carrier, in order to apply for LIBs.
- Death Benefits. If a worker has died due to a work-related injury, the employee’s family (any surviving spouse, minor children, dependent grandchildren, and/or other dependents) could be eligible for death benefits through the workers’ compensation framework. Death benefits will be paid at 75% of the deceased worker’s average weekly wage, subject to maximum and minimum death benefit limits. The widowed spouse can be eligible to gain death benefit payments for the remaining duration of their lifetime, though they cannot if they remarry. Until a child reaches 18, they can receive death benefits, or 25 if they stay enrolled in an official educational institution. Once the older child is ineligible to receive benefits due to their age, the death benefits are redistributed to the younger children. Any grandchild that is dependent upon the deceased, at least 20%, may receive benefits until they are 18, unless the grandchild’s own parents are also eligible for such benefits. Grandchildren who have exceeded the 18 year old age limit may still gain benefits, but only 364 weeks’ worth of such benefits. If there are no surviving spouse, children or grandchildren, a non-dependent parent can gain death benefits, but this is limited to 104 weeks of benefits.
- Burial Benefits. Whoever pays the burial fees for the deceased employee, can receive burial expenses. Funeral benefits are recovered as reimbursements.
Can I Choose My Own Doctor?
In Texas, in order for the employee to obtain workers compensation benefits, a wounded worker must select a medical professional so that they may get a medical examination to decide on the eligibility of the worker and whether they can get workers’ compensation benefits. The medical professional has to be designated by the Texas Department of Insurance Division of Workers’ Compensation. By and large, bosses have data for harmed specialists on the best way to discover an assigned specialist inside the business’ laborers’ pay protection supplier’s medicinal services system. Injured employees can ask for this info from their employers.
Once the injured worker is in contact with a treating expert, they will have the ability to lead the injured worker to other in-system specialists or authorities as required. In certain situations a boss might not have a care provider obligation; in this case the injured employee must find a designated doctor. In such situations, the best place to look is the employee’s regular care provider. As long as the employee’s typical health care provider works well with workers’ comp patients then the typical health care provider should be sufficient. If this is not the case, the worker can talk to their normal health care provider for a recommendation.
When all else tends to fail, a workers’ compensation chosen doctor can be found on the internet or the telephone directory. If there is an emergency, an injured worker may seek care for emergency care from a hospital or doctor. Once there are is an alleviation of any initial trauma or life-threatening risks, the injured worker must discover and go to a designated workers’ compensation treating medical doctor for all further treatment of the work-related injury or illness.
An injury attorney shouldn’t be sought after, until you have had your emergency medical and urgent follow up. These are the two reasons to wait before you get advice from a Houston workers comp lawyer, or Houston personal injury lawyer.
The first is simply because you don’t want to lose precious time in regards to getting medical treatment.
While the first reason is obvious, the second is not. If you decide to take time to see what the doctors will say about your work related injury and you wait to see what kind of medical bills you will have to deal with before you contact a workers compensation lawyer, you will have more information to offer the list of the workers comp lawyers that you interview. This info is useful in making a stronger case for your benefit.
Regarding a Work Compensation Case What Is The Responsibility Of A Designated Doctor?
Adding to a workers’ comp attorney defending your workers’ compensation claim, a designated doctor is brought in to perform a medical exam and provide you with a recommendation about the work-related condition. In addition to, the designated doctor can sometimes be relied upon to resolve a possible dispute in concern to a work-related injury. There is also the case that the designated doctor might have to:
- Merge and review any existing medical records and info in relation to the work-related injury or sickness.
- Execute exams, scans, tests, etc., as per necessity to fully assess the work-related injury
- Assess if and when the worker who has been injured has obtained their maximum amount of medical improvement
- After the maximum medical improvement has been obtained, assigning an impairment rating; and
- Produce and submit a thorough medical exam report for the injured individual to the Texas Division of Workers’ Compensation and insurance provider within the seven days deadline of the medical exam, which should include a narrative report and any other documentation concerning the injured workers’ impairment rating.
Going Back to Work After An Injury Workers Compensation Forms
The best scenario for the injured employee is to acquire workers’ compensation benefits for a work-related accident until the worker is fully able to and ready to return back to the workplace. This ensures that that worker is productive and engaged in their work, and also reduces any costs associated with the worker’s injury and time out of the workplace.
At times, an employer will place stress on the worker, to try to get them to come back to work early, this is of course not allowed, but there are times where attorneys in Pasadena often have to impede on the argument between the two parties to get the employer off the employee’s back. After the worker has finished recovering from a work-related accident, the employee is then able to go back to work. The worker does not have to be fully recovered in able to return to work.
If the worker is close to being recovered and wants to go back to work early, they should discuss this possibility with their designated doctor and manager. Before going back to the workplace, the employee should understand any kind of instructions related to returning back to work and the proper workers comp forms. ”Fine print” is a must for the employee to read.
You should ensure that you check with your workers comp lawyer and make sure that you are not in any kind of danger of losing your workers comp insurance because you accepted a temporary position offered by your boss. Until the worker has reached full recovery, there should be some kind of worker compensation insurance available.
In some cases, bosses will have a Return to Work Program which are designed to help injured workers in their return to work by providing them with short-term assignments or modifications to their original job tasks to help them in their time of recovery. In order to help the employee get back into the workforce and provide a sense of being productive, stable, and promoting normalcy, these programs give the idea that some work, is better than no work.
Workers’ comp pay can then be reduced or suspended on the account of whether the employee is working in a limited capability when returning to work.
Benefits are only depending on the worker’s eligibility to receive them, and what the actual wage is compared to their pre-injury wage.