A personal injury lawyer, in this case, a workers comp lawyer, specializes in assisting workers who need help receiving workers compensation insurance from work related incidents occurred while working 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 comp attorney can also be called an employment lawyer, injury attorney, or accident lawyer.
The biggest and the best law firms in Sugarland can have one or two personal injury attorneys, that concentrate not only on workers compensation insurance claims, but also personal injuries. A workers comp lawyer can also be a car accident lawyer and represent victims of sustained injuries in automobile accidents.
Back to workers’ injuries.
A workers compensation lawyer can determine if an injured worker has a chance to benefit from a workers’ compensation insurance in the event that they have to look for medical treatment for their sustained injures and recovery period. In very complicated cases a workers’ compensation board may be called to help settle a claim. Workers’ compensation is a type of insurance that most employers are required to provide for their workers in Texas. Workers’ employment lawyers are well trained in workers comp insurance and can help employees get reasonable and fair workers comp settlements.
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 aid from the Office of Injured Employee Counsel if the injured worker has not already had a workers comp lawyer;
3. If eligible and regardless of fault, the injured employee may have the right to financial and medical benefits through workers’ comp, with some limited exceptions, and surviving family members are also given the right to burial and death benefits if the eligible injured attorney were to die due to their work-related injuries or illness;
4. The right to medical care in order to treat the workplace injury or illness for the amount of time that the treatment is needed;
5. The right to receive monetary benefits for the work-related injury or sickness;
6. The right to disagree with a resolution regard claim concerning income benefits or death benefits;
7. The right to pick a doctor within the Workers’ Compensation Health Care Network; and
8. The right to ensure that your workers’ compensation claim info is kept confidential.
The Responsibilities of Injured Workers
Under the laws of workers compensation in Texas, injured employees have some 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 making sure that you report the injury of ailment to your manager within the next 30 days of the event;
2. The responsibility of finding out if 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 presenting 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 giving current contact info to the Texas Division of Workers’ Compensation;
7. The responsibility of contacting the workers’ compensation insurance provider and the Texas Division of Workers’ Compensation if the injured employee’s status changes;
8. If the injured employee passes away because of their work-related injury or ailment, the remaining family members have the responsibility to complete and submit a Beneficiary Claim for Death Benefits to the Texas Division of Workers’ Compensation within exactly one year from the death of the employee; and
9.The responsibility of being honest and not sending in a fraudulent or frivolous claim.
Types of Workmans Comp Insurance Benefits
In Texas, workers’ compensation is available in four different kinds of benefits:
- Medical Benefits. Medical benefits give injured workers the ability to pay for the medical care that they need to treat their work-related injury or sickness. Restrictions are in place while obtaining medical assistance, such as having to acquire medical care within a workers’ comp insurance provider’s service framework, as well as, choosing a medical physician from a list of network care providers that are prescribed (in the situation where you do need emergency treatment due to a life threatening work-related injury or ailment, you may find care in an emergency care facility).
- Income Benefits. Injured workers in Texas are eligible for four different types 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. The total amount paid for TIBs is 70 percent of the entire difference between the worker’s typical weekly wage, as well as, any wages that the injured worker could be able to earn after their work related accident. Even if the worker returns to work, there is still a chance to be paid to an injured work, but only in a modified position that accommodates their injury. If the worker is in a modified position and receives a reduced wage, TIBs can continue. Typically, TIBs will cease after 104 weeks of payment, or once the injured employee has reached their maximum amount of medical improvement, determined by the workers’ health care provider. TIBs are also known as replacement benefits.
- Impairment Income Benefits (IIBs). Injured employees can also receive impairment income benefits in Texas when the workers have suffered a permanent impairment as an effect from their work-related injury. During the time after the injured worker has seen their maximum amount of medical improvement, or the best level of recovery has been made, a health care provider will see the injured employee and determine what the impairment rating is. The employee’s impairment rating is used to determine their eligibility for IIBs. Three weeks of IIB compensations are paid dependent of the percentage of the impairment rating. IIBs are compensating at 70 percent of the worker’s average weekly wage, or 70 percent of the state average weekly wage (the last being the cap on IIBs)
- Supplemental Income Benefits (SIBs). In the event that an employee has an impairment at a rating of 15% or more, is looking for work, didn’t return to work (or returned but can only do less than 80% of their pre-work injury average payment), and did not take the IIBs in a lump sum benefit, then the injured worker could be qualified for 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. Paid on a monthly basis, SIBs are required to be paid for each quarter after the IIBs have been ended. 401 weeks(roughly 7.5 years) from when the worker suffered the injury, the SIBs end.
- Lifetime Income Benefits (LIBs). Sometimes injuries could enable to injured worker to gain lifetime income benefits. For example:
- If you lose both of your feet, or lose both hands, with any combination of the two;
- A combination of paralysis between two limbs;
- If there is a traumatic brain injury producing insanity or making the worker mentally disabled; 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. LIBs are typically reimbursed at 75 percent of an injured employee’s weekly salary, where in time, the average weekly salary is subject to a 3 percent raise, or increase, each year. LIBs must be applied by a written request with the workers’ compensation insurance carrier.
- Death Benefits. When a worker passes away because of a work-related injury, the decedent’s family (i.e., a surviving spouse, minor children, dependent grandchildren, and other dependents) may be qualified for death benefits through workers’ compensation. Paid at 75% of the departed employee’s average weekly wage, death benefits are subject to a maximum and minimum death benefit. The surviving spouse of the deceased is eligible to receive death benefit payments for the remaining span of their lifetime, under the assumption that they are not remarried in the future.
Any children of the deceased may be eligible to receive death benefits until they reach age 18, or if they are enrolled in an accredited educational college full time, until they are 25. Once the older child is ineligible to receive benefits due to their age, the death benefits are redistributed to the younger children. If grandchildren are at least 20% dependent of the person who passed away, they can receive benefits until they are 18, unless their parents are eligible for these benefits. Grandchildren who have exceeded the 18 year old age limit may still gain benefits, but only 364 weeks’ worth of such benefits. In the event that there is no surviving spouse, grandchildren or children, a non-dependent parent may be eligible to get death benefits, though only 104 weeks of benefits. - Burial Benefits. Whoever pays the burial fees for the deceased employee, can receive burial expenses. As reimbursements, burial benefits can be paid out.
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 doctor must be someone who is chosen from the Texas Department of Insurance Division of Workers’ Compensation. Many times, employers’ have information for doctors on how to find a designated medical physician within the employers’ workers’ comp insurance providers’ health care system. Injured workers can request this information from their bosses.
Once the harmed laborer is in contact with a treating specialist, they will have the capacity to guide the harmed laborer to other in-network doctors or specialists as required. In some cases a manager might not hold a care provider requirement; therefore the injured worker has to locate a designated doctor. During these times, the best place to search for a doctor, is the employee’s normal health care provider. If the employee’s normal health care provider works with employee’s compensation patients, then the normal health care provider should be adequate. If not, the employee can discuss with their regular health care provider for a recommendation.
When all else fails, an employee’s compensation selected doctor can be located on the internet or in the telephone directory. In an emergency case, an injured employee can seek care from any hospital or doctor. After any initial trauma or life-threatening risks are lessened, the injured employee must find and go to a designated workers’ comp treating medical physician for any other treatment of the work-related injury or illness. Only after the emergency medical and urgent follow up, should you locate the services of a work related injury lawyer be looked for.
You should wait before you talk to a Sugarland personal injury attorney or workers comp lawyer, because of these two reasons. The first is simply because you don’t want to lose precious time in regards to getting medical treatment. The second may not be as obvious.
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. You will be able to use this info to make a better and stronger case for yourself.
Regarding a Work Compensation Case What Is The Responsibility Of A Designated Doctor?
With the addition of an employment lawyer defending your case in regards to workers’ compensation, a designated doctor is given the task of performing a thorough examination and providing you with a recommendation about your work-related incident. In addition to this, 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 look through any medical records and/or info that is related to the work-related injury or ailment
- Conduct scans, tests, exams, etc., as needed to full address the injury
- Assess if and when the worker who has been injured has obtained their maximum amount of medical improvement
- Additionally, once the maximum medical improvement is reached, assigning an impairment rating; and
- To produce and submit a medical evaluation report for the injured employee to insurance provider and the Texas Division of Workers’ Compensation within the seven days after the medical examination has been concurred and should include both a narrative report and any other documentation that is related to the injured employee’s impairment rating.
Going Back to Work After An Injury Workers Compensation Forms
The best situation is for an injured employee to receive full workers’ comp benefits for their work-related injury or ailment until they are ready and well-enough to go back to work. This keeps the worker both productive and engaged with their job, and cuts the costs that could be associated with the worker’s injury and time off of their job. Sometimes, there is pressure from the manager to return to work earlier than recommended by the doctor, this sounds odd, but Sugarland attorneys have had to interfere with disputes between employees and employers, so that the employee can rest and is allowed the appropriate time to recover. After re-cooperating from a work-related injury or sickness, a laborer can then return to work.
The worker does not have to fully recovered in able to return to work. Employees who are injured and want to return to work early, should talk to their boss and designated medical physician about the possibility of going back early. 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. The laborer should ensure that he reads the “fine print.”
It’s also imperative to check with the workers compensation lawyer that took on the case and to make sure that the employee is not in danger of losing his workers compensation insurance due to agreeing to accept a temporary position offered by the manager for the injured worker. Until the worker has reached full recovery, there should be some kind of worker compensation insurance available. Some managers have Return to Work Programs available which are created to get injured employees back off their feet by providing returning employees with temporary assignments or modifying their preceding job tasks to accommodate for the employee’s state of recovery. With a program such as this, the thought process is that having some work is better than no work at all, while allowing the laborer to be productive, stable, and reach normalcy once again.
After the worker has returned to work, if they are working in some sort of limited capacity, their workers comp benefits can then be suspended or reduced. A worker’s benefits can be lost only dependent of the eligibility in the first place, as well as, the wage difference between their original wage and the post-injury wage.
Can I Be Fired for Filing Workers’ Compensation in Sugarland?
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