Harris TX Workers Compensation FAQs
What is Worker’s Compensation?
Texas worker’s compensation is a state regulated insurance program that injured employees can take benefits from if they are injured while in the workforce.
While the worker is on the clock, whether they are on workplace premises or not, worker’s comp can cover injuries that may occur.
Worker’s compensation also covers any situation in which an employee may develop a work-related illness.
This insurance provides compensation for hospital bills that may have incurred by the injured worker, and can also provide the injured worker with some type of temporary compensation for lost wages.
A private employe in Texas has the ability to choose worker’s compensation insurance coverage, but they must let their workers know whether they have coverage or not.
Worker’s compensation insurance coverage is not required by employers.
As long as the employee didn’t cause the injury through reckless or deliberate manner, worker’s compensation benefits will be granted.
These are the work-related injuries that are not covered by worker’s compensation:
- The work-related injury is due to the employee’s own horseplay.
- An employee who is acting reckless, is endangering themselves.
- This means that any injuries that have happened, it is the employee’s fault because of their carelessness.
- Injuries are due to the worker being intoxicated.
- A laborer in the workplace under the influence of alcohol or drugs could possibly be injured.
- If the employee was not under the influence of drugs or intoxicated, the injuries that occurred probably wouldn’t have happened.
- The worker’s negligence is the worker’s fault.
- Injuries have been the result of an employee committing willful criminal actions.
- When a worker has committed willful criminal actions, their injuries are no longer work-related and they may not receive worker’s compensation benefits.
- While off-duty, the employee participated voluntarily in recreational activities.
- In the event that an injury has become the result of a recreational activity on the workplace premises, these injuries will not be eligible for worker’s compensation, due to the fact that these activities are not work related.
- Injuries are due to criminal actions of third parties. Even if the injuries are due to a third party criminal act, the injuries could not be eligible for worker’s comp benefits.
What types of Workers Are Eligible For Worker’s Compensation?
Texas worker’s comp offers many different kinds of benefits to aid injured workers and their family.
The benefits include:
- Medical Benefits. An injured employee has the rights to medical benefits that allow the injured worker to be able to pay any medical expenses that are associates with treatment to the work-related injury.
- Income Benefits.Throughout Texas, an injured worker is qualified for four different kinds of “income” benefits.
- Temporary Income Benefits.Temporary income benefits ae paid out when a worker has missed seven or more days of work because of a work-related injury. In other words, temporary income benefits are wage replacement benefits.So they are used to help replace an injured employee’s wage. Temporary income benefits are also known as wage replacement benefits.
- Impairment Income Benefits.In Texas, an injured employee can receive impairment income benefits if the employee has suffered permanent impairment due to their work-related injury.
- Supplemental Income Benefits. An injured employee may receive supplemental income benefits depending on their impairment rating and by other satisfying qualifying criteria.
- Lifetime Income Benefits. Some specific injuries happen to be so serious that the injured employee could be entitled to lifetime income benefits.
- Death Benefits. If the employee dies as a result of the work-related injury or sickness, the decedent’s family may be able to receive death benefits.
- Burial Benefits. Whoever pays for the burial of the worker may also obtain burial expenses for the departed worker.
Can I Choose My Own Doctor?
Injured employees may choose their own doctor, as long as, the doctor they choose is designated by the Texas Division of Worker’s Compensation as a workers’ comp doctor.
There is a list of designated doctors typically provided by the injured employee’s boss.
However, if the boss is unable to provide this list, an injured worker can search for a worker’s compensation designated medical professional to give them medical treatment for their work-related injury or illness.
If I Need Help With My Worker’s Compensation Claim, Where Can I Turn?
Injured employees have three options when they need assistance in dealing with the Texas worker’s compensation system.
An injured worker can either talk to a worker’s compensation lawyer, contact the Texas Department of Insurance Division of Worker’s Compensation and speak to a staff member, or seek help from the Office of Injured Employee Counsel if the injured individual hasn’t already talked to a worker’s compensation attorney.
The injured worker is able to get help from either option with:
- A graspable understanding of the worker’s compensation framework
- Assistance on the usage and navigation through the Texas worker’s compensation system
- Answers to quires regarding what a claim is, how to file said claim, what a claim dispute is, or how to handle a claim dispute; and
- Guidance on what to do after an injured worker’s claim is denied.
Is Worker’s Compensation Claim Information Kept Confidential?
When an injured worker makes a worker’s compensation claim, all of its information is confidential and only those involved with the case are able to access the information.
An injured employee is able to designate an individual, like a spouse, to be authorized to talk to the Texas Division of Worker’s Compensation in regards to the injured employee’s worker’s compensation claim.
However, potential employers are able to see in a background check whether a prospective hire has had an worker’s compensation claims in the past.
Within the past five years, prospective employers can see if a potential hire has reported two work-related injuries.
Is Worker’s Compensation My Only Means of Recovery?
In some cases, injured workers may seek compensation from other sources if they have been injured or ill as a result of their jobs.
An injured worker might have to file a personal injury claim against a responsible third party, if the worker is injured due to a third party.
In a third person liability lawsuit, an injured employee can look for damages that are beyond compensation for hospital bills and lost income (where the injured employee can recover by filing a worker’s compensation claim), and can look for noneconomic damages for injuries that are difficult to put a financial value on, such as mental anguish, pain and suffering, etc.
Is My Boss Allowed to Treat Me Differently, Discriminate Against Me, or Fire Me?
There are some legal defenses put in place to help prevent an employer from discriminating against an injured employee who has filed for worker’s compensation benefits, and as a general regulation, an employer shouldn’t treat an employee any differently after the injured worker has filed for worker’s comp.
A wrongful termination lawsuit could be called for if an employer terminates an injured worker because they had filed a worker’s compensation claim.
In Texas, employers may terminate their employees for any reason, so long as the reason isn’t protected by the law, because Texas is an at will employment state.
In the case that business is slow, or if the injured worker cannot perform their job duties well anymore, the boss may terminate them.
Before terminating an injured employee, Texas employers must be able to give a legitimate reason.