Pasadena TX Workers Compensation FAQs
What is Worker’s Compensation?
In the state of Texas, worker’s comp is defined as a state regulated insurance program that provides benefits to injured workers if they are injured on the job.
Worker’s comp covers injuries that occur in and out of the workplace premises, if the worker is on the clock.
Worker’s compensation also covers any situation in which an employee may develop a work-related illness.
This insurance provides compensation for medical bills and temporary compensation for lost wages.
Worker’s compensation insurance coverage in Texas by Private employers, must be decided upon and the private employer must notify employees about whether they have coverage or not.
Worker’s compensation insurance coverage is not required by employers.
Worker’s comp benefits are always granted, no matter who cause the accident, unless the worker is responsible for causing the injury in a deliberate or reckless manner.
For example, work-related injuries that are not covered by worker’s comp include:
- If the injury arises from the employee’s own horseplay.
- An individual that is acting recklessly in the workplace is endangering themselves and possibly others.
- This means that any injuries that have happened, it is the employee’s fault because of their carelessness.
- Injuries have been the result of an employee intoxicated.
- An employee at work who is under the influence of drugs or alcohol has the chance of being injured.
- In the case that the worker wasn’t intoxicated, the injuries may not have happened.
- The worker’s negligence is the worker’s fault.
- The injuries are a result from the worker’s willful criminal actions.
- If the employee is injured because of their own willful criminal actions, they will not be eligible for worker’s compensation benefits.
- Injuries are due to the worker having voluntary participation in off-duty recreational activities. Even if the activities are in the workplace, if the injuries are a result from a recreational activity, the injuries are not eligible for worker’s compensation, because these activities were not related to work.
- 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. When an employee has had to miss seven or more days of work, due to a work-related injury, Temporary income benefits are paid. 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. If an injured employee has a high impairment rating and other types of qualification criteria, they may be able to receive supplemental income benefits.
- Lifetime Income Benefits. In some cases, an injury could be so serious that the injured worker could be eligible for lifetime income benefits.
- Death Benefits. In extreme cases, where the injured employee has passed away as a result of the injury or ailment, the employee’s family may be able to receive death benefits.
- Burial Benefits. If an individual pays the burial expenses of an injured employee who passed away due to their work-related injury, burial benefits may be available.
Can I Choose My Own Doctor?
As long as the doctor is chosen through the Texas Division of Worker’s Compensation as a licensed worker’s comp medical professional, the injured worker can choose their own doctor.
The injured worker’s employer will usually provide the injured worker with a list of designated doctors.
In the case that the employer is not able to supply this list, the injured employee can look for any worker’s compensation designated doctor to give them the proper medical treatment they need for their work-related injury or ailment.
If I Need Help With My Worker’s Compensation Claim, Where Can I Turn?
An injured worker has three main choices when they need help with the Texas worker’s compensation system.
Injured employees can contact an experienced worker’s compensation attorney, they may consult the Texas Department of Insurance Division of Worker’s Compensation staff member, or they can seek assistance from the Office of Injured Employee Counsel if the injured employee doesn’t already have a worker’s compensation lawyer.
Each option is just as helpful in giving the worker:
- A graspable understanding of the worker’s compensation framework
- Direction on how to navigate and use 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
- Assistance on how to handle when an injured employee’s claim is denied.
Is Worker’s Compensation Claim Information Kept Confidential?
100% confidential, an injured worker’s workers’ compensation claim info is only available to those who are handling the claim.
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.
Future employers are able to look up in background checks whether a potential hire has reported any work-related injuries 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?
Injured employees can look for compensation from multiple other sources in certain cases when they are injured or have become ill due to them performing their job functions.
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.
A third person liability lawsuit is where an injured employee can recover lost wages for an injury or ailment, if the damages are beyond compensation, in situations like mental anguish, pain and suffering, etc.
Is My Boss Allowed to Treat Me Differently, Discriminate Against Me, or Fire Me?
As a general rule, a boss should not treat a worker any differently after the injured worker has filed for worker’s compensation; though, if this occurs, there are legal provisions in place that prevent employers from such discrimination.
A wrongful termination lawsuit could be called for if an employer terminates an injured worker because they had filed a worker’s compensation claim.
However, since Texas is an at will employment state, and employers may fire their employees for any reason, except for a reason that is protected by the law.
Though an employer can fire an individual because the workplace is slow, or if the injured worker cannot perform their work duties because of the work-related injuries.
In Texas, bosses must legitimize their reason behind terminating an injured worker.