What Is the Texas Workers' Compensation Act?

If you or someone you know has gotten hurt on the job in Texas, the Texas Workers' Compensation Act provides legal avenues to seek compensation for those injuries. This legislation aims to protect both the employer and their workers before, during, and after the claims process. It also manages how an employee and the employer's insurer conduct the claims process. 

Unfortunately, Texas doesn't make it mandatory for companies with employees to provide workers' compensation insurance coverage. This reality often makes an already tragic situation even more devastating for the injured worker and their family.

Workers' Compensation Law Vs. Non-Subscriber Law

Depending on whether your employer has workers' comp coverage, one of two areas of law will apply to your injury claim: workers' compensation law or non-subscriber law. Each of these legal categories come with their own set of rules and criteria that can directly impact your right to pursue compensation after getting hurt on the job. 

Before determining which applies to you, finding out whether or not your company provides workers' comp insurance is crucial. This can be done in one of three ways, usually:

  • Ask your employer; they are legally required to give you this information
  • Check the state's online subscriber database
  • Contact a skilled workmans' comp attorney to investigate

If coverage is in place, there are some crucial details to know before filing your claim. The first being that the Texas Workers' Compensation Act benefits your employer. By going through their insurance, you won't be able to sue them civilly. In addition, their insurer could cover all of your necessary medical care costs from your work-related injury or illness. This benefit should also include lost income and possibly burial costs, if applicable. 

This legislation also benefits hurt or sickened employees as well by minimizing the chance they receive nothing at all for their damages. There have been countless cases where unsubscribed employers don't pay a dime in compensation because they simply didn't have the finances to afford it. This is why unsubscriber law allows injured employees to sue their employers for damages if negligence is a factor and in cases of third-party fault.

When it comes to lost wages, there are limitations under state law you should remember. Often, the amount of time you can receive workers' comp benefits is limited by the severity of your injuries and any impairment ratings your doctor gives you. In addition, state law has also put caps on the income amount you can receive.

As you can see, the Texas Workers' Compensation Act intends to ensure injured employees can recover damages for injuries sustained on the job. Unfortunately, this is harder to enforce. It's a well-known fact that companies will go out of their way to cut corners and avoid increased premiums because of workplace injuries and occupational illnesses. 

This means they resort to all sorts of manipulative tactics that are bad faith in nature and often illegal. Because the act allows them to choose a network of physicians they want you to see for care, they will select providers sympathetic to their own interests and not yours. When faced with these challenges in obtaining workers' comp in Texas, many opt to hire personal counsel to represent their best interests and fight for the maximum compensation possible under the law. 

Steps to File a Workers' Comp Claim in Texas

If you've determined your employer has workers' compensation insurance, you may be wondering how you go about filing a claim for your injuries. The Texas Workers' Compensation Act outlines these steps, as well as the statute of limitations for each. 

When initially hurt, you are legally required to report your injury to your company within 30 days of it happening. However, conditions like carpal tunnel syndrome or exposure to dangerous chemicals can delay symptoms. So the Texas Division of Workers' Compensation starts the clock running from when you found out or should have known about your injuries. 

There are several pieces of information you must include in this notice:

  • The date of the injury
  • That it occurred at work
  • The circumstances causing the harm
  • What parts of your body sustained injury

While you can submit this verbally or written, it's best to put it in writing to prove you did give notice in the required time frame. Once you've taken this step, you will need to file a DWC-041 (Employee's Claim for Compensation for a Work-Related Injury or Occupational Disease). This document needs to be completely filled out and filed with the TDWC branch in your area. While you can submit it online or by mail, doing so in person allows you to get a time-stamped copy for your own records. You also only have a year to submit this form or risk losing your right to workers' comp benefits. 

Texas Third Party Work Injury Claims

While this isn't always the case, there are occasions where you may need to file a claim against a third party in addition to a workmans' comp claim against your employer. Remember, your employer's insurance only protects them from you suing them for negligence, not outside entities that contributed to your injuries. So, for example, if a defective machine mangled your hand at your job, you may have grounds to pursue a personal injury case against the manufacturer.

Typically, these types of suits cover more than workers' compensation, including:

  • Past and future medical costs
  • Pain and suffering
  • Transportation costs to your medical treatments
  • Lost wages
  • Diminished work capacity
  • Loss of consortium
  • Disfigurement (burns, amputations, scarring)
  • Wrongful death
  • Burial costs

It's also possible another company's employee may have hurt you while you were working. This would mean using that worker's employer for your damages. As you can see, while workers' comp claims and personal injury suits are very different legal actions, they can easily be intertwined. Make sure to speak with a highly-trained attorney that has demonstrated practice in both these areas of law.

Work Injury Personal Injury Suits and Texas Modified Comparative Fault

If your employer doesn't carry workers' comp insurance or a third party contributed to your accident, your attorney will likely recommend filing a personal injury suit if negligence was involved. These case types require you to prove several things:

  • The liable party had a duty of care
  • They breached this duty
  • This breach caused your injuries 
  • These injuries caused you damages

Texas uses modified comparative fault when determining if compensation is paid for a work injury resulting from negligence. This means that all parties are held responsible for the part they played in the circumstances leading to the injuries you are demanding compensation for. State law currently imposes a threshold that will determine if the plaintiff can recover any monetary awards or not. If you have more than 50% liability for the injuries or illness you sustained while at work, your case will be permanently dismissed by the court. If you hold 50% or less liability, your award will be reduced by the amount you're responsible for.  

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