Navigating the Maze of Workers’ Compensation: FAQs

Workers’ compensation is an insurance program that provides financial assistance and medical benefits to employees who sustain injuries or illnesses related to their job duties. It is governed by a state law called the Texas Workers’ Compensation Act, and the process is overseen by the Texas Department of Insurance, Division of Workers’ Compensation (TDI-DWC). Through a workers’ compensation claim, a person who was hurt on the clock can seek benefits for medical expenses and wage replacement. Permanent disability benefits may also be available for more serious injuries.

You are not required to prove that your employer was “at fault” in order to bring a successful workers’ compensation claim in Texas. Indeed, "no-fault" means that workers’ compensation benefits are provided regardless of who is at fault for the injury or illness. Whether the injury was caused by the employee, employer, coworker, or a combination of factors, the injured employee is still eligible to receive benefits. In effect, this simplifies the claims process and ensures that the injured workers receive timely assistance. You merely need to establish that your injury/illness occurred within the “course and scope” of your employment.

Yes. In Texas, you are required to notify your employer of a work-related injury or illness as soon as possible. Indeed, it is imperative that you notify your employer of a workplace injury or illness in a timely manner. The notice must typically be given within 30 days of the injury. To be clear, failing to report in a timely manner could result in a denial of benefits. If you have any questions about reporting your accident, an experienced Texas workers’ comp lawyer can help.

Notifying your employer of a workplace incident is not the same thing as filing for workers’ compensation benefits. In Texas, you generally have one year from the date of injury or diagnosis of a work-related illness to file a claim for workers’ compensation benefits. The statute of limitations for a workers’ compensation claim is an important legal deadline to be aware of. Indeed, missing this deadline can result in losing the right to claim benefits. Our firm helps workers in Harris County, Fort Bend County, and across the region pursue workers’ comp benefits in a timely manner.

Workers' compensation benefits in Texas are designed to support employees who have been injured or fallen ill due to their job duties. The types of benefits available cover a broad range of needs to ensure that workers. Some of the benefits include:

• Medical Benefits: Covers all necessary medical treatments, surgeries, medications, and therapies related to work-related injury or illness.
• Income Benefits: Compensation for lost wages during recovery. For the most part, income replacement is two-thirds of a worker’s average weekly wage, subject to state minimum and maximum benefits.
• Vocational Rehabilitation: Assistance with retraining or job placement if the worker cannot return to their previous role.
• Death and Burial Benefits: Financial support for dependents and coverage of burial expenses if a worker dies due to a work-related injury or illness.

Yes. Unfortunately, some injured workers struggle to secure the full and fair workers’ comp benefits that they are due under the law. If your claim was denied, you have the right to file an appeal to seek workers’ compensation benefits. There is a specific process in place for workers’ comp appeals. Do not wait to get started with your appeal. Consult our Houston, TX, workers’ comp appeal attorney right away after receiving a denial letter.

No. Unlike most states, Texas does not require private employers to provide workers’ compensation insurance. In this way, our state has a unique workers’ compensation insurance system. By law, an employer in Southeast Texas chooses to become "non-subscribers" to the system. Of course, non-subscribers lose certain legal protection. If you were injured while working for a non-subscriber employer and your employer’s negligence contributed to your accident, you have the right to file a personal injury lawsuit against them.

If an employer opts out of the workers' compensation system, they are considered a non-subscriber. Employees injured while working for a non-subscriber must follow different rules to seek compensation. They may need to prove that the employer's negligence contributed to the injury and could pursue a personal injury lawsuit. Non-subscribers often provide alternative benefit plans, but the protections and benefits are usually less comprehensive than under the workers’ compensation system. If you have any specific questions or concerns about a non-subscriber work injury claim, please do not hesitate to contact our Houston attorney today.