A work-related injury is any injury that occurs in the course and scope of employment. The easy way to describe it is if you are doing something in the furtherance of the affairs of your employer's business, then you're engaged in the course and scope of employment.
Workers' comp in Texas lasts the entire lifetime for the claimant when it pertains to the medical care that the claimant receives. In other words, for your entire life the workers' compensation insurance company is supposed to pay for all your medical pay that you need for your injury.
Sometimes in certain situations, when you're driving to and from work, if you're involved in a car wreck, that is a workers' compensation claim. For instance, people who have places of business that are frequently changing, the common example is a plumber or an air conditioner repair man, those types of things.
Often times, someone gets injured on the job and they're forced to do a urinalysis or a blood test and it tests positive for some type of an illegal substance. When that happens, their claim is denied. So the question arises, what do I do now?
Texas is one of the few states where you don't have to carry workers' compensation insurance. There are employers in Texas that don't have workers' compensation insurance. it gets confusing because the employer may carry insurance and they may tell their employees that it's workers' compensation insurance but it's what we call an occupational benefit fund.
Unfortunately in Texas, if your employer carries workers compensation insurance, your only rights of recovery are through workers comp. That means that you can’t sue your employer for causing your workers' compensation injury. There are certain times when maybe you can’t sue your employer for causing your workers' compensation injury, but if someone else somehow did something wrong that caused your injury, you may have a claim against that third party.
If you feel threatened by your company because you want to follow workers' compensation claim, don’t feel threatened. In Texas, it is illegal for a company to retaliate both against an individual who gets hurt on the job, as well as to retaliate against any other person who assists someone who’s been hurt on the job.
I get asked all the time, "Can I just take a settlement and just be done with this workers' comp insurance company?" In Texas, you can't do that. In Texas, when your employer carries workers compensation insurance, that protects them such that your only rights are through the workers' compensation system.
Most workers' comp cases are resolved relatively quickly, in the sense that when you get injured on the job, the claim immediately starts getting processed. So for instance, if you've ever been injured in a car wreck and had a car wreck claim, what happens is you don't even start dealing with insurance, you don't even start dealing with processing that claim until the very end, until you've finished your doctor's treatment and your claim is over.
In Texas, attorneys can take a specialized exam called a board certification exam. And a board-certified attorney is an attorney who's achieved a special level of competency by handling a certain number of cases. You've got to show a board down in Austin that you completed or successfully handled a certain number of cases.
When you get injured on the job and your employer carries workers' comp, your workers' compensation attorney is paid based upon the amount of time that a case takes. So if it's a complicated case, if it's a case that's going to take a lot of time in order to process and get taken care of, then that attorney is keeping track of their time, and they submit their time to workers' comp.
When you get injured on the job, you've only got 30 days to let your employer know that you got injured on the job. So it's very, very important when you get injured you let somebody know immediately. Most kinds of personal injury cases in Texas, you've got two years in order to do something about your personal injury. On workers' comp, you only get 30 days. After you let your employer know within the 30 days, you're limited to only one year to let the insurance company know.
When you're injured on the job, there are a number of different benefits that you're entitled to. One benefit is what we call TIBs, T-I-B-S. That stands for temporary income benefits. And what the insurance company does is they take the 13 weeks prior to your date of injury, add up how much you made in those 13 weeks, and then average that amount, and that's called your average weekly wage. And then you're paid 70 percent of your average weekly wage as long as you're off work due to your injury.
A workers' compensation trial or contested case hearing is usually a much more informal type proceeding. You go into the judge's office. It's a small office. You will go in and there will be a chair sitting right next to the judge's desk. And you just go and you sit in the chair, you swear to tell the truth, and you just tell the judge what happened. But it is what decides your case.
If your employer wants to go with you to the doctor, keep in mind that Texas is an employed-at-will state. What that means is, is you can be hired and fired at anytime by the company. And so, if you tell someone with your company that they can't go with you to your doctor visits, they do have the right to fire you.
When you get injured on the job, you need a doctor. And the problem is, is how do you find a doctor when so few doctors take workers' compensation for payment. All insurance companies are supposed to have a network of doctors that they maintain that you can go see.
When you're injured on the job, the most important thing for you to do is to report the claim. Now, most companies have a lot of peer pressure on their workers. They'll have some type of a policy that says if there's no lost time, people get bonuses and that sort of thing.
In almost every case, yes, you should hire a lawyer because the lawyer is going to have the specialized skills and the specialized training and expertise to address your case, that someone with an ombudsman doesn't have.
As the Olympics draws to a close, it is appropriate to compare the drug-testing done for Olympic athletes versus those done to Texas Workers. Many states, including Texas, have a provision that creates a rebuttable presumption of intoxication when someone tests positive for drugs or alcohol. However, a new use of drug testing is gaining in prominence in Texas Workers Compensation law that is an abuse of the workers’ compensation system. [...]
When you're injured on the job and you file a workers compensation claim, the first set of income benefits that you should receive is called Temporary Income Benefits ("TIBs'). Once you miss more than 7 days of work due to your injury, then your entitlement to TIBs will begin. They can last up to 104 weeks. [...]
Few things are worse than when you’re injured on the job and unable to continue to support your family because you’re unable to return to work. There could be many reasons for not being able to return to work, such as your employer is unwilling to accommodate your work-duty restrictions imposed by your doctor or your employer has simply terminated your employment. [...]
Is there any neutrality with your Texas Workers’ Compensation Insurance Carrier when resolving a disputed claim between you and your employer? If your employer’s insurance carrier is allowed to choose an attorney, then why wouldn’t an injured worker also want to choose an attorney?[...]
Each day, Texas residents drive to and from work, expecting to arrive safely. On many occasions, employers may provide either (1) company-owned transportation or (2) financial reimbursement for travel expenses using a private vehicle. Both situations would be in furtherance of the responsibilities of the job and are directly connected with the performance of the employment. [...]