In Texas, if an employer subscribes to workers’ compensation insurance, the employee can file a claim with the Texas Department of Insurance (“TDI”) Division of Workers Compensation (“DWC”) for any injury sustained while on the job. The employee has 30 days to report his injury to his employer and one year to report the injury to TDI-DWC. If an employee does not report his injury during this time, he may waive his rights to benefits under the workers’ compensation system.
Typical issues that affect an injured worker are:
Treatment. The company doctor is typically only interested in minimizing the employee’s actual injury and getting the employee back to work prior to the employee being medically recovered. You have a right to pick a doctor in network that works for you and is focused on your treatment. Do not settle for a doctor that is the employer’s puppet!
Extent of Injury. The employer and insurance company will always try to lower their exposure and with some company doctors in their pockets it is easy for them to dispute coverage to an injured body part. The employer may argue that a certain body part was not hurt as a result of the injury or say that your injury is limited to a “sprain” and not a “tear.” Fight the extent of injury determination!
Termination. The employer may prefer to fire its employee rather than report the claim to TDI-DWC and its workers’ compensation carrier. For example, an employer may convince its employee to file the injury under its health insurance, and after 30 days have passed, fire the employee. The employer may then deny knowledge of the injury occurring at work and claim the employee has waived his/her benefits because s/he waited more than 30 days to report it. Do not fall for this trap!
Temporary Income Benefits. If your employer can’t accommodate you with light duty or fires you while you are still recovering from your injury, then you are entitled to monetary benefits equaling 70% of your average weekly wage. The insurance company typically miscalculates your average weekly wage by including weeks when you were on vacation or weeks early in your employment which are not typical of how much you worked. Do not get short changed on your weekly check!
Impairment Rating. Once you have reached your maximum medical improvement (“MMI”), you will receive an impairment rating by a designated doctor. It is no surprise that some designated doctors are insurance company puppets. The impairment rating determines how much money you will receive as a “settlement” for your workers’ compensation claim. For example, a 1% impairment rating provides you with three weeks of temporary income benefits. If you believe your impairment rating is unfair, you must dispute it within 90 days. Do not settle for a low impairment rating!
Sosa-Morris Neuman Attorneys at Law can assist you in:
changing your doctor,
fighting a termination,
fighting a denied workers’ compensation claim,
getting you your weekly check at the amount you deserve,
fighting to get you treatment for all body parts injured, and
fighting to get you a fair impairment rating.
If an employer terminated you for filing a workers’ compensation claim, you can bring a workers’ compensation retaliation claim. Contact us today for a free consultation regarding your rights.
Also, an employer can opt out of the workers’ compensation system. These are known as “non-subscriber claims.” If your employer is a non-subscriber, you can file a claim in court and do not need to go through the TDI-DWC administrative process. Contact us to find out if your employer is a non-subscriber.
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