In Texas, workers who suffer injuries on the job may be eligible for workers’ compensation benefits. Workers’ compensation is a state-run program that provides employees with income replacement and medical benefits for injuries that occur on the job. Additionally, workers who are killed in work-related injuries are also eligible for death and burial benefits. Employers are generally required to notify employees whether or not the employee will be covered under a workers’ compensation insurance program.What Are Third Party Claims?
You may have a third party work injury claim if your injury was caused by a person or company who is not your employer or a fellow employee. While workers’ compensation covers your expenses for an employer-caused injury, it keeps you from being able to file a lawsuit and seek a potentially greater recovery from the person or company who injured you.
Even if your employer says there is workers’ comp coverage, you may have a third party claim. Speak with an experienced workers’ comp/job injury attorney to make sure you receive the proper recovery you are entitled to.Workers Compensation Wage Replacement
Under the Texas workers’ compensation program, eligible employees who are injured on the job may receive temporary income benefits (TIBS) if the employee has a disability and his or her medical condition has not improved sufficiently to allow him or her to work.
The claimant (the injured worker requesting compensation) may be eligible for lost wage compensation amounting to his average weekly wage before injury (AWW) minus his Post-Injury Earnings (PIE). But, if the PIE amount is equal or greater than his AWW, then he will not be eligible for temporary income benefits.
To demonstrate that the employee/claimant should be eligible for TIBS, he must show that, due to a compensable injury, he or she has been unable to obtain and retain employment equal to his or her pre-injury employment level. A physician must document that this has occurred using what is called a Work Status Report.What is a Return to Work Program?
Return to Work programs are programs that are set up by employers to help injured workers go back to work more quickly while they heal. These Return to Work programs often involve a light duty work schedule or an alternate work assignment that allows the injured worker to work earlier than otherwise.Insurance Claim Issues
If you have problems with an insurance adjuster, it is important to keep the lines of communication open and to discuss your concerns frankly with the insurance company. Often, doing so will clear up any confusion. However, if that is insufficient, it may be worthwhile to contact an attorney to assist in dispute resolution. An attorney may be able to help ensure that you obtain the appropriate compensation for workplace injuries.
Insurers have a duty to act in good faith in reviewing claims as well as in the payment of compensation benefits. Reviewing employee workers’ compensation claims in bad faith or in an inappropriately long or unprofessional manner may be a violation of the law. Also, insurers must be as efficient as reasonably possible in distributing compensation funds to claimants. Insurers must engage in fair, consistent, and legally sounds claims processing or risk legal liability.Workers’ Compensation Discrimination
It is improper and illegal for an employer to treat an injured employee in a discriminatory fashion. When an employer fires an injured worker for filing a claim, it is called retaliatory termination and it is illegal. Employees who believe that they face discrimination as a result of filing a workers’ comp claim may have legal recourse.
It is against Texas state law for an employer to discriminate against an employee for:
- filing a workers’ compensation claim ;
- hiring a lawyer to represent the injured employee in the course of administering the claim;
- instituting a good faith workers’ compensation proceeding; or
- testifying (or preparing to testify) in a workers’ compensation proceeding.
Under the law, an employee “institutes” a workers’ compensation proceeding when he or she merely notifies an employer of a compensable injury. An employee must show a causal link between the protected activity (one of the four activities above) and termination following the protected activity in order to show retaliatory discharge under Texas law. Often, if a terminated employee can show that the employer showed a negative attitude or treated the employee differently, or outside of the normal workplace policies, then the employee may be able to show that the termination was in retaliation for engaging in a workers’ compensation claim.
If an employee can show that he or she suffered a retaliatory discharge, then the employee may be entitled to lost wages and benefits as well as compensatory damages for pain and suffering or inconvenience. Additionally, if the employer acted with malice, the employee may be eligible for punitive damages. Punitive damages are designed to punish companies who purposefully act illegally to the detriment of the injured worker. To determine punitive damages, a court will weigh four factors in setting appropriate punitive damage awards:
- The reprehensibility (or how bad the activity was) of the defendant’s conduct;
- the disparity between the actual and proposed punitive damages;
- compare the proposed punitive damages to other potential charges for similar offenses;
- the extent to which the defendant’s conduct is offensive to the public at large.
Using these factors, Texas courts are willing to award significant punitive damage sums to workers if the facts of a case deem them appropriate.Texas Workers Compensation Information
- Workers Compensation Overview
- How to File a Claim
- Third Party Work Injury Claims
- What If My Employer Doesn’t Have Workers’ Comp?
- Retaliatory Termination