How Does Workers’ Compensation Work in Texas?

Unlike other states, Texas does not require most employers to provide workers’ comp benefits to injured workers. However, you still have options for recovering compensation if you are injured on the job.

Worker’ Comp Process in Texas

If your employer does carry workers’ compensation insurance and you are injured on the job, the trade-off is that you cannot sue for a work injury or illness. However, by filing a workers’ compensation claim, you are entitled to benefits regardless of who was at fault. You must notify your employer of the injury or illness in writing within 30 days of the incident and see a doctor within their network. The doctor will send a medical report to your employer and their insurance provider. You must then submit a DWC Form-041, which your company should provide. Your employer’s insurer will review the claim and then decide whether to accept or reject it. If your claim is denied, you can appeal the decision, and it is in your best interests to consult a Waco work accident attorney first.

Types of Workers’ Comp Benefits Available in Texas

Medical Benefits

Payment for reasonable and necessary medical care for your work injury or illness.

Lost Wages

Partial lost wages for up to 104 weeks while you recover, but extensions may be possible. The four types of wage benefits are as follows:

• Temporary: 70% of your normal weekly wages, with the maximum amount being $970.
• Impairment: If you have fully recovered but have not regained the full range of functions necessary for work. The rate is 70% of your normal weekly wages, and the more impaired you are, the longer you will receive benefits.
• Supplemental: If impairment benefits run out, you may be able to receive supplemental income benefits for up to 401 weeks. You are eligible if you receive a permanent impairment rating of 15% or higher, or you are not able to return to work or earn 80% of pre-accident wages and are actively looking for work.
• Lifetime or Total Disability: If you suffer a severe and permanent work injury or illness, you can receive lifetime benefits equal to 75% of your normal weekly wages.

If a worker is killed in a workplace accident, their family is entitled to death benefits and compensation for funeral expenses.

What Happens if I Am Injured at Work and My Employer Does Not Have Workers’ Comp?

Employers that opt out of the workers’ compensation system are known as “nonsubscribers.” These companies may carry alternative occupational benefit plans that provide similar benefits, but it is not legally considered workers’ compensation insurance. Therefore, employees have the right to sue a Texas employer for a workplace injury or illness if their company does not carry workers’ compensation insurance. This is true, even if their employer pays for medical care and a portion of lost wages during recovery. To successfully file a claim against an employer, the following elements must be present:

• Notice: Injured or ill workers must notify their employer they were harmed on the job in writing within 30 days.
• Medical Care: See a doctor as soon as you are injured or feel ill. It will not only protect your health, but there must be a record of medical treatment to link the injury or illness to your job.
• Negligence: You must have evidence of the following:
• You were injured or became ill while performing a task within the scope of your job duties.
• Your employer failed to meet safety standards.
• Your employer’s failure to provide reasonable care led to your injury.

Texas prohibits nonsubscribers from using certain legal defenses typically available in most other personal injury lawsuits. For example, your employer cannot avoid liability for your injury or illness by claiming:

• Assumption of Risk: You knowingly exposed yourself to the possibility of injury or illness. (e.g. by taking the job)
• Contributory Negligence: You were mostly at fault for your injury or illness. Even if you were partially responsible, your employer may still have to fully compensate you for your losses.
• Co-Worker Negligence: Your injuries were not caused by the company but by a coworker.

There may be instances where a third party is partially or entirely responsible. If that is the case, a lawsuit can be filed against the third party as well or alone.