Bedford Workers' Compensation Lawyers

What Is Workers' Compensation?

Workers’ compensation is an insurance that benefits qualified workers who sustain injuries or incur illnesses on the job. This includes workers who are exposed to toxic substances in the workplace. Workers’ comp does not require the injured worker to prove that the employer’s negligence caused the injury or illness. Instead, the injured worker must establish only that the injury or illness was work-related.

Workers’ comp is often called a ‘grand bargain,’ a compromise between management and workers. Workers’ compensation laws benefit workers by guaranteeing compensation within a short time period, but they also limit the amount an employer must pay out to an injured worker.

Texas Workers' Compensation Law

Texas law does not require an employer to participate in the state’s workers’ compensation program. According to the Texas Labor Code § 406.002, private employers can decide whether or not to provide workers’ compensation insurance coverage for their employees. According to statistics, nearly 75% of companies in Texas subscribe to the program, and roughly 80% of Texas workers are employed by subscribing companies.

If an employer chooses not to subscribe to the Texas workers’ compensation program, then they must submit an Employer Notice of No Coverage or Termination of Coverage. Furthermore, the employer must inform its employees of their non-subscription.

If a worker experiences a work-related injury and their employer does not participate in the Texas workers’ compensation program, the employer must cover the costs of the worker’s injuries. If the amount paid by the employer is insufficient, then the injured worker can file a civil suit to seek compensation for damages.

Who Pays for Workers' Compensation Benefits?

Employers subscribing to the Texas workers’ compensation program cover potential injury costs through a workers’ compensation insurance policy. When an employee brings a successful compensation claim, the insurance company covers the costs. However, if the employer does not subscribe to the compensation program, then any damages for a worker’s injuries must be directly paid by the employer.

Who Is Eligible for Workers' Compensation?

The worker seeking compensation must be an employee. In most cases, independent contractors are excluded from compensation coverage.
The employer must subscribe to the Texas workers' compensation program.
The injured worker must fulfill the reporting requirements and file the claim within the stipulated time.

What Benefits Are Available Through a Workers' Compensation Claim?

A compensation claim under Texas workers’ compensation law offers potential benefits to workers experiencing a work-related injury or illness.

Medical expenses resulting from the injury or illness— The workers’ compensation program in Texas covers medical expenses arising from work-related injuries or illnesses. However, you may be required to undergo a medical examination conducted by a doctor chosen by your employer or the workers’ compensation insurance company. If not, you can seek treatment by a doctor of your own choice, provided the Texas Workers’ Compensation Commission deems the doctor qualified.
Rehabilitation expenses— The compensation amount encompasses rehabilitation expenses, such as physical therapy and occupational therapy.
Replacement income— You become eligible for compensation for your lost wages only after seven days of the injury or illness. The income compensation is calculated using the average weekly income for 13 weeks before the injury or illness. Typically, 70% of the income is replaced. However, if you earn less than $10 per hour, then 75% of the lost income can be compensated. It’s important to note that compensation for lost wages is exempt from income tax.
Costs for retraining— In some cases, injuries or illness might make you ineligible for your previous job. You can pursue training or education for a different job in such cases. The compensation covers costs relating to such training or education.
Compensation for any permanent injuries— If you sustain permanent injuries, you may be eligible for lifetime benefits, which include 75% of your weekly wages plus a 3% annual cost-of-living increase. Examples of permanent injuries covered by the compensation program include:
- Traumatic brain injury (TBI) resulting in any form of mental impairment
- Paralysis of one or more limbs
- Loss of an arm, foot, hand, or leg
- Complete vision loss
- Third-degree burns covering more than 40% of the body
Benefits to survivors of workers who die on the job— In cases of a worker’s death, the survivors of the deceased (spouses, dependent children, grandchildren, parents, and grandparents) can claim 104 weeks of benefits. These benefits are calculated at 75% of the deceased worker’s average weekly income, with a current cap of $895 per week.
Funeral expenses— Under Texas law, the insurance company must pay the actual funeral expenses of an employee who dies on the job, or $6,000, whichever is lower.

If you’ve suffered an injury or illness at the workplace, seek legal assistance from experienced attorneys at Bailey & Galyen.

How Long Do I Have to File a Workers' Compensation Lawsuit in Bedford?

The statute of limitations provides the maximum time period during which a workers’ compensation lawsuit must be filed. In Texas, a lawsuit can be filed within one year of the accident or injury, or from the day when the injured worker should have reasonably known about their injury or illness. It is important to notify your employer of the claim within 30 days of discovering the illness or injury. A Bedford workers’ compensation lawyer will ensure that your application is filed timely and accurately.

How to File a Workers' Compensation Claim

Seek medical attention for your injuries— If you are injured in a work-related accident or have contracted a work-related illness, prioritize seeking medical treatment at a worksite medical clinic, a hospital emergency room, an urgent care facility, or a physician of your choice. Delaying medical treatment can weaken your claim, as your employer or the workers' compensation insurance company can argue that your injuries were not serious.
Notify your employer— As soon as possible, inform your employer about your injury or illness. A notice of the injury must be sent to the employer within 30 days of the accident or discovery of the injury or illness.
Gather evidence— In addition to medical reports, collect evidence such as witness contact information, images of the accident location, and other forms of physical and documentary evidence.
Consult a Bedford workers' compensation lawyer— Consult an experienced attorney who can assist you in navigating the workers' compensation process. Your attorney will also help you collect evidence, maintain records, and file a workers' compensation claim. Furthermore, they can communicate with your employer and the insurance company on your behalf.
Complete the claim form— Fill out the DWC-041 form to initiate a compensation claim, detailing the nature of the injury or illness, your employment, identity particulars, and other information.
Submit the claim form— Submit the DWC-041 to the Texas Department of Insurance, Department of Workers' Compensation (DWC), within one year.

Once you submit the compensation claim form, the workers’ compensation insurance company will conduct an investigation. The investigators may visit the accident site, interview the witnesses and coworkers, and collect other evidence.

In Texas, the workers’ compensation insurer has a 15-day window from the date you file the claim to either start paying the benefits or notify you of the claim denial. If they deny the claim, the insurer must provide the reasons for the denial.

If your Bedford workers’ comp claim is denied, you have certain rights to appeal the decision. Below are the steps that you need to follow:

Step 1— You can file DWC-045 to request a benefit review conference. An informal meeting is arranged with the Department of Workers' Compensation. During this meeting, a benefit review officer will mediate between the parties in the hopes of reaching a settlement. If it is successful, you will sign an agreement and start receiving benefits.
Step 2— If no agreement is reached, then you have two options—arbitration or a contested case hearing (CCH). In arbitration, DWC appoints an arbitrator who will hear witness testimony and consider other evidence before making a decision. The decision of the arbitrator is final and binding on both parties. There is no right of appeal and your case ends here. In a CCH, a DWC officer conducts a hearing in a manner similar to a civil suit. Both parties make opening and closing statements, submit physical evidence, and present witness testimony. After the proceedings, the hearing officer issues a decision. In a CCH, both parties have a right to file an appeal against the decision.
Step 3— If you are not satisfied with the decision of the DWC hearing officer, then you can file a review application with the DWC Appeals Board within 15 days from the date of the CCH decision. The application is then forwarded to the insurance company, which has 15 days to submit a reply. The DWC Appeals Board will not hold a hearing. Instead, it will pronounce its decisions based on the submissions of both parties.
Step 4— If the Appeals Board refuses your claim, your only option is to file a civil lawsuit.

How Much Does Workers' Compensation Cost in Bedford?

Most workers’ compensation lawyers in Bedford work on a contingency basis. They charge a percentage of whatever benefits you recover as fees for their services. In addition, the contingency contract may specify that the client is responsible for covering certain out-of-pocket expenses, including filing costs, copying expenses, and fees associated with expert witnesses and depositions. So, it’s important to carefully review and pay close attention to the details of your contingency agreement with your attorney.

How Can a Workers' Compensation Lawyer Help With Your Case?

Navigating the workers’ compensation system can be complex and daunting, even for seemingly straightforward claims. A workers’ compensation lawyer in Bedford can prove to be of great assistance in many ways:

An experienced Bedford workers' compensation attorney will secure your rights by gathering evidence and maintaining proper records.
They will act as an intermediary in communications between you and your employer or the insurance company.
They will assist in assessing damages and compensation.
They will proactively address any challenges from your employer or the insurance company.
An attorney will help you prove that the injuries occurred due to work-related activities.
An adept attorney will ensure that all deadlines are met, all necessary documents are filed accurately and on time, and the evidence supporting your claim is compelling.
Your attorney will collaborate with your doctors, employer, and insurance company to prevent a premature return to work and risk of further injury.

Injuries Covered by Workers' Compensation Benefits

The following injuries are covered under the workers' compensation scheme:

Repetitive stress injuries— In many cases, jobs require workers to perform repetitive tasks that stress joints and lead to injuries in tendons, ligaments, and muscles. Carpal tunnel syndrome is one type of repetitive stress injury.
Bone and back fractures— Workplace accidents can cause fractures in one or more bones, or they can result in bulging and dislocated discs in your back.
Traumatic brain injury or skull fracture— Sudden impact to the head can cause a skull fracture or brain movement within the skull, resulting in an open or closed traumatic brian injury.
Sprains and strains— Injuries to hands, legs, knees, shoulders, and back from strain and sprains are covered under workers' compensation.
Soft tissue injury— A workplace accident can cause cuts and bruises.
Nerve injury— Injuries to nerve tracts can result in permanent disfigurement or disability. Such injuries typically occur when employees work with heavy machinery.

Summary

In Bedford, employees injured due to workplace activity have a legal right to claim compensation for their injuries or illnesses. If your employer subscribes to the Texas workers’ compensation program, you can receive benefits when you’re injured at work by filing a workers’ compensation claim within the stipulated time frame.

If your employer does not subscribe to the state insurance scheme, your employer should cover the costs of your injuries directly, and you can file a civil lawsuit to recover damages, if necessary. The experienced Bedford workers’ compensation lawyers at Bailey & Galyen can assist you, and are ready to help you secure the benefits you need if you’ve been injured or have sustained an illness due to exposure to toxic substances at a workplace in Bedford, Texas.

Bedford Workers’ Compensation Lawyers

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