Houston Workplace Accident Lawyer
A workplace injury can turn your life upside down, but understanding your rights is the first step toward recovery.
If you’re searching for a trusted Houston Workers’ Compensation Lawyer, knowing how the system works can help you secure the benefits you deserve after an on-the-job injury. Don’t navigate this process alone. Schedule your consultation today by visiting our
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When you are injured on the job in Texas, you may be entitled to workers’ compensation benefits regardless of who was at fault. Understanding your options is critical to protecting your health, income, and future.
Here are answers to the most common questions about how Texas workers’ compensation works, what benefits you can receive, and what to do if your claim is denied.
What Is the Difference Between Workers’ Comp and a Personal Injury Lawsuit?
There are many substantive differences between a workers’ compensation claim and a personal injury lawsuit:
- Where it is filed: A workers’ compensation claim is filed with the insurance company. A personal injury lawsuit is filed directly in court. The best outcome is that your workers’ comp claim never enters the formal legal system at all.
- How fault works: To win a personal injury lawsuit, you must prove someone else was negligent. Workers’ compensation is a no-fault system, meaning you can receive benefits simply by proving your injury was job-related.
- Who you can sue: You can only sue your employer directly if they do not carry workers’ compensation coverage. If they do, your remedy is limited to the workers’ comp system, though you may still be able to sue a negligent third party whose actions contributed to your injury.
- How much you can recover: A personal injury lawsuit may lead to more compensation because you can be paid for a broader range of damages.
How Do Workers’ Compensation Benefits Work?
Workers’ compensation benefits cover some of the economic losses that you have suffered due to a job-related injury. If your claim is granted, you will be paid for the following:
- Two-thirds of your lost wages that you would have earned from your job, up to the amount of a statutory limit
- Reasonable and necessary medical expenses to treat your injury that include, among other things, doctor’s care, prescriptions, rehabilitation, and medical expenses
- Impairment income benefits, if you have been permanently disabled
- Supplemental income benefits if you have a serious permanent impairment and cannot return to your previous level of earnings
- Lifetime income benefits if you have sustained a severe and catastrophic injury
- Death benefits, if your loved one died due to their injury
- Burial costs
You will not be able to receive non-economic damages associated with your injury, such as pain and suffering and emotional distress. You can only be paid for these damages in a personal injury lawsuit. Workplace injury attorneys will always review your case to verify whether there is a third party whom you may be able to sue (such as an equipment manufacturer, property owner, or negligent contractor).
Are Workers’ Compensation Benefits Limited to Just Physical Injuries?
You can receive workers’ compensation benefits when you can prove that any injury was job-related. Beyond physical injuries, covered conditions may also include:
- Occupational illnesses, such as lung disease from chemical exposure or hearing loss from prolonged noise
- Repetitive stress injuries, such as carpal tunnel syndrome from repeated motions over time
- Mental health conditions that stem from a specific work incident, such as PTSD after witnessing a serious accident
Although you may be facing a difficult claim because insurance companies are even more stringent when they do not see so-called objective test results, you are still eligible for workers’ compensation benefits. Note that general job stress or burnout does not qualify for workers’ compensation coverage.
Is there a Downside to Receiving Workers’ Compensation Benefits?
One of the major downsides of receiving workers’ compensation benefits is that they are not guaranteed to continue for as long as you may need them. You may reach the point of maximum medical improvement for your injury. Then, you may be asked to attend an independent medical examination (IME).
The results of the IME may lead to you being ordered to return to work, even if it is only on light duty. You may be forced to fight to show that you are still unable to work. Otherwise, you must return to work or risk losing your workers’ compensation benefits.
What are the Deadlines for Reporting My Injury and Filing a Claim?
In Texas, injured workers are required to report a workplace injury to their employer as soon as possible, and no later than 30 days from the date of the injury, under Texas Labor Code § 409.001. Failing to report within this window can jeopardize your ability to file a workers’ compensation claim.
Under Texas Labor Code § 409.003, injured workers must file a claim with the Division of Workers’ Compensation within one year of the date of injury, or risk losing their right to benefits entirely.
Can My Workers’ Compensation Benefits Be Denied?
Yes, your claim could very well be denied. Workers’ compensation is reviewed by an insurance company that is legally obligated to pay benefits if you meet the criteria. These are for-profit businesses, and they are always considering their own bottom line in their actions. Your workers’ compensation claim may be denied for the following reasons:
- Timeliness requirements for reporting the injury were not met
- The injury did not happen at work
- You were suffering from a pre-existing condition
- There was insufficient medical evidence of your injury
- The insurance company alleges that you were intoxicated or were engaging in horseplay
What Do I Do If My Workers’ Compensation Claim Has Been Denied?
Since the insurance company does not get the final say, you can and should file an appeal. First, you should request a benefits review conference, which is an informal meeting between you, the insurance company, and a benefits review officer from the Division of Workers’ Compensation. This meeting serves as a mediation, and it may result in you receiving benefits if you bring sufficient evidence.
If the conference is unsuccessful, you can file a request for a contested case hearing in front of an administrative law judge. They have the authority to overturn the denial of your claim. If you are still unsuccessful, you can take your case to state court. You may reach a settlement with the insurance company at some point before your case is decided.
Contact Our Houston Workplace Accident Lawyers
If you have been injured on the job, you deserve to have a legal team that treats your case with the urgency and attention it warrants. Our trusted Houston workplace accident lawyers at The Buzbee Law Firm take cases across the state of Texas. We can help you file a workers’ compensation claim or a lawsuit against a responsible third party. We are proud of our track record of getting results for our clients, and we are unafraid of powerful entities.
Schedule a free initial consultation to discuss your case by visiting us online or by calling us today at (713) 223-5393.