Injuries and illnesses that come about as the result of doing one’s job are unfortunately common. These may be injuries that require significant medical attention and jeopardize your ability to earn a living. If you are injured at work, it is important to take steps to protect yourself right away. Many work-related injuries and illnesses seem simple at first, but can worsen over time. In many situations, you have the right to demand financial help through a workers’ compensation insurance claim. In others, you may have to directly sue your employer for your losses.

A Houston workers’ compensation lawyer with Roberts Markland LLP could help you stand up for your rights as an employee. Our accomplished attorneys could provide guidance with pursuing workers’ compensation insurance appeals through the appropriate government agency or filing civil complaints that demand the payments that you deserve.

Possible Sources of Compensation After a Workplace Incident

Every person has the right to collect compensation that results from a workplace incident. However, in Texas, the exact means to collect these payments will differ based upon the choices that an employer has made. State law does not require any employer to retain a workers’ compensation insurance policy. This means that a worker may directly sue their bosses for the compensation necessary to make them whole after a workplace injury or illness.

Thankfully, most cases will flow through a workers’ compensation insurance policy claim. Here, the insurance company may provide benefits that include the costs of all necessary medical care, wage reimbursement for time lost while making a recovery, and payments for all permanent disabilities. A Houston attorney could take the lead in identifying the reason for a workers’ compensation claim denial and submit the necessary paperwork needed to appeal this denial at the state level.

If you confirm your employer provides workers’ compensation, it’s important to understand the different types of coverage and how it may impact your particular situation. There are four types of workers’ compensation benefits:

  • Income benefits: These benefits replace part of the wages lost due a work-related injury or illness and provide compensation for permanent impairment. There are four types of income benefits which include  temporary income, impairment income, supplemental income, and lifetime income. In order to qualify for these income benefits, your employer or the insurance company may require certain criteria to be met.
  • Medical benefits: These benefits pay for reasonable and necessary medical treatment related to the specific injury or illness. They are typically paid directly to health providers, not to the injured or ill employee. Usually, the worker must be treated by an approved doctor by the Workers’ Compensation Commission, and that doctor will serve as gatekeeper for all related medical care.
  • Death benefits: If an eligible worker is killed on the job, these are meant to provide benefits to replace a portion of the lost family income.
  • Burial benefits: If an eligible worker is killed on the job, these benefits are provided to pay some of his or her funeral expenses.

Maximum Medical Improvement

Texas workers’ compensation laws include a concept known as Maximum Medical Improvement. This is the date that is the earlier of: The time the illness or injury is healed as much as it is medically expected to, OR 104 days weeks from the date the worker became eligible for benefits. On this date, an impairment rating is determined, and the type and amount of benefits may change. Medical providers may request an extension of this date under certain limited conditions.

Resolving Workers’ Compensation Conflicts

Unfortunately, not every employee who submits an application for workers’ compensation benefits receives the full payments that they deserve. Insurance companies may deny a claim for a variety of reasons, such as the:

  • Injury did not occur while on the clock
  • Worker was engaged in horseplay in the moments leading up to an injury
  • Employee was intoxicated or impacted by drugs
  • Illness does not have a sufficient link to work duties

Regardless of the reasons for a workers’ compensation denial, every person has the right to pursue an appeal. An employee may submit a benefit review through the Department of Workers’ Compensation (DWC) under Texas Administrative Code § 141.1. This department can hold hearings to consider a claim for compensation. During these hearings, a Houston lawyer can present evidence and make legal arguments concerning an employee’s right to receive workers’ compensation. Even before a case goes to a formal hearing, the DWC will hold an informal conference as an attempt to bring the case to a settled conclusion. Our attorneys could help to represent the interests of workers during every phase of these cases.

What to Discuss with An Attorney

Selecting a workers’ comp attorney is an important step to insure you and your family are protected.  Employers will usually have legal counsel advising them along with a team of insurance representatives to protect their interests.  A dedicated attorney will work on your behalf so that you can focus on your recovery.

Asking the right questions can help you decide which attorney is right for you.  When interviewing prospective attorneys, always follow these steps:

  • Request a free initial consultation

  • Ask for references

  • Discuss the retainer agreement

  • Observe the lawyer’s demeanor, listening skills, and sense of authority

  • Get an idea of their strategy for your case and a possible timeline

  • Ask about other workers’ compensation cases and the outcomes of those cases

  • Read their online reviews or other sources for client feedback

Contact a Houston Workers’ Compensation Attorney Today

Every employee who suffers an injury or illness because of an incident that occurs at work deserves the compensation that they need to cover their losses. For most people, this involves filing a claim with a workers’ compensation insurance company. For others, it may mean directly suing one’s employer in civil court.

A Houston workers’ compensation lawyer at our firm is ready to help in both situations. Give Roberts Markland LLP a call now to learn more.