Workers Compensation Claims Process: How Do I File?

Austin Workers Compensation Lawyer Explains Straight Claims Process

Getting compensation for a work injury in Austin is complicated, since Texas, unlike all other states, does not require employers to have workers compensation insurance. Instead, companies may opt to have traditional workers comp or a “non subscriber” plan. If your employer does have workers comp insurance, then you are generally entitled to compensation regardless of who was at-fault for the accident. However, you must follow certain steps to file your claim (called a “straight workers comp claim”) and you may face opposition from your employer’s insurer. On the other hand, if your employer is a non subscriber, then you may be entitled to file a personal injury lawsuit, which presents its own challenges. An Austin work injury attorney can explain how to apply for workers comp and can also defend you in negotiations so that you get a fair settlement.

Very few attorneys in Texas represent straight workers compensation claims, as they are often more complex and the law limits attorney fees. However, Austin workers comp lawyer Aaron Allison is an exception. In fact, the Law Offices of Aaron Allison is one of only four law firms in central Texas that handle straight workers comp. We proudly continue our 40-year tradition in providing assistance to injured workers navigating the traditional claims process. If you need help with workers compensation in Texas, then do not hesitate to give us a call.

How Do I Apply for Workers Compensation in Texas?

In Texas, your employer may purchase workers compensation insurance through a commercial company. However, the Division of Workers Compensation (DWC), a part of the Texas Department of Insurance, oversees all claims. Therefore, the general steps you must follow in filing for workers comp in Texas include:

• Inform your employer as soon as possible. Technically, you have 30 days to inform your employer of a workplace accident or injury. However, the sooner you tell your employer, the better. If you wait, then the insurance company may attempt to deny your claim or asset that your injuries are not work-related.
• Determine where you can receive treatment. Your employer should inform you how to seek medical care. Depending on the circumstances, you may have to choose a doctor from an approved network of physicians. This does not include emergency treatment.
• File an Employee’s Claim for Compensation with the DWC. This is your official workers compensation application. Then, the DWC will contact your employer and the insurance company, so that they can review your claim. In Texas, you generally have one year from the date of your injury to file with the DWC. A workers compensation attorney can explain this application process and ensure you do not miss deadlines.
• Review the reply from your employer’s insurer. Your employer’s insurer will review your claim and send you a reply letter. You should review this reply with your attorney, who can tell you whether a settlement offer is fair.
• If denied, then challenge the decision through the DWC. If you receive a denial, then you may appeal through the DWC. You and your workers comp attorney may be able to negotiate with the insurance company informally. Otherwise, you may need to attend a workers comp hearing, where a judge will settle your claim.

What Workers Compensation Benefits Can I Collect?

There are exceptions, but you can generally file a straight workers comp claim for any work-related injury, regardless of fault. However, workers compensation benefits are limited compared to damages you may receive through a personal injury lawsuit against a non-subscriber. For workers comp, you may be able to recover:

• Medical costs. Workers comp should cover all work injury-related medical costs, including emergency room bills.
• Vocational rehabilitation costs. If you need retraining to return to the workforce after an injury, then workers comp may cover these expenses.
• Temporary income benefits. You may recover a portion of your lost income while you recover; in Texas, you should receive 70 percent of your lost wages. However, state law limits the maximum benefits you can receive weekly, though this number changes yearly. These benefits last until you can return to your regular job, reach maximum medical improvement or 104 weeks elapse, whichever occurs first.
• Impairment income benefits. You may receive 70 percent of your lost wages, up to the state maximum, after your temporary income benefits end. The length of time you receive these benefits is three times your disability rating, as determined by your doctor.
• Supplemental income benefits. If your disability rating is 15 percent or more, then you may receive ongoing wage loss benefits for up to 401 weeks after your impairment income ends. The calculation for this income is complex, especially if you earn a reduced wage. Additionally, you must apply every quarter for continuing benefits.
• Lifetime income benefits. If you have a severe, permanent impairment, then you may receive 75 percent of your lost income, up to the state maximum, for life. However, once you begin receiving benefits, you get a 3 percent increase each year regardless of the stat max.

More Questions on How to Apply for Workers Comp in TX? Call Us Today

If you need to know how to file for workers comp in Texas, then contact the Law Offices of Aaron Allison today. As one of only four law firms in the area that handles straight workers comp, we have the skills and experience needed to assist you in getting the benefits you deserve. We can help you understand the process of informing your employer and seeking medical treatment. Then, we can assist you in filing your workers compensation application and give you perspective on any settlement offers you receive. If necessary, we can defend you against a denial as well.

Call (512) 474-8346 or contact us online today to schedule a free initial consultation.