March 17, 2020
If you live in Texas and are hurt on the job, you may wonder: does workers’ comp pay for lost wages? You not only have to endure the pain of your injuries and focus your attention on recovery. You may also be worried about a sudden loss of income — money you need to pay your bills, feed your family, and cover your suddenly increased medical expenses.
If you have suffered a work-related injury or illness, it’s important to contact an experienced workers’ comp lawyer to make sure you know your rights and don’t leave money owed to you on the table.
Am I Eligible for Workers’ Compensation and Lost Wages in Texas?
Workers’ comp is an insurance program designed to pay employees’ medical bills and lost income due to a work-related illness or injury. In order to be eligible for benefits, you must meet three general requirements.
● You must be an employee of a company that carries workers’ comp insurance.
● You must have an illness or injury sustained on the job.
● You must meet the various deadlines for reporting your injury to the necessary parties and filing a claim.
Does Workers’ Comp Pay for Lost Wages?
Depending on the type of injury and illness and its effect on your income, you may receive compensation for a percentage of your lost wages. There are 5 main categories of benefits:
● Temporary income benefits may be paid if you lose wages for more than seven days due to your illness or injury. Benefits are typically 70% or 75% of your income and end on the date you are able to return to work for your pre-injury salary.
● Impairment income benefits are paid if your work-related injury or illness causes you permanent harm, and the benefits are 70% of your pre-injury income.
● Supplemental income benefits begin after impairment income benefits end, if you are still unable to work. You may be required to meet job-search requirements or participate in a vocational rehabilitative program.
● Lifetime income benefits are paid if you suffer a catastrophic injury that prevents you from working. Benefits are 75% of your previous salary, with annual cost of living increases, and there is no time limit.
● Medical benefits pay for the costs of treating your work-related injury or illness.
Does Workers’ Comp Cover Lost Wages in Texas?
If you work in the state of Texas and your employer carries workers’ compensation insurance, you may be eligible for benefits if you suffer an injury or illness due to your job. Workers’ comp is designed to compensate you for medical expenses and a portion of your lost wages if you meet certain criteria. In order to receive benefits, you must have suffered injury or illness on the job and report your injuries in a timely manner.
● You must inform your employer about your work-related injury within 30 days of the accident.
● You must report your injury to the Texas Department of Insurance – Division of Workers’ Compensation within a year. You must tell them, as well as the insurance company, about how the injury affected your pay and the work you’re able to do.
● You must tell your doctor how you were hurt and specify that it was work related.
● In some cases, employers require that you use a doctor in a certain network or clear your doctor with them beforehand.
What if My Employer Doesn’t Carry Workers’ Comp Insurance?
The state of Texas is unique in that it doesn’t require most private employers to carry workers’ comp insurance — only governments, educational systems, or private employers who contract with government entities or meet other specific criteria must carry it. Some employers may purchase their own private insurance policies to cover work-related injuries or illness, but others (non-subscribers) may not have coverage at all.
If you work for a non-subscriber and suffer a job-related injury or illness, you are not completely out of luck. You may be able to sue your employer for lost wages, medical bills, and other damages.
What a Workers’ Comp Attorney Can Do for You
If you’ve been hurt on the job, it’s important to hire an experienced workers’ comp attorney to help you navigate the system and ensure that you receive the full amount your injuries or illness warrants. Workers’ comp laws are complex and confusing for the layperson. And employers and insurance companies don’t like parting with their money. A workers’ comp lawyer is an expert in the law, knows the process for filing claims, and will protect your rights every step of the way.
Here are specific ways our workers’ compensation attorneys can help you:
1. In order to support your claim, you must submit documentation, including medical records, accident reports, employment records, and more. Our attorney will know what is required and help ensure that you have what you need to maximize the likelihood of approval of your claim.
2. We will carefully review all of your expenses and losses due to the incident and make sure that the insurance company doesn’t shortchange you.
3. If for some reason your claim is denied, we will work with the insurance adjuster to understand the reason for the denial and get any additional required documentation to them.
4. If we aren’t able to work out a reasonable resolution with the insurance company, we will help you take it to the next step: appeal the decision with the Texas Department of Insurance. This will involve representing your interests in a meeting called a “benefit review conference” and possibly taking it to arbitration or a contested case hearing. If that step is unsuccessful, we will help you make an appeal to the division’s appeals panel.
5. If your employer does not carry workers’ comp insurance, our lawyer can help you bring a lawsuit to recover the money that you deserve for your losses.
If You’re Worried about Lost Wages, We Can Help.
The experienced and compassionate workers’ compensation attorneys at Sandoval & Waldman will be happy to discuss your case and answer any questions you have — from “does workers’ comp pay for lost wages?” to “how much is my case worth?” to “how do we get started?” To schedule a free consultation and learn more about workers’ compensation and lost wages in Texas, call our office now at (713) 688-4878 (HURT).