In a majority of construction accident cases, there are two potential legal options available.
- File a workers’ compensation claim. What is workers’ compensation? Workers’ compensation is a type of insurance that provides benefits to employees who experience work-related injuries or illnesses. Workers’ compensation insurance provides for medical costs, lost wages, and rehabilitation costs. Each state has a statute that regulates workers’ compensation; however, if you work for the government, the federal government has a workers’ compensation insurance program as well.
Texas passed its workers’ compensation statute in 1993. Unlike most states, Texas’s workers’ compensation statute does not mandate private employers to carry workers’ compensation insurance. However, all public employers must carry workers’ compensation insurance. For Texas’s worker’s compensation statute to cover your injury, the injury or illness must have been “sustained in the course and scope of employment.”
In other words, you must have been injured while working on the job. The workers’ compensation statute covers most physical injuries, such as broken bones and burns. Typically, workers’ comp will not cover injuries from an employee’s willful criminal acts, horseplay, or alcohol or drug use.
Under Texas’s workers’ compensation statute, these benefits are available:
- Income benefits (or wage-loss benefits): These benefits are equal to a certain percentage, outlined in the statute, of the average weekly wages that an employee loses because of temporary or permanent illness or injury. Workers’ compensation insurance programs calculate the wage-loss benefits based on an employee’s injury or illness and how much time they have missed work due to the injury or illness. The workers’ compensation statute caps the total amount of wage-loss benefits.
- Medical benefits: These benefits cover the necessary medical care required to treat an employee’s work-related injury or illness.
- Rehabilitation benefits: These benefits cover expenses connected with an employee finding alternative employment.
- Death benefits: These benefits are equal to 75 percent of an employee’s average weekly wage, which is paid to legal beneficiaries. Additionally, these benefits cover up to $10,000 in burial expenses.
If a construction accident injures you and your employer carries worker’s compensation insurance, there are specific steps you must follow to file a workers’ compensation claim. As a first step, you must seek medical treatment as soon as possible. You also must report your accident in writing to your employer within 30 days from the date you sustained your injury or discovered your injury. Once you complete these steps, you have one year from the date you suffered the injury or discovered your injury to file a completed Employee’s Claim for Compensation for a Work-Related Injury or Occupational Disease form with the TDOI.
The completed forms can be mailed to TDOI or filed online. Once you complete the form and submit it to the TDOI, the company’s insurance company will evaluate the claim and decide whether to pay or deny your claim. If the TDOI denies your claim, you do have a right to appeal the insurer’s decision.
The workers’ compensation process in Texas is highly complex, and you must take many specific steps when filing a claim. Therefore, it would be helpful to hire an attorney to assist with filing your workers’ compensation claim to ensure you receive the maximum benefits available to you.
- File a third-party lawsuit. Suppose you suffer a workplace illness or injury, and your employer does not carry workers’ compensation insurance. In that case, an option is to file a personal injury claim against your employer and any other third parties who may have caused your injury. For example, if a defective power tool injured you, you can bring a personal injury suit against your employer, and the manufacturer, and even the supplier, of the power tool.
In construction workplace cases, a majority of personal injury claims claimants bring against employers and third parties are for negligence. While Texas is a “no-fault” state when it comes to workers’ compensation—that is, the employee can receive benefits without having to prove that her employer did something wrong—the same does not hold true in personal injury cases. To prevail in a personal injury lawsuit, you generally have to prove that your employer and other third parties were negligent. To prove negligence, a claimant must show that her (a) employer (or related third-party) owed her a duty of care, (b) employer breached their duty of care, and (c) the employer’s breach caused the claimant’s injuries.
Filing a lawsuit can be an overwhelming process. A licensed attorney can help you prepare your claims, filing paperwork in court, and negotiating potential settlements.