What Is Workers’ Compensation? A Guide to Filing a Work Injury Claim

Being in an accident at work can have a devastating impact on your life. If you need to visit a doctor or go to the hospital for treatment, you might face hefty medical bills — and then there’s the recovery. A minor accident could make you miss days at work, while more severe injuries could lead to an uncertain future where you don’t know if you can continue doing your job.

When you’re in an accident at work, the key question is, “What can I do about it?”.

Fortunately, you may be able to file a work injury claim. Here, we cover what constitutes a work injury, what role workers’ compensation plays, and when you might be entitled to file a work injury claim.

How Common Are Work Injuries?

Few people wake up and go to work expecting to have an accident. Still, workplace injury is extremely common — especially in environments where you perform manual labor or work with large and potentially dangerous machinery.

According to the Texas Department of Insurance, over 187 thousand non-fatal workplace injuries and illnesses occurred in the workplace in 2019. These ranged from sprains and strains to cuts, lacerations, fractures, chemical burns, amputations, and multiple traumatic injuries.

What Is Workers’ Compensation?

Workers’ compensation (also known as workers’ comp) is a type of insurance companies take out to cover accidents and illnesses at work.

The requirements for this insurance vary. In most states, workers’ compensation is mandatory for larger companies (typically, those that employ more than a handful of people), but there is one exception.

In Texas, workers’ compensation isn’t compulsory for employers.

However, there are compelling reasons for employers to take out this type of insurance, as doing so prevents an injured employee from filing a personal injury claim and receiving a potentially eye-watering settlement.

What Injuries Are Covered by Workers’ Compensation?

Workers’ compensation is no-fault insurance, meaning that as long as you did not deliberately cause the injury or were intoxicated at work, you have a good chance of securing compensation for your injury.

Any injury could qualify for workers’ compensation. You might fracture a bone from a slip or fall accident, lose a limb after a machinery malfunction, or suffer a spinal injury.

But workers’ compensation doesn’t just cover immediate physical injuries.

You can also claim workers’ compensation for conditions that develop over time, such as repetitive strain injuries and illnesses.

In hazardous environments, you might repeatedly be exposed to chemicals or other toxins, which can lead to a lung disease such as asbestosis or chronic obstructive pulmonary disease (COPD).

It’s important to mention that you shouldn’t just claim workers’ compensation for serious injuries. If you sustain a minor injury at work, you might be cautious about claiming for several reasons. These can include:

  • Not wanting to pay medical bills to prove your injury
  • Not wanting to risk being singled out at work for filing a claim
  • Wondering if claiming workers’ compensation is worth it.

But companies take out workers’ compensation insurance specifically for these situations, and it’s not something you should be shy about claiming.

Your injury might worsen over time, especially if it’s aggravated by your work duties (for example, by lifting or moving heavy objects).

If you do nothing and your injury worsens, you might struggle to get workers’ compensation because the statute of limitations has passed or you don’t have evidence from when you first sustained the injury.

On the other hand, if you make a claim and aren’t eligible to receive a payout, or your injury improves on its own, your case will close.

Ultimately, you have nothing to lose.

How Does Workers’ Compensation Differ from a Work Injury Claim?

Workers’ compensation won’t give you a substantial payout compared to a work injury (or personal injury) claim. However, it will provide cover for out-of-pocket expenses like medical bills, a percentage of lost wages (and in some cases, all your lost earnings), and funeral costs if you’re claiming on behalf of a loved one who has tragically died in a fatal accident.

With a workers’ compensation claim, you are not eligible to receive additional damages for pain and suffering, loss of enjoyment of life, or the loss of a loved one.

However, workers’ compensation is typically easier to claim. To receive workers’ compensation, you must prove that your injury happened at work or was a result of your environment.

On the other hand, a work injury claim comes with an increased burden of proof, where you have to show that your employer has been negligent and is at fault for your injury.

How to File for Workers’ Compensation in Texas

If you’re injured at work, the first thing you should do is see a doctor. Seeking treatment early is vital for a successful recovery, but this also has a bonus advantage — it establishes a paper trail. When you file your workers’ compensation claim, you’ll have clear evidence from when you sustained the injury. When you see a medical professional, you should clarify that you were hurt at work and explain what happened to prevent your employer from refuting that you were injured on the job.

Then, you should tell your employer about your injury as soon as possible, again mentioning that it occurred on the job or because of your environment.

It’s essential to do this quickly, as Texas law states you must give notice within 30 days. You don’t have to file your workers’ compensation claim immediately after, but you must do so within a year from the date of injury.

When filing for workers’ compensation, your employer may file the paperwork on your behalf. However, they may dispute your injury or not report it, so in any case, it’s worth speaking to a workers’ comp lawyer for advice or to make a claim on your behalf.

What if Your Employer Doesn’t Have Workers’ Compensation?

As workers’ compensation insurance isn’t mandatory in Texas, there’s a chance that you’ll be injured at work and can’t file a workers’ compensation claim.

However, this doesn’t rule out the chance of getting compensation for your injuries, as you may be able to file a work injury claim.

You can only claim compensation via this route if your employer was negligent and this negligence led to your accident.

Common grounds for negligence include a lack of sufficient training, faulty equipment, or not providing safety gear or protection. Depending on your type of injury, you may be able to prove negligence in other ways. For example, if you slipped due to a spillage and your employer failed to isolate the area or put up signs, you may be able to claim. Likewise, if you tell your employer about a loose platform that poses a health and safety hazard that isn’t fixed, and you later fall from the platform and sustain a traumatic brain injury, this would constitute negligence.

If your employer doesn’t have workers’ compensation insurance and you wish to file a work injury claim, your first step should be to contact a dedicated personal injury lawyer, who will fight to get you the justice you deserve.

If you’re in an accident at work, you shouldn’t hesitate to file a compensation claim. Our personal injury and work injury lawyers in McAllen and San Antonio can help you get a fair settlement so that you can focus on your recovery — without worrying about the financial fallout of your injury.

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