Best Workers’ Compensation Lawyers El Paso, TX Of 2024 – Forbes

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Worker’s compensation laws in Texas are unique. Workers’ compensation insurance is not required in the Lone Star State unless you are employed by a public entity or work for one as an independent contractor. This gives the process for these types of claims multiple avenues of resolution. Here is a brief guide on the workers’ comp laws in the state and how you can proceed if your employer has chosen not to carry insurance covering your injuries.

Who Is Protected By Workers’ Compensation Laws in El Paso, TX?

Texas law protects any employee working for a private business with workers’ compensation insurance—though, remember, most private companies in Texas are not required to provide workers’ comp insurance.

As defined by the Texas Labor Code Section 401.012, an employee is any person “in the service of another under a contract of hire, whether express or implied or oral or written.” Though this covers a wide range of hired individuals, some exceptions exist.

Workers’ Rights Under El Paso, TX Workers’ Comp Laws

Workers who are covered under optional workers’ compensation insurance by an employer have the following rights:

  • To hire an attorney to assist with their claim
  • To receive assistance from the Office of Injured Employee Counsel (OIEC) if they do not have an attorney
  • To potentially receive medical and income benefits regardless of who was at fault, with some exceptions
  • To potentially receive income benefits for their work-related injury
  • To potentially have access to dispute resolution regarding their claim
  • To choose a treating doctor for their injury
  • To have information regarding their workers’ comp claim be kept confidential

Though employees have a number of rights under workers’ comp laws, they are also subject to a number of responsibilities regarding their claims and injuries they sustained at work. They are:

  • To report their injury to their employer within 30 days
  • To know whether they are in a Worker’s Compensation Health Care Network
  •  In the event they worked for a political subdivision at the time of injury, to find out how to receive medical help
  • To tell their doctor about their injury and if it was work-related
  • To send a completed Employee Claim for Compensation for a Work-Related Injury or Occupational Health Claim Form (DWC-041) to the Texas Department of Workers’ Compensation (DWC) within one year
  • To provide their employer’s insurance carrier and DWC with personal details, including their address, phone number and employer information
  • To inform DWC or their employer’s insurance carrier if there’s a change in their employment status
  • To not make frivolous or fraudulent workers’ comp claims

Employees should note that their claim to workers’ comp benefits is void if the injury they sustained:

  • Occurred while they were intoxicated
  • Occurred because of their willful attempt to injure themselves or others
  • Occurred when a third party tried to injure them due to a personal reason, not because of their job or where they work
  • Occurred during an off-duty, voluntary, recreational, social or athletic activity not related to their work duties
  • Occurred due to an act of God, unless their work places them at greater risk of such events compared to the general public
  • Occurred due to their horseplay

Filing Process for Workers’ Compensation in  El Paso, TX

As soon as an employee is injured, they—or their representative—need to report the injury to their employer as soon as possible. If their injury or occupational disease is not reported within 30 days from the injury date, the employee may not be eligible for benefits.

Once reported, the employer must investigate the claim and submit a report to the Human Resources Department, Risk Management Division, within 48 hours. The injured employee should seek medical attention as soon as possible after the incident. Following the reporting of the incident to their employer, the employee must file Form DWC-041 with the Texas DWC within one year, which lays out their official claim. This form must be given to their employer’s insurance carrier, along with other personal details.

Workers’ Recovery for Workplace Injuries Beyond Workers’ Comp in El Paso, TX

Because Texas is the only state that does not require private companies to have workers’ comp insurance, injured employees have several options if they are not covered or not eligible. Companies that do not have coverage—known as non-subscribers—are personally responsible for injuries that workers sustain on their site and are liable to lawsuits. Employees injured due to negligence can end up seeking substantial verdicts or settlements.

Employees covered by worker’s compensation insurance may still have their claim to benefits denied. In these cases, employees can appeal the denial with the help of a workers’ comp attorney. Appealing the claim can be avoided if both parties agree.

The first step usually involves setting up a benefit review conference with the Division of Workers’ Compensation of the Texas Department of Insurance to discuss the denial with your employer and insurance agency. The parties may agree to a settlement, but if not, they have a contested hearing before an administrative law judge. If this fails to resolve the issue, then the claim denial typically needs to be appealed in court.

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