Best Workers’ Compensation Lawyers San Antonio, TX Of 2024 – Forbes

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Unlike every other state, Texas does not require employers to have workers’ compensation insurance—unless they are a public employer or a contractor for a public entity, a motorbus company, a motor carrier or natural gas or compressed gas dealers. Because of this, workers’ compensation laws in the Lone Star state are a bit different than in other jurisdictions. Below is a brief outline of the most important laws and processes to be aware of and what to do if your claim ends up denied.

Who Is Protected By Workers’ Compensation Laws in San Antonio, TX?

Per Texas law, any worker employed by a business that subscribes to workers’ compensation insurance is protected. More specifically, an employee is any person in service of another under a hired contract, regardless if that contract is verbal or written, express or implied. Though this definition does cover nearly all workers in Texas, there are a number of exceptions to be aware of.

Workers’ Rights Under San Antonio, TX Workers’ Comp Laws

Employees who are employed by businesses with workers’ compensation insurance have the following rights under Texas law:

  • The right to hire an attorney to assist with their workers’ comp claim
  • The right to receive assistance from the Office of Injured Employee Counsel (OEIC) if they do not have an attorney
  • The right to potentially receive medical and income benefits regardless of the fault of the workplace accident, with some exceptions
  • The right to potentially receive income benefits for their work-related injury
  • The right to potentially access dispute resolution services regarding their claim
  • The right to select a treating physician of their choice for their injury
  • The right to have their information regarding their claim be kept confidential

While employees do have a number of rights that protect them under workers’ compensation laws, they are also subject to a number of responsibilities regarding their claim—and the injury they sustained at work. Employees are responsible for:

  • Reporting their injury to their employer within 30 days’ time
  • Understanding whether they are in a Worker’s Compensation Health Care Network
  • Finding out how to find medical help if they worked for a political subdivision at the time they received their injury
  • Telling their doctor about their injury and if it is work-related
  • Sending a completed Form DWC-041, Employees Claim for Compensation for a Work-Related Injury or Occupational Health Claim Form to the Texas Department of Workers’ Compensation (DWC) within a year
  • Providing their employer’s insurance carrier and DWC with their personal details, including their phone number, employer information and their personal address
  • Informing DWC or their employer’s insurance carrier if there has been a change in their employment status
  • Not making frivolous or fraudulent workers’ compensation claims against their employer

In addition, under Texas law, any claims to workers’ compensation benefits against an insurance carrier will be voided if certain factors caused the injury the employee sustained. These include horseplay by the employee, a willful attempt by the employee to hurt themselves, an act of God—assuming their workplace does not place them at a greater risk to such events compared to the public—or if the injury occurred while they were intoxicated.

Injuries sustained during an off-duty, non-work-related event unrelated to an employee’s work duties cannot be used to hold an insurance carrier liable for compensation.

Filing Process for Workers’ Compensation in San Antonio, TX

Immediately following an injury, make sure you are safe and not in an emergency situation. Assuming you are safe, report the injury to your supervisor as soon as possible—no matter how small the injury—and let them know of an unsafe work environment if applicable. Any injury or occupational disease not reported to your employer within 30 days of it occurring may not be eligible for workers’ comp benefits.

Once reported, your employer will give you an injury form to present to your doctor so that you can begin your medical treatment as a worker injured on-site. Following these steps, you will need to report the injury to the Texas Department of Insurance, Division of Workers’ Compensation (DWC) using form DWC-041: Employee’s Claim for Compensation for a Work-Related Injury or Occupational Disease. This must be done within one year from the date of injury otherwise, you may not be covered. The DWC notes that injured workers can call their office two weeks after their form has been submitted to ensure it was received and processed properly.

Workers’ Recovery for Workplace Injuries Beyond Workers’ Comp in San Antonio, TX

Unlike every other state, Texas does not require all employees to carry workers’ comp insurance—unless they are a government entity. Because of this, workers have a couple of options if their claim was denied or if their employer did not carry insurance at the time of their injury.

If their workers’ comp claim is denied, an employee’s attorney will begin the appeal process. This typically begins with a benefit review conference with the Division of Workers’ Compensation of the Texas Department of Insurance to discuss the denial with the employer and their insurance agent. Both parties may agree to a settlement at this time. If they do not, the matter will proceed to a contested hearing before an administrative law judge. If this step fails to bring a resolution, then the denial will have to be formally appealed in court.

If your employer was not carrying insurance—known as a non-subscriber—they are liable for any damages you incur while injured on their job site. A workers’ comp attorney can bring a lawsuit against their employer for damages related to their injury, similar to a personal injury lawsuit.

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