How to File a Texas Workers' Compensation Claim:
When workers are injured on the job and the employer has workers' compensation coverage, there is an assumption that benefits begin automatically. However, that's not the case. Generally speaking, an injured employee has to file a workers' compensation claim before any benefit payments can even be considered.
In this article, we'll cover why it's important for you to follow the right steps in filing your workers' compensation claim and also why it's necessary to stay on top of your employer during the process. This is the only way to ensure you get the benefits you deserve.
Questions answered on this page:
- How do I file a workers' comp claim in Texas?
- What should I know before I file a workers' comp claim?
- How can a lawyer help me if I was injured at work?
Filing The Workers' Compensation Claim Yourself
First and foremost, you have to report the injury to your employer. Typically, the employer will then set up the workers' comp claim for you. The way they do this is by notifying the workers' comp insurance carrier and the Texas Division of Workers' Comp.
Sometimes, employers don't want their workers' comp premiums to increase, so they will try to handle everything under the table. Don't let this happen to you. You have only thirty days from the day the accident occurred to set up your workers' comp claim. By allowing the employer to pay for things out of pocket, you may miss the window of opportunity to get workers' comp benefits. Unfortunately, many employers take the under-the-table approach specifically so they can poison your workers' comp claim.
The best way to avoid that happening is to contact the Texas Department of Insurance-Division of Workers' Compensation yourself and ensure that a claim has been set up. This process can be done online at their website or by phone at (800) 252-7031.
Assumptions and Reality in Workers' Compensation Claims
The filing process can seem daunting after an accident, and we want to help you understand the process and address possible concerns. We tend to hear the same things over and over again, and we think its important that our clients know the realities of filing their workers' comp claim instead of going on what their assumptions are. Below are some important things to know before you file a workers' comp claim.
- Assumption: All I have to do is tell my employer that I got hurt. They'll take care of the paperwork.
- Reality: We can guarantee you this is not how it works. Yes, there is paperwork and documentation involved in reporting your injury. But, you cannot assume it will be done by your employer. If there's nothing written down by you or by your HR department, then your injury just becomes a he said/she said type of situation. Just like you would want to document everything in a traditional personal injury case, you'll need to make sure to document everything in your workplace accident.
- Assumption: My employer is used to this kind of thing. They'll make it an easy process for me.
- Reality: If there's anything we've ever learned in the hundreds of work injury cases we've won, it's that nothing is ever completely smooth. Sure, you could have a pretty communicative employer who's willing to go the distance for you, but it's not solely up to them to make sure you get the benefits your deserve. There are insurance adjusters, claims specialists, medical review boards, and even appeal committees. Your employer cannot promise any easy process, because they're definitely not the sole decision maker in your claim.
- Assumption: My employer will file my claim for me.
- Reality: This one kind of piggybacks on the previous assumption. Your employer may file your claim for you, but that doesn't mean you shouldn't follow up to make sure it's been done. We're talking about your health and recovery here, so the least you can do is make sure your employer filed the claim with the insurance carrier and the carrier actually received the claim.
- Assumption: My employer wants to file my work injury claim with the insurance carrier.
- Reality: This, sadly, is false. When your employer files your claim, they're subjecting themselves to a lot of future financial burden. They're accepting blame for the injury--which will boost up their own insurance premiums--and they will now have to reevaluate their job site for future accident possibilities. All of this costs money from their pocket, so you can bet that they don't really want to do that.
- Assumption: My employer is offering to pay me under-the-table for my injuries and recovery so we don't have to deal with the insurance. That's better for both of us, right?
- Reality: Sadly, this is far from the truth. If your employer is offering to pay you out of their own pocket and not involve the insurance company, then you're probably getting set up for a long and stressful road ahead, and your employer is getting off scot-free. By doing this, first and foremost, you're not involving the insurance-mandated doctors appointments where a physician legitimately helps you with recovery. Seeing a licensed healthcare provider not only guarantees that you'll try to reach MMI (maximum medical improvement) but that you'll also have documentation that you may need later on, if for some reason you have to dispute some of your employer's actions during your recovery.Secondly, you're allowing them remain completely unaffected for their negligence. Let's face it, if your employer does not provide a safe workplace and you're injured, don't you think that at the very least, their insurance premiums should go up and their safety protocols should get reexamined? Finally what's even more is that, legally, the workers' comp insurance carrier that your employer uses has a right to know what is happening with the company they're insuring. So honestly, to accept a payment under-the-table is just plain unlawful.
Filing a Workers' Comp Claim is The Most Important First Step
Don't go on assumptions if you've been injured at work. Make sure you file the claim, follow up with it, and hold your employer and the insurance carrier accountable for the injuries you've sustained. If you need legal help or advice, just call the workers'compensation attorneys at Grossman Law Offices in Dallas, TX. We're here, day or night, so use our 25 years of experience to your advantage: (855) 326-0000.
Related Articles for Further Reading:
- What Is a Contributing Injury and How Can it Affect Your Workers' Compensation Benefits?
- An Overview of Texas Workers Compensation Benefits
- What Is Maximum Payout through Workers' Compensation?