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There are no settlements in a Texas workers’ comp case.

At least a few times a week, our office is contacted by a potential client who wants to know how much they can settle their workers’ compensation case for. They are always shocked when we tell them nothing. This does not mean that they will get nothing, but that as a rule, there are no settlements under Texas workers’ comp.

For all intents and purposes, the Workers’ Compensation Act of 1993 sought to eliminate work injury settlements altogether. Injured workers can still obtain compensation, but it’s not in the form of a settlement like you’d find in a normal personal injury case. In this article, we’ll explain how it all works.

Questions answered on this page:

  • What is the difference between benefits and a settlement?
  • Can the benefits be taken in a lump sum?
  • Are there specific instances when you can get a settlement from workers’ comp?
  • When do you need an experienced work injury attorney to help with your workers’ comp claim?

What is the difference between a benefit and a settlement?

When a person is injured in a workplace accident and their employer subscribes to Texas worker’s compensation coverage, then the compensation the injured worker receives is paid in the form of “benefits.” Benefits are compensation paid out in real time on an as-needed basis. Unlike a settlement that is given in a lump sum at the end of legal proceedings, benefits are paid as the expense arises. So, if an injured worker needs an eye surgery, workers’ comp pays for the eye surgery. If the injured workers has lost wages, they pay a portion of the worker’s wages in the form of weekly checks.

This is different from a settlement, however. A settlement is when one party may be liable to another party in some way and agrees to pay them a certain amount of compensation to avoid going to court. Since workers’ comp prohibits injured workers from suing their employers, it is basically impossible for their to be a settlement in a workers’ comp case.

What Texas Worker’s Compensation Law Does Entitle You to Receive?

Worker’s compensation cases are unlike nearly every other personal injury case. In a normal personal injury case you sue the person that hurt you under a negligence cause of action, and a jury awards financial compensation proportionate to the losses you have sustained. As has been covered, since you lose the ability to sue your employer in a worker’s compensation case, those normal rules go out the window. Instead, Texas worker’s comp laws takes what would otherwise be negligence claims out of the court system and transform them into a type of benefits claim, like filing for social security disability.

Even though losing their right to sue their boss for negligence is a bad thing, workers who are hurt on the job while working for an employer who subscribes to workers’ comp coverage will find that their compensation is almost guaranteed. To clarify, if injured workers only had the option to sue their boss when they’re hurt, there is always risk that they will lose their case. But when an injured workers is covered by a workers’ comp policy, even though they lose their right to sue their boss, the end up getting benefits that are paid automatically and without a fight (in theory).

Suppose a restaurant worker is shucking oysters without a cut glove. The employee gets involved with a conversation with another employee and, being distracted, the oyster knife slips and impales his hand. In this instance, the employee is most likely liable for his own injuries and would probably lose if he only had the option of getting compensation by way of suing his employer in court. However, since his employer subscribes to the workers’ compensation system, he is still entitled to workers’ compensation benefits.

Instead of juries awarding compensation for an injured worker’s losses that are caused by negligence of their employer, an employer simply buys worker’s comp coverage, and Texas worker’s comp laws entitle the injured worker to benefits, irrespective of whose fault the accident is. There are several types of Texas workers’ compensation benefits, Medical, Income, Burial, and Death benefits.

Impairment benefits are like a lump-sum payment.

Hopefully by now we’ve made it quite clear that settlements only apply to cases involving lawsuits and liability, but workers’ comp cases have nothing to do with lawsuits and liability, and are instead based on the idea that all injured workers are eligible to receive benefits, irrespective of how the accident happened. Well, we have to somewhat contradict ourselves.

You see, one of the several types of benefits you can receive in a worker’s comp claim, Impairment Income Benefits, can actually be paid in a lump sum. Since Impairment Income Benefits can be paid out in a lump-sum, they can be easily mistaken for a settlement. However, unlike a settlement, which is the result of litigation and based on the subjective findings of a jury, like everything else in workers’ comp law, Impairment Benefits are determined by pre-established formulas created by lawmakers down in Austin.

Most people misconstrue this lump sum Impairment Income Benefit payment to be a settlement. Again, though, just because it’s a lump sum does not make it a settlement.

You need a workers’ comp lawyer with experience.

While in theory, there should be absolutely no need to have an attorney involved in your workers’ comp claim, since the system clearly lays out who should receive which benefits and how much of each benefit should be paid out. In practice, many times employee injuries are improperly classified, or benefits are wrongly computed and injured workers end up being denied benefits that are rightly theirs.

In such instances, the assistance of an experienced workers’ compensation accident attorney can ensure that those who administrate the workers’ comp system are living up to their legal obligations to injured workers. Should the dispute need adjudication in special courts set up within the workers’ comp system, an experienced lawyer can even argue your side of the case on your behalf. In many instances this can be the difference between an injured worker being fairly treated or suffering further indignities at the hands of the well-meaning, but overwhelmed workers’ comp bureaucracy.

Grossman Law Offices has over twenty years of experience and knows how to deal with insurance companies on behalf of their clients. Call today for a free consultation regarding your claim at (855) 326-0000.

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