How to Increase Your Chances of Getting Texas Workers’ Compensation Benefits

You can increase your chances of getting workers’ compensation benefits if you notify your employee immediately, seek proper medical care, record everything that happened, and consult with an attorney to make sure everything is filed correctly.

Workers’ compensation is an insurance program regulated by the state of Texas that pays medical bills and replaces some lost wages for employees who are injured at work or contract work-related illnesses, and it provides benefits for dependents of workers who die as a result of job-related injuries. However, insurance companies are out for profit and want to pay out as little as possible, so they will try to find reasons to deny even legitimate claims. As a result, injured workers often run into problems trying to navigate the workers’ comp system, and they never receive the benefits they deserve.

Fortunately, you do not have to deal with the system alone. The workers’ compensation lawyers at the Waldman Legal Group understand the difficulties facing injured workers and can help you take steps to increase your chances of receiving workers’ comp. We have years of experience with serious on-the-job injuries and the Texas workers’ compensation system and will work with you to ensure your claim is handled correctly from the start. We are happy to talk to you about your individual situation and determine the best way to proceed.

We offer a free and confidential initial consultation, so call us today at (713) 688-4878 to get started.

How Do I Maximize My Texas Workers’ Compensation Insurance Benefits?

It is important for you to have a general understanding of Texas workers’ compensation insurance system as regulated by the Texas Department of Insurance, and to follow the system’s requirements, procedures, and laws.

When you work with the Waldman Legal Group, we will direct the entire process to ensure that this is the case.

Our work injury attorneys can help you get benefits by:

• Making sure you know what to say and do after you are injured
• Ensuring that all forms and procedures are filled out and filed correctly in accordance with Texas law
• Investigating your case to determine how it happened
• Interviewing witnesses and gathering evidence to help prove your claim
• Obtaining all relevant work and medical records
• Negotiating with insurance companies for a fair settlement
• Making any necessary appeals if your claim is denied.

Steps That Increase Your Chances of Receiving Texas Workers’ Comp

The following are steps you can take to help increase your chances of receiving workers’ comp and maximizing your benefits:

1. Make sure you have a legitimate basis for a claim.

To get benefits, your employer must be a subscriber to the Texas workers’ comp system. If your employer is a subscriber, your injuries must fall into one of the following categories to qualify for benefits:

• On-the-job injuries and injuries you receive while doing work-related tasks
• Repetitive stress injuries from work-related activities, such as carpal tunnel syndrome
• Occupational illnesses from exposure at work to toxins and chemicals.

2. Notify your employer of your injuries and file your workers’ comp claim.

According to the Office of Injured Employee Counsel (OIEC), you must tell your employer within 30 days of the date you were injured or first knew your injury or illness might be work-related. You have one year to send a completed employee’s claim for compensation for a work-related injury or occupational claim (DWC Form-041) to the Division of Workers’ Compensation (DWC). Our attorneys can help make sure your forms are filled out correctly and in a manner that increases your chances of getting compensation.

3. Seek Medical Treatment.

You should seek medical attention immediately after your injury. Tell your doctor how you were injured and that the injury is work-related. Find out if you are in a Workers’ Compensation Health Care Network and follow the network rules for getting treatment. Getting prompt medical treatment will ensure documentation of your accident and injury, pain levels, and physical restrictions, and can be important medical evidence in your workers’ comp claim. If you delay, vital evidence could be lost, and the insurance company could argue that you weren’t seriously injured and deny or lower the amount of your claim.

Be careful about what you tell your doctor, as it can influence how the insurance company decides to proceed with your settlement. Continue your doctor’s treatment even if you think you feel better, and change doctors if you are not happy with the one you are given.

4. Document Everything

Keep a complete record of the details of your injury, medical records, and associated medical costs such as parking fees, medications, and gas bills. Make copies of all forms and paperwork regarding the accident and injury. This documentation can be used as proof of your injuries and be useful to help fight for maximum compensation.

5. Know Available Texas Workers’ Comp Benefits

Be aware of the benefits you should be entitled to and make sure they are being calculated correctly.

Detailed Understanding May Increase Your Chances of Getting Workers’ Comp Benefits
Workers’ comp provides weekly benefits at a set percentage of your average weekly wage and should factor in any overtime work, side jobs, or any other deviations from your fixed wages. Your Average Weekly Wage (AWW) is the average amount of money your employer paid you each week in the 13 weeks before your injury or illness. It includes other benefits such as health insurance or a car allowance.

According to the Texas Department of Insurance, there are four main categories of workers’ compensation benefits:

• Income benefits replace some of the money you lost because of your work-related injury or illness. (except for impairment income benefits). Types of income benefits include:
  • temporary income benefits (TIBs);
  • impairment income benefits (IIBs);
  • supplemental income benefits (SIBs); and
  • lifetime income benefits (LIBs).
• Medical benefits for reasonable and necessary medical care to treat your work-related injury or illness.
• Burial benefits for funeral expenses and death benefits to replace some of the money lost when an employee dies because of a work-related injury or illness.

Because insurance companies are out for profit, do not rely on the adjuster to fully explain all available benefits. Our workers’ comp lawyers can help ensure that you are getting all the benefits you deserve.

6. Be Prepared for Independent Medical Examinations

Your employer’s worker’s compensation insurance company may request an independent Medical Exam (IME) performed by a doctor who is working for the insurance carrier. This doctor has the insurance company’s interests at heart, not yours, and will make a report on your diagnoses, work restrictions, and the relationship between your injury and your work.

You should not refuse an IME, since this may lead to a termination of your benefits. Instead, prepare for the IME by reviewing your medical records and anticipate that the IME doctor will try to ask questions to see if you are actually disabled.

7. Be Careful When You Talk to the Insurance Company

Insurance companies will attempt to get information from you to try to show you are not really disabled or that you can do increased work, and they will use this information against you. Be aware that you do not have to provide insurance companies with a recorded statement about your injuries or how they occurred, even if requested. Tell the insurer that you will speak with your workers’ comp attorney first, and let our attorneys handle it.

8. Appeal If Your Workers’ Comp Claim Is Denied

Employers and their insurance companies will find reasons to deny claims, but that doesn’t mean you should give up. Fight the denial by having your attorney file an appeal for the court to reconsider your original claim, and you may win the benefits you deserve.

9. Enlist the Help of an Experienced Workers’ Compensation Lawyer

If you or a loved one was harmed due to a work-related injury or illness in Texas, the work-injury lawyers at the Waldman Legal Group can examine your individual situation and find the best ways to increase your chances of receiving workers’ compensation benefits.

Don’t make costly mistakes – protect your rights and your family. Call us today at (713) 688-4878 for your free and confidential initial consultation.