This article tells you about what to do if you are injured at work and what covered and non-covered-employers are.
Composed by Texas RioGrande Legal Aid • Last Updated on November 2, 2022Here, learn how to claim workers' compensation in Texas, and when workers' compensation is an option. Sometimes injured workers must go through workers' compensation rather than suing their employers. This fact sheet offers resources and links to forms and regulatory agencies.
Workers’ compensation is a state-regulated insurance program that provides medical and income benefits to workers for work-related injury or illness, regardless of who is at fault. It includes occupational illnesses (for example, a chronic lung condition caused by breathing in hazardous chemicals at work); trauma injuries caused by repetitive tasks or awkward positions while working (for example, a back injury caused by lifting heavy objects). If you are killed on the job, workers' compensation pays death and burial benefits. Workers' compensation only covers injuries sustained while working.
Workplace injuries that are self-inflicted, injuries resulting from worker intoxication, or injuries caused by worker horseplay or unsafe practices are not covered. Workers are also expected to use the safety equipment provided by the employer.
No. Private employers in Texas do not have to carry workers' compensation insurance. Those who do must inform employees and post a workplace notice with the name of the insurance carrier. If you are not sure about employer coverage, call the Texas Department of Insurance-Workers’ Compensation at 800-372-7713.
If covered by workers’ compensation, you cannot sue your employer for work-related injuries or illness. There are some exceptions — if injured while operating a punch-press, while working on a boat or ship, or while ill from asbestos exposure, you may be able to sue even if your employer subscribes to workers’ compensation. If a third party is also at fault, you can sue the third party.
Some employers don’t subscribe to workers' compensation and choose private occupational injury benefit plans instead. These plans are loosely governed by a federal law known as ERISA. If the plan is in effect you should have received information about it at the start of your employment, along with the rules for workers to give notice of their injury (usually within 24 hours), the appeals process (varies depending on the carrier), and access to medical care (usually restricted to a few doctors in the network).
If you’ve been injured at work AND your employer is covered by workers' compensation insurance:
The Office of Injured Employee Counsel (OIEC) can help with the initial claim process. Call 866-393-6432 or go to the Resource List on the website of the Office of Injured Employee Counsel.
You have the right to hire an attorney to help you at any stage of the workers' compensation process, including the benefit review conference, contested case hearing, appeals panel review and judicial review.
Yes. Appeal the final decision to the district or county court in the county where you live by filing a petition no later than 45 days from the date you receive the final decision. The OEIC cannot help with your appeal to the state courts; consult an attorney or legal aid.
It is against the law for an employer to retaliate against you for filing a claim. If you think you are being punished for making a claim, you might have a reason to take legal action against your employer. Talk to an attorney to evaluate your legal options.