Workers’ compensation is a form of insurance that allows for employees to seek out wage replacement and medical benefits in the case that they are injured or harmed in any manner while performing their work duties.
Every state has its own conditions and requirements for employees who are attempting to file for these benefits. If you are going to file for workers’ compensation in Texas, you’ll want to review all information available to you on the Texas Department of Insurance website.
You’ll be able to find guidance on how to seek workers compensation as well as the forms necessary to file a claim.
Alongside understanding the process of what to do when attempting to secure workers’ compensation, you’ll also want to know what NOT to do. Your bad faith insurance lawyers at Millin & Millin would like to share a bit of information regarding filing a workers’ compensation claim so that you can begin the process of healing and recovery.
If you wish to receive treatment, compensation, and benefits for your work-related injury, beware these common mistakes.
1. Not knowing if your employer has workers’ compensation insurance.
Although it is required by many states, in Texas, employers have the ability to opt-out of obtaining workers’ compensation, except if they are public employers or if they fall under special categories.
It is necessary for employers who choose not to obtain coverage to notify the Division of Workers’ Compensation (DWC) and to ensure all employees are well-informed about the lack of workers’ compensation. However, employers who fail to obtain workers’ compensation insurance (also known as nonsubscribers), are liable for workplace injuries and illnesses. If sued, nonsubscribing businesses cannot argue that:
Regardless of the circumstances surrounding the injury, you should know whether or not you are protected by workers’ compensation insurance or if you will have to seek out another legal route to obtain compensation for your injury.
2. Reporting your injury too late.
If you have suffered an injury while on the job, you should report the incident to a supervisor or manager immediately. Generally, accident policies - which contain information on who needs to be notified of your injury - can often be found in the company’s employee manual.
If your company does not have an accident policy, it is best to inform multiple parties about what has happened. This includes your manager, supervisor, co-workers, and also those in Human Resources.
Often employees cannot file for workers’ compensation because they failed to notify their employer within an appropriate time frame. The longer you wait to notify your employer, the more challenging it becomes to prove that the injury happened at work and not on your own personal time.
You should be aware that the law generally requires you submit a written notice to your employer within 30 days of the injury. Although this is several weeks worth of time, you should not wait the entire duration as it may raise red flags.
3. Missing the deadline to file a DWC Form-041.
Once you have reported your injury to your employer, the next important action to take is to file a workers’ compensation claim for a work-related injury or occupational disease.
You can file with the DWC online or in person, but you only have a year after the injury to do so. The organization will gather information concerning your work situation, injury, and status. You may then follow up with the Office of Injured Employee Counsel.
Missing the deadline can impact your ability to obtain benefits or how much you can collect. Make sure to file the DWC Form-041 as soon as you report your injury to your employer.
4. Not Receiving Medical Treatment
It is essential that you seek medical treatment for your work-related injury in order to receive compensation or benefits. Failure to describe all work-related injuries or be truthful with any medical professional providing you treatment can harm your claim and ability to secure benefits.
The employer or insurance will generally appoint you to a company medical provider. Even if you choose to get a second opinion, you must attend these initial appointments to assess work-related injuries.
Additionally, if you begin to obtain workers compensation benefits, but fail to attend sessions with appointed medical providers, benefits can be terminated.
Even employers that do have Texas workers’ compensation insurance may try to opt-out of giving you these benefits, try to deny your claim, or act in an unfair manner.
Emergencies happen, whether you have health insurance or not. When a medical emergency happens, seeking medical attention becomes a necessity.
While an emergency room cannot deny you medical services if you do not have insurance or cannot cover the cost, they do retain the right to bill you for services rendered. In this situation, the hospital may issue a hospital lien.
Our experienced bad faith insurance attorneys at Millin & Millin want to shed a little light on what this process is and what rights you have.
Under Texas law, a hospital lien can be issued by a medical care provider when a victim injured by a negligent third-party receives emergency treatment but cannot pay their medical bill because:
The hospital would generally request payment of these medical bills from any compensation recovered from a negligent third-party by the victim.
In accordance with Texas Penal Code 55.002(a), if a hospital treats someone that was injured by a negligent third party and who cannot pay their bills, they are granted the ability to issue out a lien against “a cause of action or claim of an individual who receives hospital services for injuries caused by an accident that is attributed to the negligence of another person.”
Essentially, the lien is attached to a personal injury claim from the person treated by the hospital for emergency medical care within a 72-hour period after the injury occurred. To put it into context, emergency medical services are defined as services used to treat an individual’s perceived need for “immediate medical care and to prevent death or aggravation of physiological or psychological illness or injury.”
After that time period, the lien must be “perfected.” What this means is that a written notice is sent out by the lien holder (in some cases, the hospital) to the patient, the patient’s lawyer, and to the county clerk.
The lien must be paid before any payoff to the injured party takes place.
While all of this seems like a minimal risk to the victim of a personal injury, there have been instances where lien holders have placed liens on a residential property owned by the injured parties.
Typically, this happens when injured parties go to a hospital where they believe their health insurance is accepted. If care is rendered but the insurance does not fully cover the costs associated with the treatment, then a hospital lien may be placed on the home.
It may be likely that the injured party won’t find out until weeks to months later. When this occurs you may not be able to sell, refinance, or transfer your home title until you pay your debt. In situations where you suffered a serious injury or were receiving treatment for a life-threatening illness, these costs can be substantially high.
The state of Texas has a number of laws that restrict the use of liens to force individuals to pay off medical debt. While your debt must still be paid, the Texas homestead exemption rule prevents the forced sale of your home.
If you choose not to, the hospital may have four years from the date when services were rendered to sue you in an effort to collect what is owed.
With the chaos that comes after a personal injury, getting everything sorted out—both in private and in legal terms—can be an overwhelming task. But, thankfully, you do not have to do alone.
Reach out to the insurance claim attorneys that have years of experience. Reach out to Millin & Millin.
Contact us today at (956) 631-5600 to set up your free legal consultation.
