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  • Christopher Le

What You Need To Know About The Texas Workers Compensation System

Getting injured at work can be life changing for many. Many injured workers do not know what rights they are entitled to. In the event you sustain a work related injury, it’s important to understand how the process works so you do not lose out on your claim for workers compensation benefits. Below are some facts to know and what you must do following an injury at work.

Filling Out The First Report Of Injury

It’s important to report your injury immediately following a work related accident. Documenting the accident in writing can be the difference between an accepted case or a denied case. Your injury report should include:

  • Time and date of the work accident

  • Witnesses to the accident

  • Location of the accident

  • What body part was injured

Why Your Claim Was Denied ?

Just because you received a denial

does not mean that denial is final. You have a right to file an appeal. In fact, more claims are denied than accepted. When you appeal a denial, it’s important to know why your claim was denied so you don’t make the same mistake. Here are some common reasons why your claim was denied:

  • Missed a filing deadline

  • Insufficient information on filed paperwork

  • The employer is denying an injury occurred

  • The employer was not timely notified of the injury

  • The injured worker failed to get medical treatment in a timely manner

  • Lack of evidence to support the injury occurred in the workplace

  • Claim was filed only after the injured worker was terminated or laid off

  • No witnesses to the injury

  • Inconsistencies were found when comparing first injury report to the medical records

  • The injured worker was found to be under the influence of drugs or alcohol

  • The illness or injury is not covered under workers’ compensation or believed to be serious enough for coverage

Why You Must Seek Medical Care With The Right Doctor

Many injured workers would prefer to seek medical treatment with their own primary care physician, however you may be limited to who you can treat with. Unless your primary care physician is familiar with the workers compensation system, you will likely be required to go to a doctor listed under your employer's workers’ compensation plan. If your own primary care doctor is not listed in the plan, your doctor most likely it will not be covered.

Many doctors may be willing to handle a workers compensation claim, but without experience, this can affect your claim. That’s why it’s important to find a doctor that is seasoned with workers compensation claims as they will know how to meet reporting deadlines and properly fill out forms. Any missed deadlines or missing information could impact your case.

Who Handles My Claim After I’ve Been Hurt?

Normally, the insurance company adjuster will reach out to you within 48 hours after they have been notified of your claim filing. It is important to be careful with your words when you speak to the adjuster. Adjusters are trained to look for ways to deny your case so it might be best to speak with an attorney, before you talk with your claims adjuster.

I Was Fired After Filing My Workers Compensation Claim. What Do I Do Now?

The employer is not restricted from

firing an injured worker after a work related accident, but if they do, they may suffer the consequences of their actions. In the event that occurs, the injured worker may be able to file a wrongful termination lawsuit against the employer. It’s important to document the reasons the employer terminated you and to save all communications such as emails, voicemails or text messages between you and your employer as that may be crucial evidence in your wrongful termination claim.

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