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I've been hurt at work, and I
have some questions....
Do I get paid while I'm off work?
If you were injured at work after January 1,
1991, while you were doing something in the
course and scope of your job, you may be
entitled to workers' compensation benefits,
including payments of money.
How long do I have to be off work before I
get paid?
When your injury causes you to be off work at
least seven days, then beginning on the eighth
day, you have a right to receive Temporary
Income Benefits weekly while you are disabled.
How much will I be paid each week?
That depends on how much you were earning
before you were hurt. As a rule, your weekly
Temporary Income Benefits will be 70% of your
weekly earnings before you were hurt. If you
were earning less than $8.50 per hour at the
time you were hurt, the weekly benefit will be
75% of what you were earning before you were
hurt. If you are still able to work but are
not earning as much as before you were hurt,
your benefit will be 70% or 75% of the
difference.
Is that 70% of my take-home pay?
No, the benefits are based on all your
earnings, and that includes not only money,
but also things like meals, car expenses,
travel expenses, health and life insurance
payments and uniforms.
How long will I be paid?
You should receive these payments as long as
you are off work because of your injury, until
the doctors treating you decide you have
medically recovered as much as can be
expected, or for 104 weeks from the date you
began missing work, whichever comes first.
What about my medical bills?
The workers' compensation insurance company
should pay all reasonable and necessary
charges for medical care.
Do I have to see the doctor my boss or the
insurance company wants me to see?
No, you have a right to choose your own
doctor, and neither your boss nor the
insurance company can require you to see their
doctor unless the Texas Workers' Compensation
Commission agrees.
My boss says that I can't get workers'
compensation because it was my fault that I
got hurt. Is he right?
No, it doesn't make any difference whose fault
it was. In most cases, unless you were
intoxicated when you were hurt, hurt yourself
on purpose or while you were horsing around,
or were hurt by someone who was mad at you for
personal reasons, you are entitled to weekly
payments and medical benefits.
They say I can't get workers' compensation
because I'm an illegal alien. Right?
They are wrong. Aliens are entitled to
benefits the same as anyone else, and it
doesn't make any difference whether they are
illegal aliens or legal resident aliens.
It was my employer's fault I got hurt.
Can't I sue him?
No, if your employer had a valid workers'
compensation insurance policy when you were
hurt, you can't sue him. The only way to get
payment is to accept the benefits of the
workers' compensation insurance policy.
I don't think my employer has workers'
compensation insurance. Does he still have to
pay me while I'm off work?
If your employer does not have workers'
compensation insurance, the law doesn't
require him to pay you anything. If you can
show it was your employer's fault that you
were hurt though, you can file a lawsuit
against him to recover your lost wages, your
medical expenses, and money for the pain and
suffering caused by your injury.
What if I'm not able to go back to work
when my doctor says I've recovered as much as
I'm going to recover? Will I still get weekly
checks?
That depends. If your doctor does not say that
you have some impairment, you can't get any
more weekly payments. If he gives you a
percentage of impairment, you can get three
weeks of payments for each percentage of
impairment. For example, if the doctor says
you have a 10% impairment, you multiply this
impairment by three and may be entitled to
receive thirty more weeks of payments. These
payments are called Impairment Income
Benefits.
Can I get any payments after that?
You may, but only if your doctor says your
impairment is 15% or more. If it is less than
15%, you aren't entitled to any more payments
even if you can't go back to work or can't
find work because of your injury. If your
impairment is more than 15%, after you have
received forty-five weeks of payments, if you
still can't work or can't find work it may be
possible for you to get additional payments
called Supplemental Income Benefits. To get
those, you have to send in reports to the
Texas Workers' Compensation Commission. They
will help you with the reports. If you don't
send in the reports, the insurance company may
not have to pay you, even if you are otherwise
entitled to payments.
What if I can't ever go back to work? Will
I be paid for the rest of my life?
No, it is only possible to receive payments
for 401 weeks from the date you were injured,
with very few exceptions.
If my doctor gives me an impairment rating,
do I have to take the payments weekly, or can
they pay me all at once?
Yes, you can settle the Impairment Income
Benefits in a lump sum. Even though you can,
you should not take a lump sum settlement
because if you do you will give up your right
to ever get any future income benefits.
The insurance company may tell you that
they will "commute" your benefits.
Do not let the insurance company
"commute" any benefits.
"Commute" means the same thing as a
lump sum settlement.
What do I have to do to get my compensation
benefits?
First, unless your employer has actual
knowledge of your injury, you have to notify
your employer that you were hurt. You can do
this by notifying your employer or supervisor,
and it is recommended you do it in writing.
You have to give this notice within thirty
days of the time you were hurt. If you do not
notify your employer within thirty days of the
date you were hurt, you may not be able to
receive any benefits.
Second, you have to file a claim with the
Texas Workers' Compensation Commission. There
is a special form that must be filled out and
filed, and the Commission will give you the
form. If you do not file your claim within one
year from the day you were hurt you may not be
able to receive any benefits. The address of
the Texas Workers' Compensation Commission in
Dallas is 6300 Forest Park, Suite 900, Dallas,
Texas 75235. The telephone number is (214)
350-9299.
What if I have some questions after I file
my claim?
The Texas Workers' Compensation Commission has
a person called an Ombudsman at each of its
offices to answer questions and to help you
with your claim. You can visit or call the
Commission office nearest you and ask to talk
with this person.
What if the insurance company is not being
fair with me?
Insurance companies are required by law to
deal with you fairly and in good faith. If
they do not, you can sue them directly, and
that claim is separate from your compensation
claim. Whether your treatment by the insurance
company is fair is something you should
discuss with a lawyer. If you think you are
not being treated fairly, please call our
office and we will talk about it with you.
YOU MAY BE ENTITLED TO OTHER BENEFITS!
If you were hurt because
another person was careless or negligent and
that person was not a co-worker, it may be
possible for you to receive additional
benefits from that person or his/her employer.
If your injury was caused by machinery or some
sort of product that was dangerous because of
the way it was made or designed, it may be
possible for you to receive benefits from the
company that made the machinery or the
product. We will be glad to discuss this with
you, and to investigate further to see if
additional benefits may be available to you.
We have made every effort to
provide correct information in this article.
It is impossible for a short paper such as
this to provide complete information regarding
a complex law such as workers' compensation.
If you have additional questions, you should
contact your attorney or the Texas Workers'
Compensation Commission.
The statements here are
general in nature. The facts in a given case
may alter their application or involve other
laws not referred to here.
For further information
on this topic please contact the law firm
of Kraft &
Associates at 2777 Stemmons
Freeway, Suite 1300, Dallas, Texas 75207.
Our telephone number is (214) 999-9999.
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