Injured Workers & Workers’ Compensation Issues in Texas

Michael S. Callahan | | Work Injuries

Some of Texas’ largest employers do not carry state regulated workers’ compensation coverage, leaving employees to face financial ruin if hurt on the job.

Workers’ Compensation benefits – medical expenses and lost wages – can be vitally important to an injured worker. The shock is some of Texas’ large employers do not carry state regulated workers’ compensation coverage, leaving employees to face financial ruin if hurt on the job.

Known as non-subscriber companies, many Texas employers have chosen to opt out of the state workers’ compensation program. These companies sometimes have a separate insurance policy that could pay for medical expenses and lost wages, but the way insurance companies draft their contracts often catches injured employees in a game of “gotcha”.

Your Accident & Injury Don’t Meet The Proper Definitions For Coverage

That’s what happened to Andrew Ellis a few years ago. He fell while unloading PVC pipe at a hardware store near San Antonio for his employer, Interstate Distributors. The Houston Press reports that his torn knee meniscus felt as though someone were pounding his knee with a hammer.

When providing a statement for Interstate’s private insurance company Providence, Ellis said his knee “gave out”, having only a layman’s grasp of how to describe the accident. That choice of words gave the Providence the green light to deny coverage, saying his description did not “meet the definition of an accident, nor does it meet the definition of an injury.”

The denial of benefits for Ellis’ alleged non-accident and non-injury was a cascading series of circumstances toward impoverishment.

When he didn’t show up for work because he couldn’t walk, he was fired. (When he called HR, they informed him he had quit.) No longer able to afford the $600-a-month rent at his uncle’s apartment in Waco, Ellis ultimately moved into a storage room at his church in southeast Houston in which the folding chairs were kept. At night, he slept on the couch in the pastor’s office. During the day, he limped. “It hurt to look at,” says his pastor, Rickey King.

Texas Stands Alone in Not Requiring Coverage

Texas is one of the few states that allows companies to opt out of the state regulated workers’ compensation plan. An estimated 470,000 workers have no insurance coverage should they get hurt, and another 1.4 million are covered by private plans their employers carry, known as non-subscriber plans.

These policies often have stringent terms which the hurt employee must follow, such as a limited time period in which to report an injury. Some private non-subscriber insurance plans require that an insurance company representative must accompany the injured employee to the doctor. And many of the private plans pay benefits for a shorter period of time compared to state plans.

Company Sued Widow of Worker Killed

The Texas Tribune reports, however, that victims and families face a labyrinth of rules and red tape to claim benefits, or, as this widowed wife and mother found out when her husband was killed, carriers will dispute whether the employee was even acting in the scope of his work.

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Attorneys Experienced in Non-Subscriber workplace injury cases

If a workplace injury at a non-subscriber company has impacted you or a loved one, don’t try to fight the battle of red tape and insurance company denial tactics alone. Injured workers and their families are rarely treated fairly when they try to make a claim on their own against an insurance company. And if the workplace injury resulted from the negligence of the non-subscriber employer or because of the negligence of some other person or company, then a claim for negligence and a lawsuit may be filed seeking money damages for medical expenses, lost wages, impairment, and other damages.

The lawyers at The Callahan Law Firm have successfully represented injured workers and their families for over 20 years in cases involving workplace accidents including non-subscriber workplace injuries.

Contact us today for your free case evaluation.