What Happens If You Can’t Return to Work After an Injury?

Michael S. Callahan | | Work Injuries
what happens if i cant return to work after an injury

On-the-job injuries can result in significant medical expenses, lost wages, impairment, emotional distress and a reduced quality of life for those who are unable to return to work because of them.

Under the Texas workers’ compensation law (also known as “workers’ comp”), an injured employee may be entitled to

  • Medical benefits
  • Income benefits
  • Death benefits

The extent of the income benefits to which you are entitled in a formal workers’ compensation claim will be determined by the date of your maximum medical improvement—or the date when a doctor says you are not reasonably expected to recover from your injuries any further. Hiring attorneys who understand the nuances of the available benefits and the maximum medical improvement standard is crucial to getting you the maximum workers’ comp benefits to which you are entitled.

If you still cannot work after reaching maximum medical improvement, then you may be eligible for impairment income benefits, supplemental income benefits, or lifetime income benefits.

Workers’ Compensation in Texas: A Quick Look

The Texas Workers’ Compensation Act sets out the procedures you must follow to receive compensation benefits as a worker injured on-the-job. The Texas workers’ compensation system requires you to notify your employer of your injury promptly.

How to File a Workers’ Compensation Claim

If you’ve been injured on the job and your employer carries workers’ compensation insurance, here’s how to file a claim:

Report the Injury: Notify your employer about the injury as soon as possible and within 30 days of the incident or within 30 days of discovering that your illness or injury is work-related. Failing to report within this timeframe could result in losing your right to benefits.

Can I Sue My Employer for a Workplace Injury?

As a general rule, in the state of Texas you cannot sue your employer for negligence if the employer participates in the workers’ compensation system. However, if your employer did not subscribe to formal workers’ compensation insurance at the time of your injury, meaning it was a “non-subscriber”, then under Texas law you can make a claim and file a lawsuit against your employer for negligence

Additionally, if a third party (someone other than your employer) is at fault for your injury, you may be able to file a lawsuit against that third party. Examples of a third-party could include a contractor on a job site, a delivery truck driver, or the manufacturer, distributor or seller of a defective product.

Are Employers Required to Carry Workers’ Compensation Insurance?

In Texas, not all employers are required to carry workers’ compensation insurance. While private employers have the option to participate in the system, they are not legally obligated to do so. However, employers who do opt to carry workers’ compensation insurance must notify their employees and display a workplace poster that includes the name of their insurance carrier.

If you are unsure whether your employer is covered by workers’ compensation, you can contact the Texas Department of Insurance, Division of Workers’ Compensation at 800-372-7713 for clarification.

What If My Employer Does Not Carry Workers’ Compensation Insurance?

In Texas, some employers choose not to carry workers’ compensation insurance and may instead provide alternative occupational injury benefit plans. These plans are typically governed by the federal Employee Retirement Income Security Act (ERISA), which sets broad guidelines but allows employers considerable flexibility.

If your employer has such a plan in place, you should have received information about it when you began your employment. This information typically includes:

  1. The process for notifying the employer of an injury (usually within 24 hours),
  2. The appeals procedure (which can vary depending on the insurance carrier), and
  3. Access to medical care (which is often limited to a network of designated doctors).

Steps to Take If Your Employer Does Not Have Workers’ Compensation Coverage

If your employer in Texas does not provide workers’ compensation coverage, follow these important steps to protect your rights:

Step 1: Seek Immediate Medical Attention
Your health and safety should be your first priority. Seek medical care right away to address any injuries or illnesses. Be sure to document all injuries and medical treatments, as this will be essential should you pursue a claim for compensation later.

Step 2: Photograph Your Injuries
Take clear, detailed photographs of your injuries as soon as possible. These visual records will serve as important evidence in supporting your claim.

Step 3: Verify Your Employer’s Insurance Status
Confirm whether your employer truly lacks workers’ compensation coverage. While Texas law does not require employers to carry workers’ compensation insurance, some employers may opt to provide alternative injury benefit plans or may choose to not carry any coverage at all. You can verify your employer’s status through the Texas Department of Insurance, Division of Workers’ Compensation.

Step 4: Consider Filing a Personal Injury Lawsuit
If your employer is a non-subscriber (does not carry workers’ comp insurance), you may be eligible to file a personal injury lawsuit. Texas law allows employees to seek compensation through a civil suit for injuries sustained on the job. This can include recovery for medical expenses, lost wages, pain and suffering, and other damages.

Step 5: Consult a Skilled Texas Work Injury Attorney
Non-subscriber cases can be legally complex. It’s important to consult with an experienced work injury attorney to help you navigate the process, understand your legal options, and maximize your potential recovery.

Step 6: Report the Injury to the Texas Department of Insurance
Even if your employer does not provide workers’ compensation, it is still important to file a report with the Texas Department of Insurance, Division of Workers’ Compensation. This creates an official record of your injury and may be necessary for any legal actions you take.

If you need assistance with your claim or have questions about your rights, the attorneys at Callahan Law Firm are ready to help you through the process.

Experienced Work Injury Attorneys are Here to Help

Navigating a workplace injury claim when your employer does not provide workers’ compensation can be complicated, but you don’t have to face it alone. Whether you’re considering a personal injury lawsuit or need guidance on how to move forward, the experienced attorneys at Callahan Law Firm are here to help. We are dedicated to protecting your rights and ensuring you receive the compensation you deserve under the law.

FAQ

What should be done immediately after an injury in the workplace?

If you’re injured at work, seek immediate medical attention and report the injury to your employer as soon as possible, following company procedures. Document the injury, take photos, and keep detailed records of treatments and symptoms.

What is the employer’s responsibility when a worker is injured in Texas?

Under the Texas Labor Code, all employers—whether they carry workers’ compensation insurance or not—are required to follow specific reporting and notification procedures, including when a worker is injured in Texas.

Can I sue my employer for a work injury in Texas?

In most cases, if your employer participates in the workers’ compensation system, you cannot sue them for a work-related injury. If your employer did not have formal workers’ compensation coverage at the time of your injury, and as a result they were a “non-subscriber”, you have the right to sue the employer for negligence that caused or contributed to your injuries and damages. In addition, there may be a viable third-party claim against another party such as a contractor on the worksite, a delivery truck driver, or in relation to a defective product.

What is the 90-day rule in Texas workers’ compensation?

The ninety-day rule, as specified in Division of Workers’ Compensation Rule 130.12, stipulates that the first valid impairment rating given to an injured worker can only be disputed within ninety days of delivery of written notice through verifiable means. After ninety days, an injured worker’s first valid impairment rating will be final.