The workers’ compensation system in Texas is a state-regulated insurance program that provides pay and medical benefits to sick and injured employees. The Department of Insurance, Division on Workers’ Compensation (DWC) is charged with regulating this benefits program and resolving any disputes that arise between insurers and employers.
The workers’ compensation system in Texas offers four types of benefits:
A severe work-related illness or injury could keep an employee out of the office for months. Fortunately, workers’ compensation protects 80% of Texas’ workforce. However, in more critical cases, an ailing worker may need to consider their long-term legal and financial options, as there are unfortunate limitations to the benefits administered by the workers’ compensation system.
There is also another issue to consider: Employers are not above disputing a worker’s claim to avoid an insurance hike. If that doesn’t work, the employer will take steps to bring the employee back to work as soon as possible.
A workers’ compensation claim can increase an employer’s future premiums. If an insurance carrier notices an increase in claims from one company, it may increase that company’s premium to reduce its own losses. Also, if an employee needs to have surgery and will be out of work for a long period of time, the insurance company needs to maintain a reserve for future treatments and wages, which can also increase an employer’s premium.
An employer can minimize the impact of a claim by getting their sick or injured employee back to work as soon as they are medically able. It’s also not uncommon for an employer to manipulate or subtly intimidate an employee just to get them back into the office sooner.
One negligent insurer in the Midwest posted the following recommendation to employers: “To save the most on future premiums, bring injured employees back to work before your state’s waiting period has kicked in, if possible. If you do this, the claim will be considered medical-only, so only 30 percent of the claim costs will be included in the e-mod calculation. In addition to the cost savings, bringing employees back to work as soon as possible helps employees maintain the mental and emotional well-being, and improve their financial stability. It’s not only the smart thing to do, but also the right thing to do.”
This is patently untrue and possibly dangerous. An employee should only return to work when they are medically able and not at risk of relapsing or suffering life-changing side effects. If you have been injured in a job-related accident, it’s vital that you follow through with your workers’ compensation claim and complete any prescribed treatment programs. Returning to work early can exacerbate your existing injuries or illness and cause you to suffer additional – and potentially costly – medical complications in the future.
It’s normal for a sick or injured employee to get a little stir-crazy when they’re stuck at home. After all, it’s not a vacation, and daytime TV airs during working hours for a reason. But you shouldn’t return to work unless you have your physician’s express permission. While there are many financial, personal, and social benefits to working, no job is worth your health and well-being. In fact, if you return to work before your body is ready, you could aggravate your condition and potentially jeopardize your career.
Unfortunately, Texas is an employment-at-will state, which means that you can be laid off for any reason, so long as your workers’ compensation claim isn’t the source of the termination. Workers’ compensation can cover a percentage of your lost wages, but the DWC does not have the power, means, or authority to protect your job. Workers’ compensation laws can protect you from retaliation, but employers are willing to jump through hoops to find an unrelated reason to fire you that won’t result in civil litigation.
Let’s review a common scenario: You’re a great employee, and your boss wants you to come back to work. After pressuring you for weeks, they suddenly call and say that your services will no longer be required. Why would your employer suddenly fire you? An employer may fire a recovering employee because it will end their income loss benefits. This tactic is underhanded, cruel, and common.
There are steps you can take to protect your career. For example, you can remain in contact with your boss, send them updates about your condition, and make preparations for your return date. Being proactive is a great way of assuring your employer that you want to come back to work a.s.a.p. This tactic also reminds them of your worth as an employee. You can also benefit from the Family and Medical Leave Act (FMLA), which gives you 12 weeks of unpaid leave time to recover from an injury or illness. Your boss cannot fire you while you are on FMLA leave. If they try, you can file a complaint with the Department of Labor.
If you’ve sustained a permanent injury, illness, or disability, you may need to discuss reasonable accommodations with your company’s human resources department. Depending on your condition, you may need to take on different job duties or accept a pay cut to stay at the company. In the latter scenario, you may have grounds to apply for reduced-earning benefits, which are also available through Texas’ workers’ compensation program.
Contact the workers’ compensation attorneys at Daspit Law Firm if you’re preparing to file a clam or need to pursue an appeal. We can help you get the coverage and protection you deserve.
Contact the Daspit Law Firm at (888) 273-1045 to discuss your case with a qualified legal professional.
All too often, accident victims are steamrolled by insurance companies determined to minimize or deny their claims. Don't let this happen to you. Hire us to fight for the compensation you deserve.