Workers’ compensation is designed to compensate employees for accidental injuries that occur in the workplace.  However, workers’ compensation can be a very tricky path to navigate.

Bare Facts

When an employee whose employer has elected workers’ compensation insurance  (all school districts), is injured on the job, the employer or the insurance company is responsible for the cost of medical care and a percentage of lost wages due to the injury. Workers’ compensation prevents employees from having to sue the district in order to collect damages. Workers’ compensation pays benefits, regardless of fault. If you choose to collect the benefits, you have most likely forfeited your right to sue your employer for further compensation.

Eligibility

All employees are eligible if they are injured “out of and in the course of employment.” Basically, you must be injured while involved in some work-related activity (volunteers and independent contractors are not covered).

Benefits

  • Weekly compensation covers lost wages after more than 7 days off work due to the injury up to 70% of wages up to a state-mandated maximum amount;
  • Death benefits;
  • Permanent or temporary partial disability benefits; and
  • Medical services deemed reasonable and necessary and related to the on the job injury, including surgery, prescriptions, physical therapy, etc.

Reporting an injury

Notify your immediate supervisor of your injury within 30 days of the injury or within 30 days of the date your injury first becomes apparent.  The next step would be for your supervisor to have you complete an injury report. In order to receive benefits you must file a claim form called a DWC041 within 1 year of injury or realization of injury. If you miss a day or more as a result of the injury, the district must report it to the Workers’ Compensation Commission. The district must provide you with information about the services, procedures, rights, and responsibilities under the Texas Workers’ Compensation Commission.

What about doctors?

Injured employees usually select a treating doctor to provide treatment from an approved list.   If you go to a doctor not on the list, worker’s compensation may not pay for your treatment.

What do I do when benefits are refused?

The Office of Injured Employee Counsel (OIEC) has an ombudsman program that will assist you by offering information and representation throughout the dispute process if you are not represented by an attorney. OIEC can be contacted at 1-866-EZE-OIEC (1-866-393-6432) and also online at www.oiec.state.tx.us.   **The information provided is of a general nature and is not to be substituted for the advice of a licensed professional.