Workers’ compensation in Texas serves to reimburse injured employees for their medical bills and lost wages so they can focus on recovery without financial strain. Workers’ compensation favors the employee – receiving benefits does not require proving anyone’s fault for the injury or illness. It is also not a requirement for employees to stop working while on workers’ compensation benefits. In fact, doing so without notifying the Department of Insurance could hurt your claim.
Partial Disability Benefits
Workers’ compensation in Texas can offer benefits for temporary or permanent partial disability, as well as temporary or permanent total disability. Total disability means the employee cannot return to work in any capacity, while partial disability means the employee can still fulfill the obligations of a job, even if it is not the same job the worker had before the accident at work. Most employers can offer modified, light-duty or alternative positions that injured workers can perform during recovery.
If an injured worker returns to a modified position, he or she may be eligible for two-thirds of the difference between what he or she was making before the injury and what the worker is making now. These partial disability benefits may continue until the employee heals and can return to his or her previous job, or they may last for life if the partial disability is permanent. If the injured worker cannot return to the same company, workers’ compensation insurance will pay to train the employee in another occupation.
Workers’ compensation insurance pays for vocational training, counseling, and education to prepare an injured worker for a different job or industry. If the workplace accident caused a permanent disability that prevents the individual from returning to work in any capacity, that worker could receive total disability benefits for life. While receiving workers’ compensation, it is the employee’s responsibility to update the Department of Insurance on any medical changes that may alter the individual’s work status.
Avoiding Workers’ Compensation Insurance Fraud
Workers’ compensation insurance fraud is a scheme in which a worker lies or withholds information during the application process to take advantage of the no-fault system. Employees filing for workers’ compensation must be honest about the extent of their injuries and disabilities, along with medical records supporting their claims. If a worker has the ability to return to work (even in a limited capacity) but claims permanent total disability, he or she is committing insurance fraud.
If you can go back to work, you have a legal obligation either to return to your job or change your workers’ compensation filing status, if you filed for temporary or permanent disability. The day your doctor clears you to return to work is the date on which you must notify the insurance company of a change in your medical status. While you do not have to return to work, you cannot continue receiving permanent total disability benefits if you have the ability to work. However, you may still qualify for partial disability benefits.
Seek Help for Complicated Situations
Navigating workers’ compensation benefits as someone who can return to work can be difficult. If you had two jobs, for example, one employer may have to cover your lost income from both positions. You may not be able to return to work for a second job, however, if you have not returned to the first.
Some employers in Texas do not lawfully need to carry workers’ compensation insurance. This could leave you wondering how to recover lost wages while you heal. Work with a Houston workers’ compensation attorney for assistance with your specific claim. Returning to work may be something you want to do as you heal, but you must do so within the guidelines of Texas’ workers’ compensation system.