Texas Workers’ Compensation

By Luis M. Julia

In an effort to bring our clients the most comprehensive legal services possible, Bailey & Galyen has added Texas workers’ compensation as its newest area of legal practice and expertise.  Overseeing Bailey & Galyen’s workers’ compensation department is attorney Luis M. Julia and his dedicated legal team.  Mr. Julia has represented injured Texas workers for over a decade.  He and his staff will put their more than 20 years of combined workers’ compensation experience and knowledge into handling your on-the-job injury.  Since this is our first workers’ compensation newsletter, we will begin with basic definitions and an explanation of temporary income benefits under the Texas workers’ compensation system.

Workers’ compensation laws are designed to ensure payment by employers for some part of the cost of injuries or, in some cases, of occupational diseases suffered by employees in the course of their work. Workers’ compensation legislation requires the employer to furnish a reasonably safe place to work, suitable equipment, rules and instructions when they are reasonably necessary, and reasonably competent foremen and superintendents. The employer is liable for an employee’s acts of negligence, for the employer’s own gross negligence and for extraordinary risks of the work. In most cases the employer is not liable for accidents occurring outside the place of work, or for those which have not arisen directly from employment.

State workers’ compensation statutes vary by state. The Federal Employment Compensation Act covers nonmilitary federal employees or those workers employed in some significant aspect of interstate commerce. This law also provides benefits for dependents of those workers who are killed because of work-related accidents or illnesses. Other statutes provide similar protection to employees for injuries due to employer negligence, such as railroad employees under the Federal Employment Liability Act (FELA) and seamen under the Merchant Marine Act (the Jones Act). The Longshore and Harbor Workers’ Compensation Act (LHWCA) provides workers’ compensation to specified employees of private maritime employers.

Here in Texas, workers’ compensation benefits are divided into four categories:

Income benefits — replace a portion of any wages you lose because of a work-related injury or illness.

Medical benefits — benefits that are paid for necessary medical care to treat your work-related injury or illness.

Burial benefits — benefits paid for some of the deceased employee’s funeral expenses to the person who paid the funeral expenses.

Death benefits — replaces a portion of lost family income for eligible family members of employees killed on the job.

Income Benefits:

Income benefits may not exceed the maximum weekly amount set by state law.  Temporary income benefits, impairment income benefits and lifetime income benefits are the three categories of benefits and are also subject to a minimum amount set by state law.

Average Weekly Wage:

Your income benefits are determined from the calculation of your average weekly wage (AWW).  A full-time employee is one who regularly works at least 30 hours per week.  To calculate your average weekly wage, add your earnings for the 13 weeks prior to the injury, including any overtime or other special pay and any non-pecuniary wages the employer does not continue after your injury, and divide by 13.

Temporary Income Benefits:

You may be paid temporary income benefits (TIBs) if your work-related injury or illness causes you to lose all or some of your wages for more than seven days.  If you work more than one job, you may be paid TIBs if you lose all or some of your wages from other employers.

Temporary income benefits are equal to 70 percent of the difference between your average weekly wage and the wages you are able to earn after your work-related injury.  If you earned less than $8.50 per hour before you were injured, your temporary income benefits for the first 26 weeks of payments will equal 75 percent of the difference between your average weekly wage and the wages you are able to earn after your work-related injury.

After an injury, your doctor may release you to return to work at modified duty or under restrictions.  You may still be entitled to TIBs if your employer provides the modified duty at reduced wages.

You become eligible for TIBs after you miss eight days from work.  Remember, disability refers to your inability to earn an income, not to a physical handicap.  You have a disability if your work-related injury or illness causes you to lose all or some of your usual pay.  Benefits are not paid for the first week of lost wages unless disability lasts for two weeks or more.

TIBs will end at the earlier of: (1) the date you reach maximum medical improvement (the point that your work-related injury or illness has improved as much as it is going to improve); (2) the date you are again physically able to earn you average weekly wage, which would be the same wages you were earning prior to being injured on the job; or (3) at the end of 104 weeks from your eighth day of disability.

In our next newsletter we will continue with further explanations of workers’ compensation income benefits.  Remember, the Texas workers’ compensation system is a complicated system to maneuver.  There are many rules and regulations, deadlines and forms to deal with during the aftermath of your work injury.  Failure to adequately and timely file and respond pursuant to workers’ compensation rules and regulations may cost you and your family much needed benefits and medical care.

At Bailey & Galyen, we are now able to offer you expert legal representation for your on-the-job injury.  If you have been injured at work, now more than ever, you need the knowledge and expertise of a competent and experienced workers’ compensation attorney to secure and protect your benefits.  Call us now for all of your workers’ compensation needs.

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