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Workers’ Compensation: Am I Eligible?

Posted on in Work Place Injuries

Whenever someone sustains an injury on the job, countless questions come to mind regarding the situation. Will the injured party be able to work? If not, how will he or she be able to earn an income? What benefits are available to him or her?

Unfortunately, on-the-job injuries in Texas are slightly complicated because the law does not require all businesses to carry workers' compensation insurance for employees. Some employers provide this type of coverage, but for those who don't, injured employees may have legal action available when negligence is present.

When you must file a workers' compensation claim, you must know what makes you eligible to get the benefits you deserve.

Did You Report the Injury to Your Employer?

Whether your employer has workers' compensation coverage, the first thing you should do is report the incident to a supervisor. Reporting the injury is imperative to getting the injury on record and protecting your ability to file a claim.

Many times, when insurance companies deny workers' compensation claims, one of the reasons is the injured person's failure to report the injury.

Does Your Employer Provide Workers' Compensation Insurance Coverage?

After you report the incident, you should check to see if your employer offers workers' compensation insurance. If they do, you will go through the insurance company to pursue benefits. You'll go through the workers' compensation system and file the necessary paperwork.

If your employer does not have workers' compensation insurance, you may still be able to pursue compensation through legal options. You may file a lawsuit for any negligence that may exist in the workplace that caused your injury.

Is Your Injury Covered Under Workers' Comp Benefits?

One of the most common questions people have when filing for workers' compensation is, “Will workers' compensation insurance cover my injury?”

Workers' compensation insurance does not cover all types of injuries. Filing a claim for a non-eligible work-related injury can result in a denial. Before you start the claims-filing process, be sure you know what injuries the insurance company will cover and which ones are not eligible for benefits.

Injuries eligible for workers' compensation can include:

  • Physical disabilities
  • Permanent scarring or disfigurement
  • Heart attack
  • Vision loss
  • Hearing loss
  • Neck injuries
  • Back injuries
  • Diseases (cancer or mesothelioma)
  • Repetitive stress injuries

Keep in mind that these injuries must result from someone else's actions or by accident. They cannot be injuries that are self-inflicted or because of something the injured worker did him or herself. For instance, workers' compensation insurance will not cover the following:

  • Injuries the worker sustains after starting a fight in the workplace
  • Injuries the worker sustains because of a natural occurrence
  • Injuries the worker sustains because of self-harm
  • Injuries the worker sustains when engaged in horseplay
  • Injuries the worker sustains while intoxicated on the job
  • Injuries the worker sustains in an accident unrelated to his or her work

If you feel you are eligible for a workers' compensation claim, yet the insurance company denies you, get legal help. There may be legal remedies to help you get the benefits you need. A lawyer can help you file the initial claim, put together the necessary paperwork, and protect your rights if the insurance company denies your claim.

At The Edwards Law Firm, we're committed to the rights of our clients. We know that workers' compensation cases can be challenging, and many employees are unaware of their rights. Those who don't understand the process are at risk of having a valid claim denied.

Our Corpus Christi workers' compensation attorneys can work with you to help you pursue the benefits you need. We'll put together the claim you need to succeed and protect your rights if the insurance company denies your claim.

Call our firm today at 361-698-7600. We offer free consultations to help you understand your rights without financial obligations, allowing you to make the right decisions moving forward.

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