What Are the Advantages and Disadvantages of Filing a Work Comp Claim?
You’ve been hurt on the job and your injuries are such that you can’t perform the duties required. In most states, you’ll automatically have the right to file a workers’ compensation claim. Texas is a little different, as employers are allowed to opt out of participation in the state’s workers’ compensation program. As a practical matter, though, most Texas employers subscribe to workers’ compensation—a 2019 study showed a 76% subscription rate. What is workers’ compensation and how does it differ from any other personal injury lawsuit? What are the advantages and disadvantages of the system, both to workers and employers?
What Is Workers’ Compensation?
Technically, workers’ compensation is a type of business insurance that allows employers to manage the risk of injury or illness to workers. Those employers who participate in the program purchase workers’ compensation insurance, with the premiums based on a variety of factors, including the type of work performed by employee and the frequency of injury claims filed for past injuries. Typically, when you have been hurt at work and your employer subscribes to the workers’ compensation system, you’ll file a claim with your employer, who will submit it to the work comp insurance provider. If your claim is approved and you have no dispute, the state doesn’t need to get involved. If, however, the insurer or your employer either deny the claim, or attempt to pay less than you deserve, there are governmental channels for appealing and securing benefits.
What Are the Benefits of Workers’ Compensation for Employees?
The primary benefit to workers is the timely availability of benefits after an injury or illness. With a personal injury lawsuit in the civil courts, it may be months, but it’s typically years, before your case even makes it to trial. There’s also the possibility of appeals, which can also take years. Accordingly, it can be a long time before you receive any payment for your losses. With a workers’ compensation claim, however, you’ll typically file your claim within 30 days and the insurer must respond within 30 days. If your claim is initially approved, you’ll usually start receiving benefits within a couple weeks.
Another benefit for workers—you don’t have to prove that your employer was negligent. Most personal injury claims are based on a legal theory of negligence—you have to prove that the defendant acted unreasonably, causing your injuries. With a workers’ compensation claim, there are only two requirements—you must show that you were injured and that you were in the course of your employment when you suffered the injury. It’s essentially a strict liability system.
What Are the Disadvantages of Workers’ Compensation for Employees?
The biggest disadvantage for workers is that work comp benefits are limited, based on your average weekly wage for a specified period of time. You are also entitled to payment of or reimbursement for all reasonable and necessary medical expenses arising out of your injuries. However, workers’ compensation won’t cover pain and suffering, loss of enjoyment of life or loss of companionship or consortium, common claims in a personal injury lawsuit.
What Are the Benefits and Detriments for Employers?
The biggest benefit to employers is the cap on benefits. An employer doesn’t have to worry that a sympathetic jury will return a large damage award. All benefits are based on actual losses. Additionally, the employer can manage the risk of injury through insurance.
Conversely, if an employer has a high accident rate, work comp insurance rates can escalate.
Contact the Results-Oriented Work Comp Attorneys at Bailey & Galyen
At the law offices of Bailey & Galyen, we have extensive experience protecting the rights of injured workers, helping them successfully navigate the Texas workers’ compensation system. We will help you file your claim and will be your voice in all legal proceedings, including any dealings with workers’ compensation insurance companies, so we can maximize the amount recovered for your losses. Contact us by e-mail or 844-402-2992 call our offices at one of the convenient locations listed below. Our phones are answered 24 hours a day, seven days a week.
