What Are Your Options When Your Employer Fails to Notify the Insurance Company? What Are the Potential Sanctions Against Your Employer?
The Texas workers’ compensation laws are somewhat different from other states. Employers in Texas are not required to subscribe to the state’s workers’ compensation program (though more than 70% do subscribe). Instead, an employer may choose to be essentially “self-insured,” thought there are significant risks to doing so.
However, if your employer subscribes to the Texas workers’ compensation system, once you’ve reported your injury (you must do so within 30 days), your employer has 8 days within which to report the injury to the workers’ compensation insurance provider. That rule applies when:
- The employer learns of any occupational disease
- The worker is absent from work for more than one day due to a job-related injury
- There has been a workplace fatality
Texas law requires that the employer complete the Division of Workers’ Compensation Employer’s First Report of Injury or Illness—form DWC-001. The form must be submitted to the insurance company with a copy to the employee.
Why Would an Employer Fail to Report an Injury to the Insurance Company?
It may seem odd that an employer would purchase a policy of workers’ compensation insurance, but fail to properly notify the insurance when a claim needs to be filed. Here are some things to remember, though:
- The employer’s premiums for the work comp insurance are based in part on claims made. If the employer can minimize the number of claims, premiums will stay low.
- The boss or supervisor may have an incentive built into his compensation plan that rewards him for maintaining an accident/injury free work environment
- The person responsible for reporting the accident or injury may not want the additional work required when a claim is filed
- The boss or supervisor may fear that the injury will reflect negatively on him or her
- Your employer may contest the seriousness of your injury or whether it was work-related—the injury should still, however, be reported to the insurance company in accordance with Texas law.
What Are the Potential Consequences of Failing to Report an Injury?
Under Texas law, an employer who neglects to file an injury or illness report without good cause can be subject to significant administrative penalties under Section 415 of the Texas Labor Code. Furthermore, the employer can lose the right to reimbursement of any voluntary benefits paid, even when there is no administrative fine or penalty.
If your employer has refused or failed to report your work-related injury, there are a few options open to you:
- You can write directly to the insurance company, notifying them of the date and circumstances of your injury, as well as your claim for work comp benefits
- You can file a claim directly with the Division of Workers’ Compensation
- With respect to payment of medical expenses, you can work directly through your health insurance provider, who may then seek reimbursement from the work comp insurer
Contact the Experienced Personal Injury Attorneys at Bailey & Galyen
At the law offices of Bailey & Galyen, we will aggressively help you pursue full and fair compensation when you have been injured in the workplace. 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.
