If you are injured or become sick at work, your employer’s workers compensation insurance carrier will pay for the costs associated with your treatment to the medical provider directly. Your treating physician can send you a copy of the bill, marked “information only,” if you request it. But your treating doctor is not allowed to send you a bill, have a collection agency contact you about any balance due, or file a lawsuit against you.

Workers Compensation Health Care Networks

Some employers use a workers’ compensation Health Care Network (HCN), which means that if you are injured, you must use a doctor within that network unless you have prior approval to seek treatment elsewhere. Others choose not to use an HCN, which means you are free to choose your own doctor.

It is important to note that some doctors do not provide medical treatment if it’s related to a workers compensation claim, be it due to personal preference or disciplinary reasons. Before you see a physician for treatment, you should check this list of Health Care Professionals who are no longer authorized to handle workers compensation cases, which is maintained by the state of Texas. Should you still choose to receive treatment from anyone on this list, you’ll be paying for it out of your own pocket.

Understanding Income and Death Benefits in Worker’s Compensation Claims

“Income benefits” refers to the replacement of a portion of the wages you’ve lost due to your work-related injury or illness.  Depending on the circumstances of your case, you may be entitled to:

  • Temporary Income Benefits (TIBs), which are available after 8 days of missed work
  • Impairment Income Benefits (IIBs), which are available if you have a permanent impairment, based on your Impairment Rating (IR)
    • Have an impairment rating of 15 % or more
    • Have not returned to work
    • Are working earning less than 80% of the prior average weekly wage
    • Are looking for work
    • Have not received a lump sum payment for injury
  • Lifetime Income Benefits (LIBs) are available if you are suffering certain conditions, including:
    • Permanent complete loss of sight in both eyes
    • Loss of both feet
    • Loss of both hands
    • Loss of one foot and one hand
    • A spinal injury that has resulted in permanent and complete paralysis of both arms, both legs, or a combination of one arm and one leg
    • Traumatic brain injury in the extreme
    • Third degree burns over 40 percent of the body, requiring grafting or
    • Third degree burns covering a majority of both hands or the face and one hand
  • Death Benefits may be paid to certain family members if someone dies due to a work-related injury or illness.

If You Have Been Injured at Work or Have Lost a Loved One

If you have been injured at work or have lost a loved one due to a work-related illness or injury, you need to speak with a worker’s compensation attorney. Workers’ compensation law is fact specific, and every situation is different. With the right legal counsel on your side, however, you can successfully claim the benefits you rightfully deserve. Contact the attorneys at David K. Wilson & Associates today at (903) 870-9050 for a free consultation.