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Almost 80% of workers in the country are covered under the workers compensation insurance scheme. Those who are not covered under this insurance scheme are covered under different schemes, depending on their industry. The workers compensation insurance scheme provides guaranteed benefits to workers in high-risk industries and protects employers from lawsuits. To enjoy full coverage, employees must be signed-up by their employer. They must also give up their right to sue the employer in case of a work-related injury. This means that both the worker and employer have rights, duties and benefits they derive from the scheme.
How it Works
Every state has its own set of rules and guidelines governing the workers compensation insurance scheme in their state. Texas is no different. Companies with eligible workers are required to pay premiums to have all their workers covered. It is an offense for an employer to refuse or fail to properly-sign up their employers or or pay premiums to have their employees covered.
When a worker gets injured at the workplace, while going to work or leaving work for home, they are required to formally-inform their employer about the injury within 30 days. The employer will then file a claim with the Texas Workers Compensation Commissioner. The claim must clearly indicate the injuries suffered, how the incident occurred, where the worker received treatment and so on.
Texas Workers Compensation Benefits
There are three main categories of benefits workers can expect when they are injured at the workplace. These are:
– Income replacement/supplementation benefits
– Medical benefits
– Death and burial benefits
After getting injured, workers need to seek treatment at a facility that has been approved by their employer. The cost of medical treatment for all the injuries related to the incident will be covered by the workers’ compensation insurance scheme. This means that workers can rest easy and recover knowing that their medical bills will be paid off by the workers compensation insurance. Read on to learn more about these benefits in detail.
1. Medical Benefits
As noted above, your insurance provider will pay medical benefits to cover all essential medical procedures and treatment related to the injuries sustained at the workplace or illnesses developed at work. However, any other illnesses will not be paid for by your insurer. For instance, if you suffered head damage and had to undergo an operation that revealed a tumor, the cost of removing the tumor will not be covered by the workers compensation insurance.
2. Temporary Income Benefits
This is commonly referred to as TIBs. If you are forced to stay out of work fully or you return to work, but you are not able to make as much money as you used to for more than 7 days, you will get temporary income benefits.
TIBs is paid at the rate of 70% of the difference between what you used to make and what you are able to make after the injury. For instance, if you used to earn $700 a week before the injury and you are now only able to make $400, you will be paid $210 as TIBs.
3. Impairment Income Benefits
If you have been impaired due to a work-related illness or injury, you will receive impairment income benefits. After receiving treatment, your doctor will assign you an impairment rating or IR. For each percentage of impairment you receive, you will get three weeks of impairment income benefits. They are paid at the rate of 70% of average weekly wage. If you are 20% impaired and you used to earn $700 weekly, you will receive 60 weeks of IIBs, which will total $29,400.
More info available at arawc.org.
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