One moment, you are doing your job on a Dallas construction site, in a warehouse, or behind the wheel. The next moment, a fall, a heavy piece of equipment, or a careless co-worker leaves you on the ground and in pain. While you are trying to figure out how to get medical care and keep up with bills, your employer, its insurance carrier, and sometimes even a workers’ compensation adjuster may already be working to limit what they pay.
You should not have to fight that battle alone. That is when you call Jim Adler & Associates, led by The Texas Hammer®, Jim Adler. Our Dallas work injury lawyers step in to protect your rights, deal with the insurance companies, and push for every dollar the law allows.
Our client was a young employee for a furniture delivery company. One ordinary morning, he climbed into the company van expecting a full day of work and a safe trip home. He trusted the co-worker behind the wheel to pay attention to the road.
Instead, the driver chose to watch a video on his phone while driving the van down the highway. As his eyes left the traffic ahead, the vehicle drifted out of its lane, left the roadway, and slammed into a highway sign at high speed. The impact tore the van apart and left our client unconscious and fighting for his life.
He spent weeks in the hospital, including two weeks in a coma. When he finally woke up, he learned that his right arm had been amputated, his lung had been punctured, and he had suffered a traumatic brain injury that would affect him for the rest of his life. Simple tasks he once took for granted suddenly required help and long-term rehabilitation.
Jim Adler & Associates investigated the crash, uncovered the driver’s cell phone use, and built a case showing how this preventable distraction destroyed a young worker’s future. We worked with medical experts and life-care planners to explain the full cost of his injuries, from lost earning capacity to ongoing treatment and care.
Result: $5,500,000 recovery for our injured client.
This compensation helped cover extensive medical bills and future care needs, replace lost wages, and provide financial security as he adjusts to life with permanent injuries.
Past results do not guarantee future outcomes. Every case is different, and the value of your claim will depend on the specific facts of your work injury case.
A workplace accident can upend your life in just a few seconds. One moment, you are focused on your shift, running a machine in a warehouse, tying rebar on a construction site, or making deliveries across the Dallas-Fort Worth area, and next, you are on the ground in pain. Suddenly, there are ER visits, follow-up appointments, and medical bills stacking up while you wonder how your family will get by without your paycheck. Too often, these injuries trace back to things that should have been prevented, like worn-out equipment, safety rules that were never followed, or coworkers who were rushing and not paying attention.
Texas ranks among the most dangerous states for workers, and the Bureau of Labor Statistics reports that more than 500 workplace fatalities occur in Texas each year, with thousands more workers suffering serious injuries that leave them unable to return to their jobs.[1] Dallas and the surrounding North Texas area account for a significant share of these incidents because of the area’s concentration of construction projects, distribution centers, manufacturing facilities, and commercial transportation routes. When your employer or their insurance company starts pushing back on your claim, you need a Dallas work injury lawyer who understands how to fight for the benefits you deserve.
At Jim Adler & Associates, we have spent more than 50 years standing up for injured workers across Texas, and The Texas Hammer® is ready to fight for you and your family. A knowledgeable work injury lawyer Dallas families trust can protect your rights, guide you through the complex claims process, and work to secure the full benefits you need to recover and provide for your loved ones.
References
[1] Bureau of Labor Statistics, Census of Fatal Occupational Injuries Summary. https://www.bls.gov/news.release/cfoi.nr0.htm
[2] Texas Department of Insurance, Division of Workers’ Compensation, Your Right to Benefits. https://www.legis.state.tx.us/tlodocs/83R/handouts/C0402013021910301/a102758c-67ff-4bbf-93c8-bb8d52e9a3bc.PDF
[4] Texas Department of Insurance, Division of Workers’ Compensation, Employer Requirements. https://www.tdi.texas.gov/wc/employer/index.html
[6] Texas Labor Code, Chapter 451, Discrimination Against Workers’ Compensation Claimants. https://statutes.capitol.texas.gov/Docs/LA/htm/LA.451.htm
[9] Texas Department of Insurance, Division of Workers’ Compensation, Benefits: Income and Medical. https://www.tdi.texas.gov/wc/employee/benefits.html
[10] Texas Department of Insurance, Division of Workers’ Compensation, Death and Burial Benefits. https://www.tdi.texas.gov/wc/employee/deathben.html
[12] Office of Injured Employee Counsel, Important Deadlines. https://www.oiec.texas.gov/employee/importantdeadlines.html
[13] Texas Department of Insurance, Division of Workers’ Compensation, Benefit Review Conference. https://www.tdi.texas.gov/wc/idr/brc.html
[14] Texas Department of Insurance, Division of Workers’ Compensation, Contested Case Hearing. https://www.tdi.texas.gov/wc/idr/cch.html
[15] Texas Labor Code, Chapter 406, Workers’ Compensation Insurance Coverage. https://statutes.capitol.texas.gov/Docs/LA/htm/LA.406.htm
After a workplace injury, you need more than just someone who will file paperwork and wait for the insurance company to respond. You need a team that will move quickly, investigate thoroughly, and fight aggressively to protect your rights at every stage of the claims process. At Jim Adler & Associates, our Dallas work injury attorney team brings decades of experience to every case, and we know the tactics employers and insurance companies use to deny valid claims or reduce the benefits injured workers deserve.
You should never have to worry about paying legal fees out of pocket while you are recovering from a serious injury and unable to work. Jim Adler & Associates handles work injury cases on a contingency fee basis, which means you pay no attorney fees unless we recover compensation for you.* Our contingency fee is 35 percent of any recovery obtained without filing a lawsuit and 40 percent if we file a lawsuit on your behalf.* Your initial consultation is completely free, and we will explain exactly how our fees work before you make any decisions about moving forward with your case.*
When you hire Jim Adler & Associates, you work directly with a dedicated Dallas work injury lawyer and a legal team that keeps you informed every step of the way. You will not be left wondering what is happening with your claim. We understand that a workplace injury affects your entire family, and we treat you like a person rather than just another case number.
Our team is available to answer your questions, explain your options, and provide the guidance you need during one of the most stressful times in your life. We also help coordinate medical care through our network of trusted providers who can treat you now and defer payment until your case resolves under a Letter of Protection arrangement.
Evidence in workplace injury cases can disappear quickly if no one acts to protect it. Surveillance footage is recorded over quickly, incident reports can be altered or lost, and witnesses transfer to other job sites or leave the company entirely. Insurance companies and employers know that weak evidence makes claims easier to deny, and some will deliberately delay the process, hoping that critical proof will vanish before you can use it.
Jim Adler & Associates sends preservation letters immediately after accepting your case, demanding that your employer and their insurance carrier maintain all relevant records, footage, and documentation. Our team works to photograph accident scenes, identify witnesses while their memories are still fresh, and obtain equipment inspection records that may prove safety violations contributed to your injury.
Insurance companies deny valid workers’ compensation claims every day because they know that many injured workers will simply give up rather than fight back. When your claim is denied or your benefits are cut off too soon, you have the right to appeal through the Texas Division of Workers’ Compensation dispute resolution process.[14] This process begins with a Benefit Review Conference and may proceed to a Contested Case Hearing before an administrative law judge if the dispute cannot be resolved.
A work injury lawyer Dallas workers trust can guide you through each stage of the appeals process, ensuring that your case is presented effectively and that you do not miss critical deadlines or make procedural mistakes that could cost you benefits. Jim Adler & Associates has extensive experience fighting denied claims and knows how to build cases that insurance companies cannot easily dismiss.
At Jim Adler & Associates, we do not accept lowball settlement offers just to close cases quickly. We understand that your workplace injury may affect your ability to work and provide for your family for months or even years to come, and we fight for compensation that reflects the true impact of what happened to you. The Texas Hammer® has built a reputation for taking on insurance companies and winning, which gives us leverage at the negotiating table.
When negotiations fail to produce a fair result, we are fully prepared to take your case to a hearing or trial. Insurance companies know that our firm has the resources and experience to see cases through to the end, and this knowledge often motivates them to offer reasonable settlements rather than face us in a contested proceeding.
Workplace injuries occur throughout the Dallas-Fort Worth metroplex, from busy construction sites in downtown Dallas to sprawling distribution centers in the surrounding suburbs. No matter where in North Texas your injury occurred, Jim Adler & Associates is ready to help you navigate the workers’ compensation system and fight for the benefits you deserve.
Our Dallas work injury attorney team represents injured workers throughout the Dallas-Fort Worth metroplex, including:
We also serve clients in the following North Texas counties:
Whether you were hurt at a job site in downtown Dallas or a facility in the outer suburbs, a work injury lawyer Dallas families count on is just a phone call away. Jim Adler & Associates offers free consultations to injured workers throughout the region, and we can meet with you at a time and location that works for your situation.*
Navigating the workers’ compensation system in Texas can be confusing, especially when you are already dealing with painful injuries and financial stress. Texas is unique among states because it does not require private employers to carry workers’ compensation insurance, creating a patchwork of coverage options that can leave injured workers unsure of their rights. Understanding how the system works is the first step toward protecting yourself and your family after a workplace injury.
Workers’ compensation is a state-regulated insurance program that provides medical care and replaces a portion of lost wages for employees who suffer work-related injuries or illnesses. The system operates on a no-fault basis, which means you do not have to prove that your employer or anyone else was negligent in order to receive benefits. If you were hurt while performing your job duties, you are generally entitled to coverage regardless of who caused the accident.
In exchange for guaranteed benefits, employees who are covered by workers’ compensation typically give up the right to sue their employer for negligence related to the workplace injury. This trade-off provides certainty for both sides, as injured workers receive benefits without having to prove fault while employers avoid potentially larger jury verdicts. However, the benefits available through workers’ compensation are limited compared to what you might recover in a personal injury lawsuit, which is why understanding your coverage options matters so much.
Many large companies with operations in the Dallas area have opted out of the Texas workers’ compensation system. According to the Texas Department of Insurance, Texas is the only state that gives private-sector employers the choice of whether to provide workers’ compensation coverage, and approximately 25 percent of Texas employers are non-subscribers.[4] If you work for a non-subscriber and suffer a workplace injury, you will not have access to traditional workers’ compensation benefits, but you may have options that could actually result in greater compensation than what the workers’ compensation system provides.
When you sue a non-subscriber employer for negligence, you can seek damages that go far beyond the limited wage replacement and medical benefits available through workers’ compensation. Under Chapter 41 of the Texas Civil Practice and Remedies Code, injured employees of non-subscribers may recover compensation for pain and suffering, mental anguish, disfigurement, and loss of enjoyment of life in addition to their economic losses.[5]
Non-subscriber employers also lose important legal defenses, meaning they cannot argue that you contributed to your own injury or assumed the risk of harm by accepting the job. A Dallas, Texas workers’ compensation attorney can help you determine whether your employer is a subscriber or non-subscriber and explain your options for seeking compensation.
Many large companies with operations in the Dallas area have opted out of the Texas workers’ compensation system. According to the Texas Department of Insurance, Texas is the only state that gives private-sector employers the choice of whether to provide workers’ compensation coverage, and approximately 25 percent of Texas employers are non-subscribers.[4] If you work for a non-subscriber and suffer a workplace injury, you will not have access to traditional workers’ compensation benefits, but you may have options that could actually result in greater compensation than what the workers’ compensation system provides.
When you sue a non-subscriber employer for negligence, you can seek damages that go far beyond the limited wage replacement and medical benefits available through workers’ compensation. Under Chapter 41 of the Texas Civil Practice and Remedies Code, injured employees of non-subscribers may recover compensation for pain and suffering, mental anguish, disfigurement, and loss of enjoyment of life in addition to their economic losses.[5]
Non-subscriber employers also lose important legal defenses, meaning they cannot argue that you contributed to your own injury or assumed the risk of harm by accepting the job. A Dallas, Texas workers’ compensation attorney can help you determine whether your employer is a subscriber or non-subscriber and explain your options for seeking compensation.
Our Dallas work injury lawyers help Texans get the financial compensation they deserve. We only get paid if you win.* And we fight to win.
Workplace injuries can happen in virtually any setting, from high-rise construction sites in downtown Dallas to climate-controlled office buildings in the suburbs. Texas consistently leads the nation in workplace fatalities, and the Texas Department of Insurance reports that more than 560 fatal occupational injuries occur in Texas in a typical year.[7] According to the Texas Workforce Commission, neither federal law nor Texas law requires employers to provide rest breaks during the workday, and Texas is the only state that allows private employers to opt out of the workers’ compensation system entirely.[8] These policy gaps create a more dangerous work environment for employees across the Dallas-Fort Worth area.
Construction crews work around open edges, tall scaffolds, and live wiring, so a missed step or loose connection can mean a fall, an electrical shock, or a blow from swinging equipment or dropped materials. In warehouses, workers spend long days around forklifts and pallet jacks, lifting and moving boxes until one bad turn, a careless driver, or a poorly stacked load leaves someone pinned or badly hurt. Even people in office jobs are exposed to risk, from slipping on wet floors in common areas to neck, back, and wrist problems caused by cramped workstations and repetitive typing. Across Texas, thousands of employees in every setting deal with injuries that started as “just another day at work.”
The types of injuries Dallas workers suffer vary widely by industry and circumstances, but certain categories recur in workers’ compensation claims.
Repetitive stress injuries and ergonomic conditions are also compensable under Texas workers’ compensation, even though they develop gradually rather than resulting from a single accident. If your work activities caused or contributed to your condition, a work injury lawyer Dallas workers rely on can help you understand whether you qualify for benefits.
With hundreds of work injury lawsuits filed, our numbers speak for themselves.
Medical benefits cover the reasonable and necessary treatment you need to recover from your work-related injury or illness. This includes doctor visits, hospitalization, surgery, prescription medications, physical therapy, and medical equipment like crutches or wheelchairs. Your employer’s insurance carrier pays for approved treatment, but you may be required to see doctors within the carrier’s approved network rather than choosing your own physician.
If you need to change treating doctors, you must follow specific procedures through the Texas Department of Insurance, Division of Workers’ Compensation, or your employer’s network. Insurance carriers sometimes dispute whether certain treatments are medically necessary, and these disputes can delay the care you need. A Dallas work injury lawyer from Jim Adler & Associates can help you navigate the medical benefits process and challenge denials when the insurance company refuses to approve treatment your doctor recommends.
Income benefits replace a portion of the wages you lose because your injury prevents you from working or limits your earning capacity. Texas workers’ compensation provides four types of income benefits depending on your situation and the severity of your injury.
Temporary income benefits become available if your injury causes you to miss more than seven days of work, and these benefits pay 70 percent of the difference between your pre-injury average weekly wage and any wages you can still earn.[9] You can receive temporary income benefits until you return to work at your previous wage, reach maximum medical improvement, or hit the 104-week limit. Impairment income benefits compensate you for permanent damage after you reach maximum medical improvement, and you receive three weeks of benefits for each percentage point of your impairment rating.[9] Supplemental income benefits may be available if you cannot earn at least 80 percent of your pre-injury wages after your impairment benefits run out. Lifetime income benefits provide ongoing support for workers who suffer catastrophic injuries such as total blindness, paralysis, or loss of multiple limbs.
When a workplace injury or illness results in death, the Texas Department of Insurance provides death benefits to help the worker’s family replace a portion of the lost income.[10] A surviving spouse can receive death benefits for the rest of their life unless they remarry, and if there are dependent children, the benefits are split equally between the spouse and the children.[10] Death benefits are calculated at 75 percent of the deceased worker’s average weekly wage, subject to maximum and minimum limits set by the state.
Burial benefits reimburse the person who paid for funeral expenses, up to a maximum of $10,000 for recent injuries.[10] The request for burial benefits must be submitted to the insurance carrier in writing within twelve months of the date of death. Jim Adler, The Voice of The Victims™, understands how devastating it is to lose a loved one to a workplace accident, and a Dallas, Texas workers’ compensation attorney from our team can help your family navigate the claims process during this difficult time.
If your employer opted out of the workers’ compensation system, you are not limited to the benefits described above. Instead, you may file a personal injury lawsuit against your employer and seek compensation that goes far beyond what workers’ compensation provides. Non-subscriber claims allow injured workers to recover damages for pain and suffering, mental anguish, disfigurement, and loss of enjoyment of life, none of which are available through the workers’ compensation system.
You can also seek full recovery of your lost wages rather than the partial replacement that workers’ compensation offers, and there is no cap on medical expenses, unlike network requirements that can limit your treatment options under workers’ compensation. Non-subscriber employers lose key legal defenses, meaning they cannot argue that you contributed to your own injury or assumed the risk of harm by taking the job. These advantages make non-subscriber claims potentially more valuable than workers’ compensation benefits, but they also require proving that your employer’s negligence caused your injury.
Jim Adler, The Texas Hammer®, has spent more than 50 years fighting for injured workers, and an experienced work injury lawyer Dallas families trust can evaluate whether you have a non-subscriber claim and help you pursue the full compensation you deserve.
Filing a workers’ compensation claim involves strict deadlines and procedural requirements that can trip up even the most careful injured worker. Missing a single deadline or making a procedural mistake can cost you benefits you would otherwise be entitled to receive. Understanding the process from the beginning can help you protect your rights and avoid common pitfalls that insurance companies use to deny or reduce valid claims.
The most important step you can take after a workplace injury is to report it to your employer as soon as possible. According to the Texas Department of Insurance, Division of Workers’ Compensation, you must report your injury to your employer within 30 days from the date you were hurt or from the date you knew your injury or illness was related to your job.[11] If you fail to meet this deadline, you may lose your right to benefits entirely, even if your injury is legitimate and clearly work-related.
When you report your injury, make sure to document the date, time, and method of your report. Put your report in writing if possible, and keep a copy for your records. Be specific about what happened, where it happened, and what body parts were affected. The insurance company will scrutinize every detail of your report, so accuracy matters from the very beginning.
Getting prompt medical attention after a workplace injury is critical for both your health and your claim. Your treating doctor will document the nature and extent of your injuries, and this documentation becomes essential evidence in your workers’ compensation case. If you delay treatment or skip appointments, the insurance company may argue that your injuries are not as serious as you claim or that something other than work caused your condition.
You should attend all scheduled appointments and follow your doctor’s prescribed treatment plan, including taking medications as directed and completing physical therapy. The Texas Department of Insurance allows injured workers to seek second opinions, but you should continue seeing your workers’ compensation doctor while pursuing additional medical input.[9] Gaps in treatment or failure to comply with medical advice give insurance adjusters ammunition to dispute the severity of your injuries or deny ongoing benefits.
Texas workers’ compensation involves numerous deadlines beyond the initial 30-day reporting requirement, and missing any of them can jeopardize your benefits. According to the Texas Workforce Commission, you must file your formal claim paperwork within one year of the injury date, and you must appeal your initial impairment rating within 90 days of its issuance.[12] The Office of Injured Employee Counsel maintains a comprehensive list of additional deadlines that apply at various stages of the claims process.[12]
These deadlines are strictly enforced, and insurance companies know exactly when each one expires. An experienced Dallas work injury attorney can track all applicable deadlines and ensure that your case moves forward without procedural errors that could cost you benefits.
Jim Adler, The Tough, Smart Lawyer®, understands how the system works and fights to protect injured workers from the technical traps that catch unrepresented claimants off guard.
When disputes arise between you and the insurance carrier, the Texas Department of Insurance, Division of Workers’ Compensation, provides a formal process for resolving those disagreements. The first step is typically a Benefit Review Conference, which is an informal meeting where you, your attorney or ombudsman, a representative from the insurance carrier, and a benefit review officer discuss the disputed issues and attempt to reach an agreement.[13] The issues raised at this conference define what can be argued later, so anything you fail to raise may be waived forever.
If the Benefit Review Conference does not resolve your dispute, the case proceeds to a Contested Case Hearing, which is a formal, trial-like proceeding before a Texas Department of Insurance, Division of Workers’ Compensation administrative law judge.[14] Both sides present evidence, call witnesses, and make legal arguments, and the judge issues a written decision based on the record. Having experienced legal representation at this stage is crucial because the rules of evidence and procedure can be complex, and the insurance company will have attorneys fighting to minimize or deny your benefits.
Insurance companies deny workers’ compensation claims every day, and they count on injured workers being too overwhelmed, confused, or financially desperate to fight back. Adjusters may claim that your injury is not work-related, that you failed to report on time, that your condition is pre-existing, or that the treatment you need is not medically necessary. These denials are often based on technicalities or selective interpretation of the facts rather than the actual merits of your claim.
If your claim is denied or your benefits are reduced, you have the right to challenge that decision through the dispute resolution process. However, navigating appeals while you are injured, unable to work, and facing mounting bills can feel impossible without professional help. A work injury lawyer Dallas injured workers trust can review your denial, identify the insurance company’s weak points, and build a case to fight for the benefits you deserve. Jim Adler & Associates has spent decades taking on insurance companies, and we do not back down when they try to shortchange injured workers.
After a workplace injury, you may wonder whether you really need an attorney or whether you can handle your claim on your own. The truth is that the Texas workers’ compensation system is designed by and for insurance companies, and injured workers who try to navigate it on their own often find themselves outmatched and overwhelmed. Having an experienced advocate in your corner can make the difference between receiving the full benefits you deserve and settling for far less than your claim is worth.
The Texas workers’ compensation system is filled with procedural requirements, strict deadlines, and technical rules that can trip up even careful claimants who try to handle their cases on their own. Missing a single filing deadline can permanently destroy your right to benefits, and phrasing a dispute incorrectly at a Benefit Review Conference can waive issues you needed to raise. An experienced Dallas work injury attorney understands how the system works and can guide you through each step without the costly errors that derail so many claims.
Insurance companies have teams of experienced adjusters, investigators, and attorneys whose job is to minimize payouts and protect the carrier’s bottom line. When you try to handle your claim on your own, you are negotiating against professionals who have every advantage in knowledge, resources, and experience. A Dallas, Texas workers’ compensation attorney levels the playing field by bringing the same level of expertise and preparation to your side of the case, and when the insurance company knows you have experienced representation, they often take your claim more seriously from the start.
Some employers pressure injured workers to avoid filing claims, and others retaliate against employees who exercise their legal rights by reporting workplace injuries. Texas law specifically protects workers from retaliation, and an attorney can help ensure your employer follows the rules while also securing the medical care and income benefits you need during your recovery. Your attorney serves as a buffer between you and the insurance company, handling communications and disputes so you can focus on getting better.
When you are looking for legal representation after a workplace injury, you should seek an attorney with extensive experience in Texas workers’ compensation law, a proven track record of recovering benefits for injured workers, and a contingency fee arrangement that means you pay nothing unless your case is successful.* At Jim Adler & Associates, we have spent more than 50 years fighting for injured Texans, and The Texas Hammer® is ready to put that experience to work for you.*
After a workplace injury in Dallas, you need a team that knows how to take on insurance companies and employers who refuse to treat injured workers fairly. Jim Adler & Associates steps in to secure evidence, handle claim disputes, and build your case while you focus on recovery. We fight for injured workers with thorough preparation and aggressive representation, not empty promises. Our team is available to speak with you in both English and Spanish.
We offer a free case review to help you understand your options before you commit. If a work accident turned your life upside down in Dallas or anywhere in the DFW metroplex, let our team carry the legal load so you can focus on healing. No fee unless we win.*
After a serious workplace injury, you probably have questions about your rights, your benefits, and what steps you should take to protect your family’s future. The answers below address some of the concerns we hear most often from injured workers in Dallas and throughout North Texas. If you have questions that are not covered here, our team is always available to speak with you directly.
Workers’ compensation is a no-fault, state-regulated insurance program that pays medical benefits and income benefits to employees who suffer work-related injuries or illnesses. You do not have to prove that your employer did anything wrong to receive benefits, but the amount you can recover is limited by the statutory framework. In a non-subscriber claim, your employer has opted out of the workers’ compensation system entirely, which means you cannot file a workers’ compensation claim through the state. Instead, you must file a personal injury lawsuit and prove that your employer’s negligence caused your injury.
The trade-off is that non-subscriber claims allow you to recover damages that are not available through workers’ compensation, including compensation for pain and suffering, mental anguish, disfigurement, and the full value of your lost wages rather than just a percentage. Non-subscriber employers also lose key legal defenses under Chapter 406 of the Texas Labor Code, making it easier to hold them accountable when their negligence causes harm.[15] These lost defenses include contributory negligence, assumption of risk, and the fellow employee doctrine, which means injured workers often have a clearer path to compensation in non-subscriber cases.
Determining whether your employer is a subscriber or non-subscriber is one of the first steps in understanding your legal options after a workplace injury. The Texas Department of Insurance maintains a database where you can verify your employer’s coverage status.[3] If you are unsure whether your employer carries workers’ compensation insurance, Jim Adler & Associates can help you find out and explain your options.
Texas workers’ compensation provides four main categories of benefits for injured workers. Medical benefits cover the reasonable and necessary treatment you need to recover from your work-related injury or illness, including doctor visits, surgery, hospital stays, physical therapy, prescription medications, and medical equipment.[9] Income benefits replace a portion of your lost wages and include temporary income benefits for short-term disability, impairment income benefits for permanent damage, supplemental income benefits when you cannot return to your prior earning level, and lifetime income benefits for catastrophic injuries like paralysis or total blindness.
Temporary income benefits typically pay 70 percent of your average weekly wage up to a maximum amount set by the state, though the exact calculation depends on your earnings history and the date of your injury. Impairment income benefits are based on a percentage rating assigned by your treating doctor that reflects the permanent damage your injury has caused. If your injury prevents you from earning at least 80 percent of your pre-injury wages after you reach maximum medical improvement, you may qualify for supplemental income benefits.
If a workplace injury results in death, the worker’s family may be eligible for death benefits that replace a portion of the deceased worker’s income, as well as burial benefits that help cover funeral expenses up to $10,000.[10] Understanding these benefits can feel overwhelming when you are already dealing with pain and uncertainty, and The Texas Hammer® is here to help you navigate the process.
You must notify your employer of your workplace injury within 30 days of the accident or within 30 days of learning that your injury or illness is work-related.[2] Failing to meet this deadline can result in losing your right to benefits, even if your injury is legitimate. You must also file your formal claim paperwork with the Texas Department of Insurance, Division of Workers’ Compensation, within one year of the injury date.[12]
The 30-day reporting requirement exists because employers and insurance companies argue that delayed reports make it harder to investigate claims and verify that injuries are truly work-related. Even if you think your injury is minor at first, you should report it to your supervisor right away because some injuries worsen over time, and symptoms may not appear until days or weeks after the initial incident. Reporting promptly also creates an official record that connects your injury to your workplace, which can be critical if the insurance company later disputes your claim.
Additional deadlines apply at various stages of the claims process, including a 90-day window to appeal your initial impairment rating if you believe it does not accurately reflect the extent of your permanent damage.[12] Missing any of these deadlines can jeopardize your benefits, which is why having an attorney track them for you matters.
Jim Adler & Associates fights to ensure injured workers do not lose their rights due to missed paperwork or confusing rules.
Claim denials are unfortunately common in the Texas workers’ compensation system because insurance companies have financial incentives to minimize payouts. If your claim is denied, you have the right to challenge that decision through the dispute resolution process administered by the Texas Department of Insurance, Division of Workers’ Compensation.[11] The first step is typically a Benefit Review Conference, where you attempt to resolve the dispute informally with the insurance carrier and a benefit review officer.[13]
Insurance companies deny claims for many reasons, some legitimate and some not. Common reasons include disputes about whether the injury is work-related, disagreements about the extent of your disability, questions about whether you reported the injury on time, and arguments that your need for treatment is not reasonable or necessary. Understanding why your claim was denied is the first step in building an effective appeal.
If the Benefit Review Conference does not resolve your dispute, your case can proceed to a Contested Case Hearing before an administrative law judge.[14] This is a formal legal proceeding where both sides present evidence and testimony, and the judge issues a binding decision. An experienced attorney can challenge the insurance company’s reasons for denial, present evidence supporting your claim, and fight to recover the benefits you deserve. A denial does not have to be the end of your case, and Jim Adler & Associates has helped many injured workers overturn unfair decisions.
Texas workers’ compensation covers a wide range of injuries and illnesses that arise out of and in the course of your employment. This includes traumatic injuries like broken bones, whiplash, crush injuries, lacerations, burns, amputations, and back injuries. It also covers occupational illnesses caused by exposure to harmful substances or conditions in your workplace, as well as repetitive stress injuries like carpal tunnel syndrome that develop gradually over time from performing the same motions repeatedly.
The key requirement is that your injury or illness must be work-related, meaning it must have occurred because of your job duties or while you were performing tasks for your employer. Injuries that happen during your commute to or from work are generally not covered unless you were traveling for work purposes at the time. Injuries that occur during lunch breaks or personal errands may also be excluded depending on the circumstances.
Some injuries are harder to prove than others, particularly those that develop gradually over time or that could have multiple causes. Back injuries, for example, are sometimes disputed because insurance companies argue that the damage was pre-existing or caused by activities outside of work. Mental health conditions like post-traumatic stress disorder can also be difficult to establish in workers’ compensation cases. If you have questions about whether your injury qualifies, The Texas Hammer® is here to listen and help you understand your options.
[1] Bureau of Labor Statistics, “Census of Fatal Occupational Injuries Summary, 2023,” U.S. Department of Labor. https://www.bls.gov/news.release/cfoi.nr0.htm
[2] Texas Department of Insurance, Division of Workers’ Compensation, “Your Right to Benefits.” https://www.legis.state.tx.us/tlodocs/83R/handouts/C0402013021910301/a102758c-67ff-4bbf-93c8-bb8d52e9a3bc.PDF
[3] Texas Department of Insurance, Division of Workers’ Compensation, “Coverage Verification.” https://www.tdi.texas.gov/wc/employer/coverage.html
[4] Texas Department of Insurance, Division of Workers’ Compensation, “Employer Requirements.” https://www.tdi.texas.gov/wc/employer/index.html
[5] Texas Civil Practice and Remedies Code, Chapter 41, “Damages.” https://statutes.capitol.texas.gov/docviewer?docPath=%2FCP%2Fhtm%2FCP.41.htm
[6] Texas Labor Code, Chapter 451, “Discrimination Against Workers’ Compensation Claimants.” https://statutes.capitol.texas.gov/Docs/LA/htm/LA.451.htm
[7] Texas Department of Insurance, Division of Workers’ Compensation, “2023 Report on Workplace Fatalities in Texas.” https://www.tdi.texas.gov/wc/safety/sis/documents/2023fatalrpt.pdf
[8] Texas Workforce Commission, “Employment Law: Breaks and Meals.” https://efte.twc.texas.gov/d_breaks.html
[9] Texas Department of Insurance, Division of Workers’ Compensation, “Benefits: Income and Medical.” https://www.tdi.texas.gov/wc/employee/benefits.html
[10] Texas Department of Insurance, Division of Workers’ Compensation, “Death and Burial Benefits.” https://www.tdi.texas.gov/wc/employee/deathben.html
[11] Texas Department of Insurance, Division of Workers’ Compensation, “Compensability and Liability Disputes.” https://www.tdi.texas.gov/wc/idr/compensability.html
[12] Office of Injured Employee Counsel, “Important Deadlines.” https://www.oiec.texas.gov/employee/importantdeadlines.html
[13] Texas Department of Insurance, Division of Workers’ Compensation, “Benefit Review Conference.” https://www.tdi.texas.gov/wc/idr/brc.html
[14] Texas Department of Insurance, Division of Workers’ Compensation, “Contested Case Hearing.” https://www.tdi.texas.gov/wc/idr/cch.html
[15] Texas Labor Code, Chapter 406, “Workers’ Compensation Insurance Coverage.” https://statutes.capitol.texas.gov/Docs/LA/htm/LA.406.htm
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