According to the Texas Department of Insurance, workers’ compensation insurance pays medical bills and some lost wages of employees who are injured or killed in the scope of their duties at work, or who have developed a work-related illness or disease.[1] The law has described it as an “exclusive remedy” meaning that, with few exceptions, it keeps that employee or his family from seeking additional damages through a lawsuit.[2] If a company chooses to purchase and take advantages of this type of coverage, they are making sure that their employees can only get the monetary reimbursement for the damages that were a result of the injury and that are allowed by the Act.
If the employer is a subscriber to workers’ compensation insurance, the only way for an injured employee to file a lawsuit for the injuries sustained is to either be intentionally injured by the employer (if he is still alive) or injured by gross negligence (if he died as a result of the accident). If the employee loses his life due to the injuries sustained, the receipt of workers’ compensation does not keep the family of the deceased from filing a lawsuit against the employer if the family believes that the actions of the employer rise to the level of gross negligence.[3]
The types of impairments that one suffers is rated on a scale to properly determine the amount and duration of benefits received. There are temporary and permanent impairments and each is dealt with differently. For a more detailed article on the Impairment Ratings for Workers’ Compensation, Click Here. If you are denied workers’ compensation because of a rating of the impairment, that does not open the door for litigation. Instead, you are required to file an appeal with the agency that governs, which is usually the workers’ compensation appeals board.
If you are eligible to file a lawsuit against your employer, you will not be limited to the amounts provided by workers’ compensation benefits. You will, however, only be able to recover punitive damages. Punitive damages can be a great deal higher than the actual amount spent but are capped by statutory law.[4]
If your employer chooses not to provide workers’ compensation coverage, the Texas Department of Insurance requires all non-subscribers to file notice with their offices, display notices of non-coverage in the workplace, and give a written notice of non-coverage to each new employee. Without this coverage though, employers are giving up immunity from most lawsuits by injured employees.[5] These uninsured employers are also giving away the use of certain common-law defenses. Some of those defenses include the defense that the injured employee’s negligence caused the injury, that the negligence of other employees caused the injury, or that the injured employee knew about the danger and voluntarily accepted it. An employer with coverage may only have a concurrent lawsuit filed against them after all facts have been reviewed by the TDI’s administrative dispute process.
Written by:
Lyndsey Mott
Approved By Francisco Guerra IV
Watts Guerra LLP
4 Dominion Drive, Bldg 3, Suite 100
San Antonio, Texas 78257
Phone (210) 447-0500
© Watts Guerra LLP 2015
*Please note that all workers’ compensation laws are governed by state, which means they can vary from state to state. Please check with your state’s requirements and law or contact an attorney that can do so for you.
[1] http://www.tdi.texas.gov/pubs/consumer/cb030.html
[2] Labor Code, Title 5 (a) (408): Workers’ Compensation Benefits, §408.001 (2005).
[3] Labor Code, Title 5 (a) (408): Workers’ Compensation Benefits, §408.002 (1991).
[4] Beth Laurence, Suing Your Employer for an Injury in Addition to Filing for Workers’ Compensation, < http://www.disabilitysecrets.com/resources/workers-compensation/suing-your-employer-injury.htm>
[5] http://www.tdi.texas.gov/pubs/consumer/cb030.html
