Every state has its own workers’ compensation programs and laws, which serve to aid injured workers in the aftermath of work-related accidents. Texas’ Workers’ Compensation Act in Texas Labor Code, Title 5, outlines the provisions of the state’s workers’ comp program. Certain employers must abide by these laws to protect their employees in the event of injuries. Failure to follow the laws can result in insurance fraud and negligence charges. As a worker in Texas, understanding compensation laws can help you protect your rights.

Who Must Carry Workers’ Compensation Insurance?

Unlike other states, Texas’ workers’ compensation laws do not apply to every single employer in the state. Texas Labor Code Chapter 406 makes workers’ compensation insurance an elective coverage, except for public employers. An employer that does not obtain this type of insurance coverage must notify the Division of Workers’ Compensation in writing. Employers must also notify employees of the status of workers’ comp coverage at the time of hire. The employer must place notices around the workplace informing employees whether or not it carries workers’ compensation insurance.

What Injuries Does Workers’ Compensation Cover?

If your employer carries workers’ compensation insurance, it will cover all injuries or illnesses sustained “within the course and scope of employment,” regardless of fault. This includes injuries that occur within the workplace, as well as outside of the office if the worker is engaged in work-related activities. For example, a delivery person would receive workers’ comp benefits after a car accident if he or she were delivering food at the time of the crash. If the accident occurred when the employee was driving home after clocking out, however, the employee would not have work-related injuries.

Workers’ compensation will also not cover injuries that stem from horseplay, willful criminal acts, intentional self-injury, drug/alcohol intoxication, acts of God, or a third party’s criminal act if directed at the employee for personal reasons not relating to work. In any of these situations, the employee will be responsible for his or her own injuries. However, it may be up to the employer to prove that one of these scenarios existed at the time of the employee’s injuries.

How to Apply for Workers’ Compensation Benefits in Texas

Directly following a work-related injury, report the incident to your employer. You have 30 days to notify your employer of your injuries before you lose your right to collect workers’ comp benefits. However, waiting even a day without reason can raise a red flag for the insurance company and your employer. Your employer should tell you to seek medical care through a doctor within the workers’ compensation health care network.

Next, download the correct workers’ compensation employee form. It is likely Form DWC041, titled “Employee’s Claim for Compensation for a Work-Related Injury or Occupational Disease.” Fill out the form in its entirety, within one year of the date of your injury. Send the form to the Department of Workers’ Compensation, at which point your employer’s insurance company will review your claim and issue an approval or denial. In the event of a denial, you can challenge the decision through the Department of Workers’ Compensation or before a judge.

Workers’ Compensation vs. Personal Injury Lawsuit

In filing for workers’ compensation coverage, the employee gives up his or her right to file a personal injury claim. This is a decision employees should consider carefully. While it does not take proof of fault to receive workers’ comp benefits, the employee may receive less than he or she would in a personal injury lawsuit. A lawsuit can result not only in payment for medical expenses and disability but also for all lost wages and noneconomic damages. If your workplace accident involved someone else’s negligence or if your employer does not carry workers’ compensation insurance, speak to an Austin personal injury attorney before you file for workers’ comp.