How Do You File a Work Injury Claim After an Accident? Advice from a Work Injury Attorney in Midland, TX

Report the Injury to Your Employer

Promptly notify your employer about the accident. In the report, include the date, time, and location that the injury happened. Then you should give a brief account of how the accident occurred and describe all relevant details you can remember.

A written notification is best, if at all possible, such as an email or written note, since it is important to have an official record of the incident and the fact that you notified your employer. The report will let your employer know they need to initiate an investigation into what happened and notify their insurance carrier.

Seek Medical Attention

Get checked out by a medical doctor as soon as possible, even if you feel fine or the injury seems minor. You will need official medical documentation of your injury in order to file a work injury claim later. Your employer might request that you go to a specific medical provider. The main thing is to get a medical report with details about what your injuries are, how extensive they are, what treatments are prescribed, and how the injuries may affect your ability to work.

Gather Evidence Related to Your Accident

Collect any and all evidence of what happened. Did you or anyone else take photos and/or videos of the accident scene and your injury? Is there any security camera footage from that day and time? Request that your employer preserve that footage, and if you have any concern that they won't, talk with your work injury attorney right away.

Check with those who saw what happened and see if you can get written witness statements to help corroborate your account. Get a copy of the incident report, for a detailed record of the incident. Clear evidence will help if there are any disputes about the cause or severity of the injury.

Keep Track of All Medical Treatments and Expenses

Keep organized records of your medical treatments and related expenses. It's a good idea to have a file with all the receipts, invoices, prescriptions, and records of therapy. If you have it all in one location, it makes it easier to document how much you've spent on your injury-related expenses. Also, be sure to keep documentation of any follow-up treatments or specialized care.

Check for Workers' Compensation Insurance

Texas does not require most private employers to carry workers' compensation insurance, but it doesn't hurt to check with your employer to find out whether they do have workers comp. If they do, you may be able to file a claim for compensation, depending on the nature of your employment and the circumstances of the accident. (Independent contractors, for instance, may not be covered by traditional workers' compensation policies.)

If Your Employer Has Workers' Comp

Initiate a Clam

To start an official workers' compensation claim, complete the DWC Form-041, Employee's Claim for Compensation for a Work-Related Injury or Occupational Disease. This form must be filed within one year of the injury date or the date you became aware of the work-related nature of your condition. You can file the form online or by mail.

Communicate with the Insurance Adjuster

After filing, an insurance adjuster typically reviews the claim. This person evaluates the information in the claim and decides whether to approve benefits. The adjuster may reach out to you for more information that you provided. They might request more documentation of your injuries. Respond promptly and accurately to any inquiries from the adjuster, but talk to your lawyer about what to say.

Understand Potential Benefits Available

Learn what benefits are covered by your workers' compensation insurance so you are able to respond intelligently to settlement offers. Workers' compensation benefits cover medical expenses, lost wages, and more, and your lawyer is the best one to give you details. If your injury has left you temporarily or permanently unable to work, you may be eligible for temporary or permanent disability benefits, which are typically calculated based on your wage history and how severely you are disabled.

Respond Promptly to Any Denials or Disputes

If your employer's insurer disputes your claim, read their letter carefully to understand what their reason or reasons are. You can send in further documentation to help clarify the dispute or consult with a lawyer for advice about how best to proceed. It's best to respond as quickly as possible to keep the process moving.

If your claim is denied, you have the right to appeal. Reasons for denial are often lack of evidence, discrepancies in the report, or the belief that the injury is not work-related. Making an appeal involves filing a formal request for reconsideration. During an appeal, you can present additional evidence, medical records, and witness testimonies to support your case.

If Your Employer Does Not Have Workers' Comp

In Texas, if your employer does not carry workers' compensation insurance, you have the right to file a personal injury lawsuit if your injury was due to your employer's negligence. You must be able to prove that your employer was at fault or that unsafe working conditions led to your injury. In a personal injury lawsuit, you may be able to recover compensation for medical expenses, including future treatments, lost wages and potential future income, pain and suffering (which workers' compensation does not typically cover), and emotional distress.

Consult an Attorney Specializing in Workplace Injury Law

If you decide to file a personal injury lawsuit, consult with an attorney who has experience in work injury cases. They can advise you on the best course of action, help you with gathering the evidence you'll need to support your lawsuit, negotiate for you, and represent you in court.

Maintain Communication with Your Employer Throughout Recovery

Stay in touch with your employer while you recover to keep them informed about how your recovery is going as it relates to your ability to perform the job. Share if your doctor has placed you under any restrictions and if you have an expected date for a return to work.

Be clear and professional in your interactions and be sure to keep the lines of communication open. Having open communication is the best protection against misunderstandings and differing expectations. If you do have issues come up over returning to work, especially if modified work duties will be needed, discuss them with your employer or with a workers' comp lawyer.

When to Seek Legal Assistance

If your work injury claim is facing disputes, delays, or an uncooperative insurance company, consult an attorney as soon as possible, and look for someone experienced in workers' compensation. Legal representation is especially valuable if your claim has been denied, if your injuries are severe, or if you need to pursue additional benefits beyond workers' compensation. A good lawyer can guide you through appeals and communicating with insurance adjusters and make sure you haven't left an avenue for potential compensation unexplored.

If you need assistance with your work injury claim, contact Cesar Ornelas Law in Midland, TX, for help through every stage of the process.