If I’m Unhappy With My Texas Workers’ Compensation Decision, Can I Appeal?

man in protective equipment at work

When you sustain an injury while on the job, you may assume it’s simply an unfortunate accident. While this may be true, you are still entitled to workers’ compensation when you become injured or fall ill because of your job. However, when you file the claim, you may be shocked to find that you were denied compensation. If this reflects your circumstances, you’ll want to keep reading. You’ll discover how to dispute a workers’ compensation decision with the help of a Houston workplace accident lawyer.

What Is Workers’ Compensation?

When someone is injured on the job in Texas, their employer may have workers’ compensation insurance to help cover the cost of the damages they’ve endured. Essentially, this allows injured employees to receive benefits for their injuries, such as the cost of medical treatment, partial lost wages, and funeral expenses in the event of death, but they cannot file a lawsuit against their employer.

It is essential to note that Texas does not mandate that employers carry this coverage. If you are injured and your employer does not have workers’ compensation insurance, you cannot file this claim. You must file a third-party lawsuit if you are looking to pursue damages from your employer.

If I Disagree With My Workers’ Compensation Decision, Can I Appeal?

If your claim was denied, the most important thing to do is discover why. In some instances, this could be something as simple as an error when filing out your form. In other cases, you may find that your employer has disputed the claim. Often, companies will do this to avoid higher premiums when someone files a claim against them. Your employer may say you were off the clock when the injury occurred or that it was from a pre-existing condition.

Regardless, knowing how to dispute the denial is essential to recovering the compensation you deserve. Generally, the first step is to file a hearing with the Benefit Review Conference (BRC). This is an informal meeting where you will discuss the details of your claim to try and receive the compensation you deserve. You and the insurance company will both explain your side and provide evidence.

If you are still the victim of an unfavorable outcome, you can elevate this appeal to a contested case hearing, followed by an appeal directly to the appeals panel.

Do I Need an Attorney to Help?

As you can see, fighting for the compensation you deserve when your claim is denied can be intimidating. That’s why it’s in your best interest to enlist the help of an experienced attorney to guide you through appealing a workers’ compensation decision.

At the Gonzalez Law Group, we understand how complex it can be to heal from an injury while fighting for the compensation you are entitled to. That’s why our team is ready to assist you from the moment you sustain an injury while on the job. Contact our firm today to discuss the details of your circumstances with a member of our committed firm.