Houston, TX Workers Comp Attorney

Hurt at Work in Houston? Get the Benefits You Deserve

Experienced Advocacy for Texas Workers’ Compensation Claims

Workplace injuries can leave you stressed about medical bills and lost income. If you’ve been hurt on the job in Houston, Texas, you need to know your rights under workers’ compensation. The Adley Law Firm is here to help injured workers navigate the Texas workers’ comp system and secure the benefits they’re entitled to. Our professional yet approachable team will guide you through every step – from filing your claim to appealing a denial – so you can focus on recovery. Don’t wait – contact Adley Law Firm today for a free case evaluation and let our Houston workers’ comp attorneys fight for you.

Read More:

Lost Wage Benefits
Medical Care Rights
Filing a Workers’ Comp Claim
Denied Claims & Appeals
How a Workers’ Comp Lawyer Helps
Frequently Asked Questions (FAQs)

Lost Wage Benefits in Texas Workers’ Comp

If your work injury forces you to miss work, workers’ compensation provides lost wage benefits to replace a portion of your income. In Texas, these are often called Temporary Income Benefits (TIBs). The amount you receive is based on your Average Weekly Wage (AWW) – usually the average of your gross pay over the 13 weeks before your injury. By law, TIBs typically pay 70% of your average weekly wage (or 75% if you earned low wages) as income replacement. These payments start after you’ve been unable to work for at least a week due to the injury. For example, if your pre-injury wage was $900 per week, your TIBs might be about $630 per week (70% of $900).

It’s important to note that workers’ comp wage benefits are tax-free, meaning you won’t pay income tax on the checks you receive. This helps your reduced benefit go a bit further to cover your expenses. However, there are limits. Texas sets a maximum and minimum weekly benefit that can be paid, regardless of your AWW. As of late 2024–2025, the state’s maximum TIBs payment is about $1,219 per week (with a minimum of $183), based on the state average wage. High earners may hit this cap, so you could receive less than 70% of your actual wage if your salary was well above average.

How long do lost wage benefits last? Texas TIBs continue until one of the following occurs: you return to work, you reach Maximum Medical Improvement (MMI) (the point where your doctor says further recovery isn’t expected), or you’ve received 104 weeks (two years) of payments. In other words, you can generally get up to 2 years of wage benefits while you’re healing. If you have a lasting impairment after MMI, you may transition to Impairment Income Benefits (IIBs), which pay a smaller amount for a set duration (typically 3 weeks of pay for each 1% of impairment rating). For the most catastrophic injuries, Lifetime Income Benefits may be available, but those cases are rare and defined by law (for example, loss of limbs or total blindness).

Calculating the correct AWW and benefit amount can be tricky. Your employer’s insurance should handle this, but mistakes happen. An experienced attorney can help ensure your wages are calculated accurately so you receive the maximum benefit you’re owed. If your checks are delayed, incorrect, or stopped too soon, contact a Houston workers’ comp lawyer at Adley Law Firm to protect your rights. We make sure you aren’t short-changed on the income you need to support yourself and your family.

Medical Care Rights and Employer-Directed Care

When you’re hurt at work, you have the right to receive all medical care that is reasonable and necessary to treat your work-related injury. Workers’ comp should cover 100% of your approved treatment costs – with no co-pays or deductibles charged to you. This includes doctor visits, hospital bills, surgery, medication, physical therapy, medical tests, and even rehabilitation services needed for your recovery. You may also be reimbursed for certain out-of-pocket expenses related to treatment, such as mileage for traveling to medical appointments.

In Texas, your employer (or its insurance company) has some say in which doctor you see initially. Many employers are enrolled in a certified workers’ comp healthcare network. If so, you’ll need to choose a treating doctor from that network’s list of providers. If your employer is not in a network, you generally can pick any doctor who is approved by the Division of Workers’ Compensation (DWC) to handle workers’ comp cases. Either way, make sure to inform the doctor that your injury is work-related, so they bill the treatment under workers’ comp.

While you do have to follow certain rules about authorized doctors, you still maintain important rights over your medical care. You are entitled to a second opinion or to request a change of treating doctor if you are not satisfied with the care (though you may need approval from the insurance carrier or DWC to switch). Your employer or insurer might require you to attend periodic evaluations with a doctor of their choosing (an “independent medical exam”), but they cannot dictate your day-to-day treatment beyond the network rules. All recommended treatments must be medically necessary – if the insurance company denies a procedure or therapy as unnecessary, your attorney can help challenge that denial through the proper DWC dispute process.

Bottom line: you have the right to quality medical care to recover from your injury. You should never have to pay out-of-pocket for approved treatment for a work injury. If you’re being billed for care or your employer refuses to allow treatment, that’s not okay. Our Houston workers’ comp lawyers can intervene to ensure you get the care you need. We can communicate with medical providers and insurance adjusters to clarify coverage and push for quick approvals on surgeries, specialists, or rehabilitation. Your health is the top priority, and the workers’ comp system exists to make sure you get proper care without financial burden.

Process for Filing a Workers’ Comp Claim in Texas

Filing a workers’ compensation claim in Texas involves a few critical steps and deadlines. Taking the right actions early on will set your case up for success. Here’s an overview of the process:

Report your injury to your employer within 30 days. The very first thing to do after a work accident or upon discovering a work-related illness is to notify your employer (tell your supervisor or HR) as soon as possible. Texas law requires that you report the injury within 30 days of when it happened, or when you realized it was job-related. Failing to report in time can cause you to lose your right to benefits, so don’t delay. Give the date, time, and details of what happened. For an occupational illness or repetitive stress injury that develops over time, report it as soon as you learn it may be work-related.
File an official claim with the state. Telling your employer is not the same as filing a workers’ comp claim form. In Texas, an injured worker must submit a form called DWC Form-041, Employee’s Claim for Compensation to the Texas Department of Insurance, Division of Workers’ Compensation (DWC) to start an official claim. This form asks for information about your injury, your employer, and wages. You have up to one year from the date of injury (or from the date you knew an illness was work-related) to file the claim form, but it’s best to do it much sooner. Filing promptly keeps your case moving and avoids any argument that you missed the deadline. The form can be filed online, by mail, or in person with the DWC.
Employer’s responsibilities after you report: Once notified, your employer should immediately inform their workers’ comp insurance carrier of your injury and provide you with information on your rights. The employer or insurer should give you a list of network doctors if applicable, and they must also fill out an internal report of the injury. In Texas, the employer files a form called the First Report of Injury (DWC-001) to notify the state of the incident. As the injured worker, make sure you get a copy of any paperwork and a claim number from the insurance carrier.
Follow doctor’s orders and attend all exams: From the moment you’re injured, make sure to get medical attention and keep records. When you see the doctor, explain that it’s a work injury so they bill the correct insurer. Attend all scheduled appointments, treatments, and any insurer-required medical exams. This not only ensures you heal as fast as possible, but also creates documentation for your claim. If you miss appointments or ignore treatment plans, the insurance might argue you’re not seriously hurt or are delaying recovery.
Keep track of benefits and communications: After your claim is filed, the insurance company will review it. They should start paying your income benefits promptly if everything is in order – generally by the 21st day after the injury was reported, if you’re eligible for wage benefits. You will receive an approval or denial in writing. Save all letters from the insurance company or DWC. If you get a denial or notice of dispute, or if nothing happens at all, that’s a sign to involve an attorney right away.

Throughout this process, the Adley Law Firm can assist you with filing and paperwork. We help injured workers in Houston properly notify their employers, fill out and submit DWC forms, and communicate with the insurance carrier. Small mistakes or missed deadlines can jeopardize a claim – our experienced legal team makes sure everything is done by the book. We also gather supporting evidence (like accident reports or witness statements) to strengthen your claim from the start. With our guidance, you can avoid common pitfalls and move your workers’ comp case forward smoothly.

Denied Workers’ Comp Claims & the Appeal Process

Unfortunately, not every workers’ comp claim sails through without issues. Insurance companies sometimes deny claims upfront or stop benefits prematurely. A denial isn’t the end of the road – but you must act quickly to protect your rights. If your workers’ comp claim is denied in Texas, you have the option to challenge that decision through the DWC dispute resolution process.

Why are claims denied? Common reasons include disputes over whether the injury is work-related, allegations that you missed the 30-day notice or 1-year filing deadline, claims that the injury was due to horseplay or intoxication (which aren’t covered), or simply lack of evidence. Sometimes insurance will initially pay benefits but later stop, claiming you’ve recovered or that you didn’t attend a required exam. Regardless of the reason, you have a right to appeal a denial or termination of benefits.

How the appeals process works: The first step is typically a Benefit Review Conference (BRC), which is an informal mediation meeting between you and the insurance company (with a DWC benefit review officer facilitating). The goal is to see if the dispute can be resolved by agreement. You’ll present evidence (medical records, accident reports, etc.) supporting your claim. Having an attorney at this stage is highly recommended – we’ll prepare a strong case to convince the insurer to reverse the denial. If no agreement is reached at the BRC, the next step is a formal Contested Case Hearing (CCH) in front of a workers’ comp hearing officer (a type of administrative judge). This is like a small trial where each side can call witnesses and present arguments.

Contested case hearings follow specific legal procedures and rules of evidence. It’s very difficult for an injured worker to successfully represent themselves at a CCH. In fact, most workers who go to a hearing choose to hire a lawyer, because an experienced workers’ comp attorney knows how to navigate the system and present a compelling case. After the hearing, the officer will issue a decision. If you disagree with the outcome, there is another level of appeal within the DWC (an Appeals Panel that reviews the record). Beyond that, there is a possibility to appeal into the court system, but only under certain circumstances. Throughout these stages, strict deadlines apply – for example, you may have as little as 15 days to appeal a hearing decision, or 30 days from a denial to request a BRC in some cases. Missing a deadline can forfeit your claim, so time is of the essence.

The role of an attorney in denied cases: If your claim has been denied or disputed, contact Adley Law Firm immediately. Our Houston workers’ comp lawyers will review the denial letter and quickly file the necessary appeals paperwork within the deadlines. We’ll gather additional evidence – such as medical expert opinions – to counter the insurance company’s reasons for denial. Our team will represent you at the Benefit Review Conference, using our negotiation skills and knowledge of Texas workers’ comp laws to push for a favorable resolution. If the case proceeds to a hearing, we will advocate on your behalf before the judge, making legal arguments and examining witnesses to prove your claim is valid. Remember, the insurance company will have adjusters and attorneys on their side; you deserve a dedicated advocate on yours. We fight to get wrongfully denied benefits approved, so you aren’t left bearing the costs of a work injury alone.

How a Houston Workers’ Comp Lawyer Can Help Your Case

Dealing with a workers’ compensation claim can be overwhelming – especially when you’re trying to recover from an injury. Having a knowledgeable attorney in your corner can make all the difference. Here are several ways a Houston workers’ comp lawyer at Adley Law Firm can support you:

Expert Guidance and Case Evaluation: We explain your rights and options in plain language. From the outset, we’ll tell you what benefits you likely qualify for and what steps to take. Texas workers’ comp laws are complex, but we make sure you understand the process and we strategize the best way to pursue your claim.
Handling Paperwork and Deadlines: Workers’ comp requires a lot of forms (injury reports, claim forms, medical reports, etc.) and every one of them must be done correctly. We take care of filing all necessary paperwork with the DWC and insurance company, so you don’t have to worry about technicalities. This includes reporting the injury, filing the claim within the one-year deadline, and submitting any appeals on time. You won’t have to navigate the bureaucracy alone.
Maximizing Your Benefits: Our attorneys work to ensure you receive the full benefits you’re entitled to. We check that your average weekly wage calculation is accurate (including overtime or multiple jobs if applicable) and push back if the insurer tries to underpay you. If you’re eligible for supplemental or impairment benefits, we make sure those kick in appropriately. Simply put, we fight for every dollar and every medical treatment you deserve under the law.
Communicating with the Insurer: Once you have a lawyer, the insurance adjuster should direct all further questions or settlement offers to us. This protects you from saying anything that could hurt your case. We handle calls and correspondence with the insurer, advocate for you, and keep you updated. If there are any problems – for example, a check is late or a medical procedure isn’t approved – we immediately reach out to resolve it.
Appeals and Hearings Representation: As discussed, if your claim requires a dispute hearing or appeal, going it alone is risky. Our legal team will represent you in any BRC or contested case hearing, presenting a strong case with evidence and legal arguments. We know the ins and outs of the Texas workers’ comp hearing process and will greatly improve your chances of success. Our job is to persuade the hearing officer or appeals panel that you are entitled to benefits, countering the insurance company’s lawyers with facts and law.
Peace of Mind and Support: Perhaps most importantly, we take the stress off your shoulders. Suffering a serious injury is hard enough without dealing with insurance adjusters and legal deadlines. When you hire Adley Law Firm, you can focus on your health while we focus on the legal battle. We’ll keep you informed at each step and advise you before you make any big decisions (like considering a settlement or returning to work on light duty). Our clients often say that having a dedicated lawyer made them feel more confident and secure during a difficult time.

No upfront costs: Injured workers are often concerned about attorney fees. Rest assured, at Adley Law Firm we offer free consultations, and we typically handle workers’ comp cases on a contingency or regulated fee basis – meaning you pay nothing out of pocket. In fact, Texas workers’ comp laws make it feasible to hire a lawyer even if you’re strapped for cash. Attorney fees must be approved by the DWC and are usually taken as a percentage of the benefits or paid by the insurer, not directly from your wallet. We only get paid if we successfully recover benefits for you. This allows you to get legal help when you need it most, without adding financial strain.

If you’ve been injured at work in Houston, don’t navigate the workers’ comp system alone. Contact Adley Law Firm today at (713) 999-8669 for a free, no-obligation consultation with an experienced Houston workers’ comp lawyer. We are dedicated to protecting the rights of injured workers and helping you secure the benefits and compensation you deserve. Let us put our knowledge and experience to work for you – so you can rest and recover with peace of mind.

Frequently Asked Questions (FAQs)

What if my employer doesn’t carry workers’ compensation insurance?

Texas is unique in that private employers are not required to subscribe to workers’ comp coverage. If your employer is a “non-subscriber” (meaning they have no workers’ comp insurance), you cannot file a workers’ comp claim for your injury. However, you’re not out of options – you may be able to file a personal injury lawsuit against the employer for negligence. Non-subscriber employers lose the usual legal protections that come with carrying workers’ comp. In a lawsuit, you could seek damages for medical bills, lost wages, pain and suffering, etc. (things that standard workers’ comp wouldn’t fully cover). The downside is you must prove the employer’s negligence caused your injury, which can be challenging. It’s crucial to speak with an attorney in this situation. The Adley Law Firm handles workplace injury cases both inside and outside the comp system. We can determine if your employer has insurance and, if not, help you pursue a direct claim against them or any other responsible third party. Either way, you have a right to seek compensation for a work injury – with or without workers’ comp insurance in place.

How long do workers’ comp benefits last in Texas?

The duration of benefits depends on the type of benefit and the severity of your injury. Temporary Income Benefits (TIBs) (lost wage benefits) generally last until you return to work, reach Maximum Medical Improvement, or for up to 104 weeks – about two years – whichever happens first. If you have a permanent impairment after that, you can receive Impairment Income Benefits (IIBs). The length of IIBs is determined by your impairment rating. Texas awards three weeks of IIB payments for each percentage point of impairment. For example, a 10% impairment rating would equal 30 weeks of IIBs, paid at 70% of your AWW (up to the set cap). After IIBs, workers with very serious, ongoing disabilities might qualify for Supplemental Income Benefits (SIBs), which are paid monthly and can continue until 401 weeks from the date of injury (roughly 7.7 years post-injury), as long as you meet the eligibility criteria every quarter. Lastly, for the most severe injuries (such as total and permanent losses like paralysis, major limb loss, or blindness), Texas provides Lifetime Income Benefits (LIBs), which, as the name implies, are paid for the remainder of the injured worker’s life. Most cases won’t involve LIBs – they are reserved for catastrophic injuries. It’s also worth noting that medical benefits can continue for as long as treatment is reasonably necessary, even after wage benefits end. Every situation is different, so consult with our attorneys about what benefits apply in your case and how long you can expect to receive them.

Can I choose my own doctor for my work injury treatment?

In many cases, yes, but with some limitations. In Texas, if your employer’s workers’ comp insurance is through a certified health care network, you must select a treating doctor from that network’s list. Your employer or the insurance carrier should give you information on how to find an in-network workers’ comp doctor. You have the right to pick from among the network providers – the employer cannot hand-pick the doctor for you, but they restrict the pool to network doctors. If your employer is not subscribed to a network, then you may choose any doctor who is willing to handle workers’ comp claims (the doctor should be on the approved doctors list maintained by the DWC). It’s important to choose a doctor experienced with work injuries. This doctor will be responsible for overseeing your treatment and issuing necessary reports on your work status.

If you are unhappy with the doctor or the care you’re receiving, you usually have a right to change your treating doctor once by requesting a change through the DWC (for non-network claims) or through the network’s procedures (for network claims). It’s critical not to just start seeing a new doctor on your own without following the process, or the insurance may not have to pay for those visits. Keep in mind, the insurance company can require you to attend an independent medical examination with their chosen doctor for a second opinion, but that does not change who your primary treating doctor is.

The goal is for you to get quality medical care and recover. If you’re confused about your rights to choose a doctor or feel the employer’s doctor isn’t taking your injury seriously, talk to our attorneys. We can advise on selecting a doctor, and if necessary, help you request a change of doctor through the proper channels. Your health comes first.

Can I be fired or retaliated against for filing a workers’ comp claim?

It is illegal for a Texas employer to fire or otherwise retaliate against you just because you filed a legitimate workers’ compensation claim. Texas Labor Code Chapter 451 specifically prohibits employers from punishing employees for filing a workers’ comp claim, hiring a lawyer to help with a claim, or even testifying in a co-worker’s claim. This means your employer cannot lawfully fire, demote, harass, or reduce your pay simply out of revenge for you seeking benefits. If they do, you may have grounds for a separate lawsuit against the employer for retaliatory discharge.

However, Texas is an “at-will” employment state, which means an employer can fire you for almost any reason that isn’t expressly illegal. Sometimes employers try to hide retaliation by claiming another reason for the termination (e.g., “poor performance” or that your position was eliminated). This can make these cases complex. The key is proving the real motivation was your workers’ comp claim. Timing and documentation are important – if you were a good employee with no prior issues and you’re fired right after filing a claim or while receiving benefits, it raises suspicion of retaliation.

If you suspect you were fired or mistreated because of your work injury or claim, contact Adley Law Firm. Our lawyers can evaluate your situation. We’ll look for evidence (like emails or witness statements) that suggest retaliation. These claims have their own legal process and remedies – potentially including lost wages, reinstatement, and additional damages against the employer. Remember, most employers won’t outright say they’re firing you for filing a claim, but the law is on your side if you can show that was the reason. We are here to protect you from retaliation so that you can assert your right to workers’ comp benefits without fear.

What should I do if my workers’ comp claim is denied?

If you receive a denial letter from the workers’ comp insurance or a decision that you disagree with, it’s crucial to take action quickly. First, carefully read the denial notice – it should state the reason your claim (or a specific benefit) was denied or disputed. Common reasons might be “not work-related,” “insufficient medical evidence,” or an allegation of a missed deadline. Next, mark your calendar for any deadlines mentioned. In Texas, you generally have to file an appeal or request a hearing within a certain number of days (for instance, you have 90 days to dispute an impairment rating or 30 days to appeal a denial of compensability in many cases – the exact timeframe can vary).

The Texas workers’ comp system requires that you go through its dispute resolution process to fight a denial. This means requesting a Benefit Review Conference with the DWC. On the request, you’ll outline the issues in dispute. It’s highly advisable to enlist a workers’ comp attorney at this stage (if you haven’t already). We will help fill out the dispute forms correctly and craft arguments backed by evidence. At the Benefit Review Conference, we’ll present your case and negotiate with the insurer in an attempt to resolve the issue. If that fails, we prepare for a Contested Case Hearing, where we can bring witnesses (like your doctor) and cross-examine the insurance’s witnesses.

You should also continue medical treatment in the meantime. Don’t give up and assume a denial is final. Often, denials can be overturned when additional evidence or clarification is provided. Keep all paperwork related to the denial and any communication from the insurance. Provide these to your lawyer. At Adley Law Firm, we have extensive experience handling denied workers’ comp claims – we know the tactics insurers use and how to counter them. Our goal is to get your claim approved or your benefits reinstated as soon as possible, whether through a settlement at the conference or a favorable ruling by the hearing officer.

How much does it cost to hire a workers’ comp lawyer, and is it worth it?

It will cost you nothing upfront to hire our workers’ comp lawyers. We understand that after a work injury, finances are tight. That’s why Adley Law Firm works on a contingency-fee basis for workers’ comp cases, or as allowed by Texas law, our fee is a percentage of the benefits recovered. Texas workers’ comp attorney fees are regulated by the state – attorneys must get DWC approval for their fees, and those fees are often deducted from the compensation awarded (or paid by the insurer), rather than coming directly out of your pocket. In short, you won’t be writing a check to us while your claim is ongoing. If we don’t win benefits for you, we don’t get paid. This arrangement allows any injured worker, regardless of finances, to obtain legal representation.

As for whether it’s worth it: consider that the insurance company has professionals on their side aiming to minimize or deny your claim. An experienced lawyer helps even the playing field. We take on the legal legwork and fight for the maximum benefits, which often results in a much better outcome than if you went solo. Whether it’s ensuring you get every benefit you’re entitled to, preventing your claim from being denied on a technicality, or winning your case at a hearing, a workers’ comp lawyer is your advocate. Most people unfamiliar with the system might inadvertently miss a deadline or fail to submit crucial evidence. Our job is to prevent those mistakes and handle the pressure for you. While some straightforward cases get approved without a hitch, many others encounter issues – and that’s where having a lawyer pays off. During a free consultation, we can honestly assess if we think we can add value to your claim. If your case is simple and on track, we’ll tell you. But if there’s any risk to your benefits, having our Houston workers’ comp attorney by your side is absolutely worth it for the peace of mind and the results we strive to achieve.

Where is Adley Law Firm located?

Our firm is conveniently located in downtown Houston, Texas. We are at 1421 Preston St, Houston, TX 77002. Injured clients throughout the Houston area and beyond are welcome to visit our office (by appointment) or we can handle consultations over the phone. For your convenience, we’ve included a map below showing our Houston office location. If you need help with directions or arranging transportation to our office, let us know – we’re here to help.

When you’re ready to discuss your workers’ comp case, give us a call at (713) 999-8669 or contact us online. The Adley Law Firm’s Houston workers’ compensation lawyers are prepared to fight for you. Don’t settle for less than you deserve – let us help you secure the benefits and justice you are entitled to after a workplace injury.