Houston, TX asked in Workers' Compensation for Texas

Q: Do you have to pay back workers comp if you get a settlement

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2 Lawyer Answers

Daniel Morris

Answered
  • Workers' Compensation Lawyer
  • Dallas, TX
  • Licensed in Texas

A: It depends upon what you mean by settlement. If you receive short/long term disability disability, it will depend upon the policy. If you receive a settlement for a bad faith claim from you cause of action, you do not reimburse the insurance carrier.

However, if you are injured in your employment by the negligent act of a third party, your workers compensation insurance carrier my place a subrogation lien against your future entitlement to benefits and/or medical treatment.

If you are found entitled to social security disability or insurance, it will not affect your workers compensation. However, your workers compensation benefit may affect your social security benefit.

Roy Lee Warren

Answered
  • Workers' Compensation Lawyer
  • San Marcos, TX
  • Licensed in Texas

A: If you are asking if you have to pay back money to the WC carrier for a 3rd party claim (money you get from a person whose negligence caused an injury)you do not pay it back. However the WC carrier will require you to show that you have spent the money you recovered on medical expenses to treat your injury before the WC carrier will pay for any additional medical expenses on your claim. In addition when your 3rd party claim is settled the WC carrier is usually there holding its hand out to grab at least a portion of your recovery. By law the WC carrier may be entitled to a subrogation right of 2/3s (or more) of your recovery to repay the WC carrier for benefits it has paid on your claim.

If you are asking about a payment from a disability claim YOU PAID FOR, and assuming the disability contract does not address a WC claim, the money should be yours, based on a decision I wrote (I may have been a ghost writer on it) while with the WC appeals panel. If your employer paid for the claim then the carrier is entitled to the disability benefits and if both you and your employer paid for the disability plan you share in the proportion of your payment. Also be aware you may have short term disability and long term disabilty. In that case be sure to review the contracts for both because they may be different. Good luck. Roy

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