What you need to know about workers’ compensation in Texas

What does it mean for a state to be an “opt-out” state for workers’ compensation? Most states require employers to cover employees under a workers’ compensation policy to help them with things like medical bills and lost wages when employees are injured.

However, this is not true in Texas. Here, employers are not required to carry any type of workers’ compensation insurance. That means that in Texas, if a worker is injured and the employer has chosen not to provide workers’ compensation coverage, then the employee is at the mercy of whatever alternative plan the employer has devised (this, of course, precludes the possibility of a third-party injury claim against a negligent party). A staggering 40 percent of all Texas businesses, large and small, no longer carry workers’ compensation insurance. These companies are known as workers’ compensation non-subscribers.

Because non-subscribers to workers’ compensation are allowed to devise their own alternative workers’ compensation plans, employees often get into trouble. Employer-created plans tend to cover fewer injuries, cut benefit payments earlier, dictate which doctors employees can see, and sometimes impose mandatory settlements that don’t fully cover injured workers’ costs, such as medical bills and lost wages. Because of these issues, victims of workplace accidents who are not covered by workers’ compensation face serious financial and medical uncertainty.

A deep dive into the problem

Research by the nonprofit ProPublica and NPR found that many independent insurance plans in Texas only cover care for an average of two years. This is in direct contrast to workers’ compensation insurance, which lasts as long as the worker needs it.

Also, employer-created plans will sometimes not pay for things like wheelchair vans or complications due to occupational illnesses caused by exposure to dust, mold, and even asbestos. Worse yet, appeals are often controlled by employers, and payments for catastrophic injuries and wrongful death can be strictly limited.

For the reasons listed above, whenever you are injured on the job, your best course of action is to discuss your case in a free consultation with a workers’ compensation attorney.

Without the assistance of a qualified personal injury/workers’ compensation attorney, it can be extremely confusing and complicated to seek fair reimbursement for medical expenses, lost wages while unable to work, and any other financial losses related to your accident.