What does it mean for a state to be an “opt-out” state for workers’ compensation? Most states impose requirements on 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, barring 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 non-underwriters of workers’ compensation.
Because workers ‘compensation non-subscribers can create their own alternative workers’ compensation plans, employees often run into trouble. Employer-created plans tend to cover fewer injuries, cut benefit payments sooner, dictate which doctors employees can visit, and sometimes impose mandatory arrangements that don’t fully cover injured workers’ costs, such as medical bills and lost wages. Because of these issues, workplace accident victims 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 stand-alone 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 sometimes don’t pay for things like wheelchair vans or complications due to occupational illnesses caused by exposure to dust, mold, and even asbestos. Worse, 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, the best course of action is to discuss your case in a free consultation with a workers’ compensation attorney.
Without the help of a qualified workers’ compensation / personal injury attorney, it can be extremely confusing and complicated to seek fair reimbursement for things like medical expenses, lost wages from being unable to work, and any other financial loss related to your accident.