Texas Employees Compensation Insurance coverage Legal guidelines – Forbes Advisor
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If you get sick or injured due to work, you may be entitled to unemployment benefits. This includes medical care, physiotherapy, disability benefits and the reimbursement of lost wages.
Most, but not all, employers in Texas offer workers compensation insurance for their employees. Here’s a look at employee compensation insurance in the state of Texas.
Who Needs Compensation For Workers In Texas?
Unlike other states, Texas does not require employers to purchase workers compensation insurance. The decision to forego insurance, however, carries risks.
Waiver of insurance leaves an employer open to personal injury claims from workers injured on the job. Damage and legal fees are other costs to consider.
Regardless of whether or not you have employee accident insurance for your company, you must inform your employees about the employee accident status of your company. And you will want to do this at the time of hire. Notify each new employee about your employee compensation insurance or lack of coverage and post a notice along with your other workplace notifications.
If your company has workers ‘compensation insurance, you must also inform new employees that they have five days to waive their right to workers’ compensation and retain their right to sue the employer for an industrial accident.
This notice must inform employees that if they forego employee compensation coverage, they will be relinquishing the right to medical and income benefits under the Texas Employee Compensation Act.
If an employer decides to end employee compensation, the employer must notify employees and the Texas Department of Insurance’s Employee Compensation Department as soon as possible.
The largest insurance company for workers in Texas
Types of Compensation Benefits for Workers in Texas
The benefits for workers in Texas consist of:
Medical benefits who pay for the necessary medical care to treat a work-related injury or illness of an employee.
Funeral services for an employee’s funeral expenses if the employee dies of illness or injury at work.
Death benefit for families to replace some of the money lost when an employee dies from work-related injury or illness. The death benefit is 75% of the average weekly wage of the deceased employee.
Income benefits Replace some of the money employees lose due to work-related injury or illness, including:
- Temporary income benefits
- Impairment Income Benefits
- Additional income benefits
- Lifelong income benefits
In Texas, you can receive Temporary Income Benefits if you lose all or part of your wages for more than seven days due to work-related injury or illness. Temporary income is 70% of the difference between your average weekly wage and the money you can earn after your accident at work.
In Texas, you can get disability benefits if you have an work-related injury or illness that affects your entire body. The amount of impairment benefits that you will receive is based on an impairment assessment given to you by your healthcare provider. This rating is based on the percentage of permanent damage done to your body. For each percentage of the depreciation, you will receive three weeks of depreciation benefits.
Income supplement benefits are paid monthly by the insurance company after your impairment benefits have expired. The supplementary income benefits are 80% of what you get if you deduct the difference between 80% of your average weekly wage and the wage you earned after your accident at work.
Depending on the severity of your injury, you may be eligible for lifelong income. Lifetime income is 75% of your average weekly wage with an annual increase of 3%. You will receive these benefits for life.
Injuries Not Controlled by the Texas Workers Comp. are covered
In Texas, an injury or illness is insured regardless of fault if it arose in the course of employment. This includes injuries that occur during work-related travel.
However, the following injuries are not covered by Texas Workers Compensation Insurance:
- Injuries from horse games
- Deliberate criminal acts or self-harm
- Injuries resulting from drug or alcohol poisoning
Filing an Employee Comp Claim
Injured employees must file damage reports within 30 days of the injury. And they must submit the formal documentation for the workers’ compensation claim within one year of the injury.
If an employee does not notify their employer of an injury or illness within 30 days, they may not receive employee compensation. For this reason, it is important to report an employee compensation and damage claim as soon as possible.
Doctors for accidents at work
Some employers choose to secure employee compensation through a certified health network. If your employer is on a certified health network, you will need to select a doctor from the list of network providers to provide care (unless it is an emergency or the employee has prior permission to leave the network). Ask your employer for this list.
The Texas Ministry of Insurance has a list of certified workers in health networks.
If your employer is not on a network, you can ask your current doctor if they treat employee compensation patients. If not, ask them to recommend a doctor who will. Family and friends are other good sources. You may know doctors who admit patients with occupational injuries or illnesses.
When you find a doctor treating a disability injury or illness, you need to provide the doctor with the following information:
- Name, phone number and work address of your employer
- Name of the employer’s employee accident insurance and claim number
- Name and phone number of the insurance expert handling your claim
Texas Workers Compensation Insurance Costs
There are several factors that affect the cost of workers’ compensation insurance in Texas: the number of employees and payroll, the type of work the employees do, the location, and the type of industry.
According to Cerity, the estimated employer cost for employee insurance in Texas is 7 cents per $ 100 payroll for the lowest risk employees and $ 13.29 for every $ 100 payroll for the highest risk employees.