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 obliged to take out any form of workers’ compensation insurance. This means that in Texas, if a worker is injured and the employer has opted out of providing workers’ comp coverage, then the employee is at the mercy of whatever alternative plans the employer has come up with (this, of course, barring the potential for a third-party injury claim against a negligent party). An astounding 40 percent of all Texas businesses, large and small, no longer have workers’ compensation insurance. These companies are known as workers’ non-subscribers.
Because employee non-subscribers are allowed to come up with their own alternative employee plans, employees often run into problems. Employer-created plans tend to cover fewer injuries, cut off benefit payments more quickly, dictate which doctors employees can visit and sometimes impose mandatory settlements that don’t fully cover the injured workers’ costs, such as medical bills and lost wages. Because of these problems, victims of workplace accidents not covered by workers’ compensation face serious financial and medical uncertainty.
A deep dive into the problem
An investigation 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 a worker needs it.
Also, employer-created plans sometimes won’t pay for things like wheelchair carriages or for complications due to occupational diseases caused by exposure to dust, mold, and even asbestos. Even worse, appeals are often controlled by employers, and payments for catastrophic injury and wrongful death can be severely limited.
For the above reasons, the best course of action when you suffer an injury at work is to discuss your case in a free consultation with a workers’ compensation attorney.
Without the help of a qualified personal injury/workers’ compensation attorney, seeking fair compensation for things like medical expenses, lost wages while unable to work, and other financial losses related to your accident can be extremely confusing and complicated.
