How Does Workmans Comp Work in Texas?

by Nicholas Pell; Updated September 26, 2017

Workman's compensation provides help for those who have been injured on the job or are suffering from workplace illness. In Texas, workers compensation is not compulsory. Knowing the ins and outs of the law allows a worker to stand on firm ground in the event of unfortunate accidents.

Coverage

Texas is one of the few states where workman's compensation insurance is not mandatory. The only exception to this rule is the government, which must have insurance. Likewise, contractors doing business with the federal or state government must also have insurance. You are not entirely without recourse, however. You may have a civil case against an employer who lacks insurance. The Texas state government will provide you with legal assistance through the Office of Injured Employee Counsel.

Exceptions

Texas state law has a number of exceptions to your right to sue an employer for a workplace injury or work-related illness. You cannot seek compensation for injuries obtained while intoxicated. Nor does the law allow you to sue your employer or collect compensation benefits for "acts of God." Horseplay and injuries sustained on purpose or while trying to injure another person are likewise not covered. Anything that happens while voluntarily participating in work-related social activities is not covered.

Rights

Even though employers don't have to get workman's comp insurance in Texas, workers in the state still have rights when they are injured. Primarily, you have the right to benefits, even if they must be obtained in civil court. Texas law grants you the right to medical care for your injuries and illness. Furthermore, you have the right to choose your doctor. If you are in a managed care program, you have the right to choose the doctor from that plan.

Denied Claims

When an insurance adjuster denies your claims, you have a number of options in the state of Texas. First, you can speak directly to the adjuster and try to work something out. Failing this, there is a dispute resolution process. You start with a benefit review conference before proceeding to a hearing. Then you may file an appeal with the state. Finally, a judge can review your case before ordering arbitration.

About the Author

Nicholas Pell began writing professionally in 1995. His features on arts, culture, personal finance and technology have appeared in publications such as "LA Weekly," Salon and Business Insider. Pell holds a Bachelor of Arts in English from the University of Massachusetts at Amherst.