Can I Get Workers' Compensation in Texas?

In 1911, Wisconsin became the first state to pass a comprehensive workers’ compensation law. By 1920, 42 states had workers’ compensation laws on the books. Today, every state requires companies to carry workers’ comp insurance.

Well, not every state. “Texas does regulate insurance,” says Matthew Lewis of MLF Legal in Dallas. “But there are no minimum requirements for what a work injury policy would cover outside of the state’s regulated workers’ compensation system.”

That system, says Kay Goggin, who runs an eponymous firm in Dallas, “is a procedural and regulatory nightmare that will drive everyone crazy.”

For legal guidance on a workers’ compensation claim in the state of Texas, reach out to an experienced workers’ comp lawyer.

Texas Workers’ Compensation Law

Workers’ comp wasn’t always so challenging. “In the 1970s, the Democratic Legislature and judges were pretty friendly to workers,” Goggin says. But in 1989, the Texas Workers’ Compensation Act was enacted.

“The state adopted the concept that insurance companies can put together a treatment network for injured workers,” Lewis says. “Injured workers have to go to doctors on the workers’ comp insurance company’s list. Those lists are limited to the doctors that the insurance company wants them to see.” 

Injured workers are ruled against, in Lewis’ estimation, “More than 70% of the time. The number of doctors willing to work in that capacity has dropped from thousands to a few hundred.”

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Requirements for Filing a Claim as an Injured Employee

Requirements for filing a claim are stringent, Lewis adds. “In a claim under the state’s workers’ comp system, an injured worker has 30 days to report an injury to their employer,” he says. “In most nonsubscriber policies, employees only have 24 hours.”

The law also makes litigation more difficult. “I would expect that workers are only winning about 25% of the time,” Lewis says.

And there is no consideration for an injured worker’s pain and suffering. “It went from a system where we could settle with insurance companies to a model to specifically pay for a set amount,” Lewis says.

How Lawyers Are Paid in Workers’ Comp Cases

It’s no surprise that few attorneys in Texas practice in this area anymore. “Fees for attorneys are tied to benefits, so there is no value to an attorney to handle a workers’ comp claim,” Lewis says. 

Even lawyers’ fees are prescribed. Goggin says guidelines from the Texas Department of Insurance – Division of Workers’ Compensation (TDI-DWC) only approve about half of what her typical hourly fee is in other cases. Moreover, the rules only approve two hours per week of talking to a client, though lawyers can petition for more time.

Why do they still do it? “I had to decide whether it was about the money or helping people,” Lewis says. “I stuck with a practice that allows me to help people.” 

What To Do if You’ve Had a Workplace Injury

So what should you do if you’re injured at work?

“Navigating the overwhelming amount of rules, regulations, forms for the claim, and the process of administrative dispute process can be annoyingly frustrating and time-consuming. A Texas employer may not have workers’ comp insurance at all or has some other work injury plan which falls under a whole different set of rules, laws, deadlines,” Goggin says.

“Best suggestion: Don’t wait to seek legal advice,” she adds.

Workers’ Compensation Benefits When You Work from Home

The rules that apply for work-related injuries at a worksite also apply for those who work from home. A claimant must prove they were injured and that the injury occurred during work for their employer. 

“If you’re in your home office doing work, and you pick up a pile of papers and your back goes out, that is related to work,” Matthew Lewis says. “But what happens if you’re in your home office, the baby wakes up from a nap, you jump up to check on the baby and trip over the dog?

“In an office, you have a personal comfort and convenience doctrine, which means if you are taking care of yourself at work — for example, in the restroom or on break — you are still covered,” he adds. “At home, you don’t have a break room. So that has to be addressed.”

He says there is not a lot of precedent on those questions. “I had a case where a guy was carrying a computer box that had been delivered to his house out the back door to his home office, tripped, fell and broke his ankle. The insurance company denied the claim, but we got a judge to rule he was covered. It all comes down to whether the activity is benefiting the employer.” 

So far, Lewis has handled only two or three work-from-home cases, and they were straightforward. “I haven’t had a case where mom trips over the dog,” he says. “But that case is going to come up.”

Find Experienced Legal Help

For legal advice on claiming workers’ compensation coverage, speak with a local attorney who’s experienced in state workers’ comp law.