The Texas Department of Insurance, Division of Workers’ Compensation (DWC), recently released its Biennial Report to the Texas Legislature. The report highlights what DWC considers “significant improvments in the system.” These “improvements” include the following:
– Decrease in workers’ compensation insurance premiums of 40% since 2003;
– Increased number of employers who are workers’ compensation policyholders;
– Increased number of workers’ compensation health care networks; and
– Decrease in non-fatal workers’ compensation claims of 19% since 2005.
While these and many of the other statistics from DWC’s report may appear promising at first glance, the report merely presents statistics and does not analyze several areas of Texas workers’ compensation law where change is most urgently needed. The report is focused on selected statistics, and even those numbers do not tell the whole story.
The expansion of health care networks has removed some of the best-qualified doctors from injured employees’ access, and it has stripped injured employees of the ability to choose and retain a doctor of their own choice. They are left with a few doctors that have been hand-picked by their insurance companies to cut corners and prematurely cut off care to injured employees.
Injured employees in rural areas are especially hard hit, and they are frequently left without a nearby network doctor and cannot even get travel reimbursements from their insurer.
A mere decrease in claims fails to account for an increase in the number of claims that are not pursued due to insurer denials. And the report does not even present denial statistics, besides to note that they are being “tracked.” Moreover, this statistic is unreliable due to decreased economic activity overall.
And Texas still remains the only state in the nation that permits employers to opt out of workers’ compensation coverage, leaving 17% of Texas employees uncovered by workers’ compensation insurance if they are injured on the job.
DWC is focused on statistics, but statistics do not speak to the quality of care recieved by Texans who are injured on the job. DWC’s report should be focused instead on ensuring that injured employees are treated fairly and promptly by their insurer, so that they can recover and return to work.
The entire report is available from DWC here.