Workers’ compensation is the method by which covered workers are compensated for work-related injuries or illnesses. In Texas, the workers’ compensation system is regulated by the Texas Department of Insurance (TDI).
When a covered worker suffers a work-related injury or illness, the employer’s workers’ compensation insurance company pays the medical and income benefits due the employee. (In some cases, employers may self-insure their workers’ compensation claims or join with other employers to self-insure. In these instances, the employer or the self-insurance group pays benefits.)
Texas law limits a covered employer’s liability to a specific schedule of benefits based on the type and severity of the worker’s injury.
Benefits include:
lifetime medical benefits for necessary treatment of compensable injuries and illnesses
disability income benefits for a specified period of time and up to dollar limits set by law
limited funeral expenses for workers killed on the job
death benefits for surviving dependents of workers killed on the job.
Benefits are not payable for injuries:
that are intentional or self-inflicted
result from the employee’s horseplay or voluntary intoxication (either alcohol or drug-induced)
arise from voluntary participation in off-duty recreational, social, or sports events
result from “acts of God,” unless a person’s job exposes him or her to a greater than ordinary risk of injury from such acts
- are inflicted by someone else for personal reasons unrelated to employment.
Information on this page was obtained from the Texas Department of Insurance. These are general descriptions of plans. Policies and coverages differ.
Please read your policy carefully.