Austin, TX – To understand the impact of COVID-19 on the Texas workers’ compensation system, on June 2, 2020, The Texas Department of Insurance, Division of Workers’ Compensation (DWC) issued a mandatory data call with 74 selected insurance carriers, and has released an updated factsheet with results as of August 1, 2021.
The Texas Department of Insurance, Division of Workers’ Compensation (DWC) has prepared a factsheet to provide information on the potential impact of COVID19 on the state’s workers’ compensation system.
The factsheet provides preliminary information on COVID-19 claims, including indemnity benefits and medical costs paid on claims, as well as information on the percentage of these claims that insurance carriers accepted or denied. Please note that the factsheet does not reflect the impact of Senate Bill (SB) 22 (87th Legislature, effective June 14, 2021), which created a statutory presumption for COVID-19 claims involving
most first responders, detention officers, and custodial officers.
The bill also allows injured employees or beneficiaries to request that their previously denied claims be reprocessed under the new presumption and permits new COVID-19 claims to be filed for infections that occurred before June 14, 2021. Future factsheets will include an initial analysis of the claims subject to SB 22 once sufficient data has been collected.
- COVID-19 claims: As of August 1, 2021, insurance carriers reported more than 50,000 COVID-19 claims and 269 fatalities to DWC. Nearly half of these claims and fatalities involve first responders and correctional officers.
- COVID-19 claims with benefits: In 2020, only one-third of COVID-19 claims filed had medical or indemnity benefit payments associated with them.
- Claims with positive test or diagnosis: Most claims (59%) involved injured employees who tested positive or were diagnosed with COVID-19.
- Denials and disputes: Data call results show insurance carriers accepted slightly more than half (51%) of COVID-19 positive test claims. Despite nearly 14,000 denials of COVID-19 claims with positive tests or diagnoses, there were only 112 disputes filed with DWC as of August 1, 2021.
- Benefits paid: For COVID-19 claims, most of the benefits paid were indemnity benefits (particularly employer salary continuation), compared to medical benefits.
- Claims with post-COVID conditions: About one out of five claims that received professional or hospital/facility services received these services beyond one month post-injury.
Read the full factsheet: TDI-DWC REG: COVID-19 in the Texas Workers’ Compensation System (PDF)