Austin, TX – The Texas Department of Insurance, Division of Workers’ Compensation (DWC) recently released the latest update to its report that provides information on the impact of COVID-19 on the state’s workers’ compensation system.
The report provides ongoing information on COVID19 claims, including the percentage of claims that insurance carriers accepted or denied, as well as indemnity benefits or medical costs paid on claims.
Key Findings included:
- COVID-19 claims: As of November 6, 2022, insurance carriers reported nearly 95,000 COVID19 claims and 465 fatalities to DWC. Half of these claims (50%) and slightly more than half of the fatalities (55%) involve first responders and correctional officers.
- Claims with positive test or diagnosis: More than two-thirds of all claims (70%) involved injured employees who tested positive or were diagnosed with COVID-19. Insurance carriers accepted more than half (60%) of COVID-19 positive test claims.
- Denials and disputes: Insurance carriers denied less than half (38%) of COVID-19 positive test claims. Despite more than 24,500 denials of COVID-19 claims with positive tests or diagnoses, there were only 224 disputes filed with DWC as of November 6, 2022.
- COVID-19 claims with benefits: During the COVID-19 pandemic (i.e., March 13, 2020, through September 30, 2022), slightly more than one-third (34%) of COVID-19 claims filed had medical or indemnity benefit payments associated with them. Benefits paid: Most of the benefits paid on COVID-19 claims were indemnity benefits (particularly employer salary continuation and temporary income benefits), compared to medical benefits.
- Claims with post-COVID conditions: Nearly one quarter of claims (23%) that received professional, or hospital/facility services received these services beyond one month post-injury
- Administrative claim data reported to DWC by insurance carriers from March 13, 2020, through November 6, 2022, on COVID-19 claims. Specific information on indemnity and medical benefits paid for COVID-19 claims is limited to benefits paid as of November 9, 2022, on claims reported to insurance carriers as of September 30, 2022.
- A data call with 74 selected insurance carriers to gather more detailed information on how many workers’ compensation claims resulted in a positive test or diagnosis as of September 30, 2022, and the disposition of those claims (accepted, denied, or under investigation).
Read the free report: TDI-DWC: Covid-19 in the Texas Workers’ Compensation System, Dec 2022 (PDF)