Texas Workers Compensation networks working

The Texas Department of Insurance just released their annual report on the state of the Worker’s Compensation heathcare network in Texas.

The 2012 Workers’ Compensation Network Report Card compares health care outcomes across a spectrum of statistics from the twelve network providers with non-network entities. The report is based on telephone surveys of 3,276 injured employees with new lost-time claims, which represents approximately 26 percent of the total lost-time claim population.

And it seems from the results that the system is working efficiently.

Here are some outcomes:

• Overall, 504-Alliance, 504-Others, Travelers, and Zurich injured employees had lower average medical costs than non-network injured employees for the first six months after the injury.
• Regarding lost-time claims, 504-Alliance, 504-Others, Corvel, and Texas Star injured
• employees had lower average medical costs than Non-network injured employees.
• 504-Alliance, 504-Others, and Zurich had lower average professional costs than Non-network.
• Overall, networks tended to have higher utilization of professional and pharmacy services than Non-network.
• Networks tended to have lower utilization of hospital services than Non-network Access to Care and Satisfaction with Care
• Injured employees from seven network entities reported higher levels of agreement with their treating doctors than non-network injured employees (up from zero networks in 2011).
• All twelve network entities reported higher return-to-work rates than Non-network.
• All twelve network entities had lower average numbers of weeks off from work than Non-network.

Information on the Workers Compensation network itself is also on the TDI website.

Workers covered under worker’s compensation insurance in Texas may not sue subcontractors or contractors as long as their worker’s compensation policies are in place, even though they are not the same policy, or so said a recent decision by the Texas Court of Appeals.

In the case Garza v. Zachry Construction Corp., 2012 WL 1864350 (Tex. Ct. App. May 23, 2012), an employee of DuPont at its Ingleside, Texas plant was injured in a rail accident and received worker’s comp benefits from DuPont. However, he also attempted to sue a subcontractor and several of its employees who were responsible for the accident. DuPont had them covered under a different worker’s compensation insurance plan. The subcontractor argued that because DuPont provided the coverage, they were also “deemed employees” of DuPont so could not be sued under Texas labor statutes.

The plaintiff argued basically that because employees of DuPont and the subcontractor were not covered under the same policies, that the bar against filing suit for injury did not come into play. And they further argued that even if the bar did obtain, it violated the Texas constitution guarantee of open courts – that a common-law cause of action will not be hindered from access to the courts.

The Court of Appeal agreed with the argument of the defendants.

So as long as your worker’s compensation policies are in force, contractors and their subcontractors are protected from suit by employees.

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