- Worker's Compensation- Texas Department of Insurance
Workers' Compensation
| Division of Workers' Compensation | Workers' Compensation Classification & Premium Calculation |
| Health & Workers' Compensation Network (HWCN) | Workers' Compensation Research & Evaluation |
Related Links
Highlights
Office of Injured Employee Counsel
- A state agency created by the Texas Legislature to represent the interests of injured workers in the workers' compensation system. | OIEC Website
Shopping for Workers' Compensation Insurance
- Texas law does not require workers' compensation. However, your customers may require you to carry it. Shopping for Workers' Compensation
Workers' Compensation Reform
- The 79th Texas Legislature enacted workers' compensation reform through House Bill 7. Key provisions were effective September 1, 2005, including the merger of the Texas Workers' Compensation Commission with TDI.
| Help For | Toll-Free # |
|---|---|
| Consumers | 800-252-3439 |
| Injured Workers | 800-252-7031 |
| Reporting Arson | 877-434-7345 |
| Reporting Fraud | 800-252-3439 |
| Safety Violations | 800-452-9595 |
| [ tdi phone listings ] | |
| Help For | Link |
|---|---|
| Agents / Adjusters | |
| Filing Complaints | |
| Media / Others | |
| Website Problems | |
| Favorite Links | |
|---|---|
| Agent Lookup | Company Lookup |
| Enforcements | DWC Home |
| DWC Forms | All Other Forms |
| TDI Jobs | TXCOMP Home |
| TDI StormLink | Windstorm |
| [ popular links · more lookups ] | |
For more information contact: PIO@tdi.state.tx.us
Last updated: 09/24/2012
Contact Information and Other Helpful Links
Translation by WorldLingo
Division of Workers' Compensation
Current Division Initiatives
- New Plain Language Notice (PLN-12), Notice of Potential Entitlement to Workers' Compensation Death Benefits
- Proposal: Amend 28 TAC §134.803 and §134.807 Concerning Reporting Standards and State Specific Requirements
- Input Needed for Development of the Medical Quality Review CY 2013 Annual Audit Plan
- Adopted MQRP Rules | MQRP Process Document | MQRP Application
- DWC Form-057, Request for Extension of Maximum Medical Improvement Date for Spinal Surgery
- TDI-DWC Finalized Insurance Carrier/Utilization Review Agent Plan-Based Audit
- New Medicare Administrative Contractor for Texas
- TDI-DWC is seeking qualified individuals to provide professional services as a member of the MQRP. The Request for Qualifications for MQRP member is available from the Electronic State Business Daily at http://esbd.cpa.state.tx.us/bid_show.cfm?bidid=101716.
- Injured Employee
Assistance
800-252-7031 - Comp Connection for
Health Care Providers
800-372-7713 Ext. 3 - Insurance
Coverage
800-372-7713 Ext. 6 - Safety Violations
Hotline
800-452-9595
For more information contact: WebStaff@tdi.state.tx.us
Last updated: 11/14/2012
Contact Information and Other Helpful Links
Translation by WorldLingo
Workers' Compensation Resources for Employers
Workers’ compensation is a state-regulated insurance system that provides covered employees with income and medical benefits if they are injured on the job or have a work-related injury or illness. Workers’ compensation insurance coverage limits an employer’s liability if an employee brings suit against the employer for damages. In Texas private employers can choose whether or not to carry workers’ compensation insurance coverage.Texas employers who do not carry workers’ compensation insurance coverage are required to report their non-coverage status and work-related injuries and occupational diseases to the Texas Department of Insurance, Division of Workers’ Compensation (TDI-DWC). Employers who do carry workers' compensation insurance coverage are required to report all known occupational disease and any work-related injuries that result in more than one day of lost time. Employers that fail to meet these requirements commit an administrative violation and may be subject to administrative penalties.
- About Workers' Compensation
- Information for Employers with Workers' Compensation Insurance Coverage
- Information for Employers without Workers' Compensation Insurance Coverage
- How a Workers' Compensation Claim Works
- Employer Frequently Asked Questions (FAQs)
- Return to Work: Getting Your Employee Back to Work Safely
- Workers' Compensation Health Care Networks
- Workplace Safety
- Complaint Resolution
About Workers' Compensation
- What is Workers' Compensation?
- Workers' Compensation Insurance Information
- Workers' Compensation Insurance Coverage Data
Information for Employers with Workers' Compensation Insurance Coverage
- Shopping for Insurance Coverage
- Certified Self Insurance
- Group Self Insurance - Private employers that have established a workers’ compensation self-insurance group under TLC, Chapter 407, Subchapter A are regulated by the Texas Department of Insurance. For information call 512-322-4176 or 512-322-3507.
- Employer Coverage Forms and Notices
- Fact Sheet: Employer Rights and Responsibilities | Derechos y Responsabilidades del Empleador
- Act
Information for Employers without Workers' Compensation Insurance Coverage
- Information for Workers' Compensation Non-Subscribers
- Fact Sheet: Non-Covered Employers
- Forms
- DWC Form-005, Employer's Notice of No Coverage or Termination of Coverage
- DWC Form-007, Employer’s Report of Non-covered Employee’s Occupational Injury or Disease
How a Claim Works
- Report an Injury (DWC Form-001)
- FAQ: One of my employees was injured. What do I do?
- Employee Benefits (fact sheets)
- Dispute Resolution
Complaint Resolution
Contact Information and Other Helpful Links
Translation by WorldLingo
Workers Compensation Resources for Employees / Injured Employees
Recursos Informativos para Empleados / Empleado Lesionado En españolWhat is Workers’ Compensation?
Workers’ compensation is a state-regulated insurance program that provides covered employees with income and medical benefits if they sustain a work-related injury or illness. Texas private employers can choose whether or not to provide workers’ compensation insurance coverage for their employees. In most cases, your employer is required to notify you whether or not they provide coverage.Workers’ compensation pays your medical bills and replaces a portion of your lost wages if: you are injured at work or have a work-related illness; and your employer has workers’ compensation insurance coverage under the Texas Workers’ Compensation Act, Title 5, Subtitle A, Labor Code.
Who is the Division of Workers’ Compensation?
The Texas Department of Insurance, Division of Workers’ Compensation (TDI-DWC) is a state agency that regulates the delivery of workers’ compensation benefits to injured employees and to eligible family members of employees killed on the job. The TDI-DWC also helps resolve disputes about claims and provides workplace safety and health services. The TDI-DWC does not pay benefits. Benefits are paid by workers’ compensation insurance companies, by employers certified by the TDI-DWC to self-insure, by groups of employers certified by TDI to self-insure, or by self-insured governmental entities.You may request assistance from the TDI-DWC by calling 1-800-252-7031.
Who is the Office of Injured Employee Counsel?
The Office of Injured Employee Counsel (OIEC) is the state agency created to advocate for the injured employees of Texas. OIEC assists injured employees by: educating and providing general assistance to injured employees regarding the workers’ compensation system; providing an ombudsman once a dispute proceeding has been scheduled to assist the injured employee throughout the dispute process; referring injured employees complaints to the appropriate entities and licensing boards; and providing injured employee referrals to other local, state and federal agencies, including the Department of Assistive & Rehabilitative Services (DARS), as appropriate.You may request assistance from the Office of Injured Employee Counsel by calling 1-866-EZE-OIEC (1-866-393-6432).
Resources for Employees
- Frequently-Asked Questions
- Glossary of Workers' Compensation Terms
- Benefits - Information about the different types of workers' compensation benefits available.
- Dispute Resolution - Information about the process to resolve a dispute about a work-related injury.
- Office of Injured Employee Counsel - Assists injured employees with workers' compensation disputes.
- Return-to-Work: Getting Back to Work After Your Injury
- Complaints File a complaint regarding a workers' compensation claim.
Contact Information and Other Helpful Links
Translation by WorldLingo
 |
Workers' Compensation ClassificationsResearch | Statistical Plan | Workers' Comp Coverage | Workers' Comp Manual DownloadsWorkers' Compensation Research
Statistical Plan
Workers' Compensation Coverage
SubscribeSubscribe to Property & Casualty Bulletins via eNews.For workers' compensation claims information, contact: WorkersCompCustomerServices For coverage information, contact: WorkersComp@tdi.state.tx.us Texas Workers' Compensation ManualUpdated: June 15, 2011
Texas WC Retrospective Rating Plan Manual (6,141KB, PDF) Requesting P&C Filings / Information Highlights
Research
Networks
Classifications
Shopping for Workers' Compensation
Insurance | Office of Injured Employee Counsel | Workplace Safety |
Self-Insurance
Regulation
Reporting a Workplace Safety Violation | Health Care Networks for Injured Employees | Complaint Resolution form
For more information contact: WorkersComp@tdi.state.tx.us Last updated: 09/24/2012 Contact Information and Other Helpful Links Translation by WorldLingo Workers Compensation
Contact Information and Other Helpful Links Translation by WorldLingo Texas Workers' Compensation Rate Guide
as of January 30, 2012
Basis of Rates Tables
Company/Group Index This rate guide is published to assist you in comparison shopping for your workers’ compensation coverage. A company may choose to base its rates on (1) the Texas workers’ compensation classification relativities (relativities) established by the Commissioner of Insurance (Commissioner); (2) its own independent company-specific relativities filed by the company; or (3) loss costs filed by the National Council on Compensation Insurance (NCCI), which is an advisory organization to the Texas Department of Insurance (TDI).The relativities established by the Commissioner and the independent company-specific relativities filed by the company represent the relationship between classifications. Companies that choose to use the relativities as a basis for their rates file a deviation factor, which takes into consideration the company’s experience. The relativities and the company’s deviation are intended to cover the indemnity and medical benefits provided under the workers’ compensation system in Texas, as well as profits, taxes and expenses for the company. The loss costs filed by NCCI for each classification are intended to cover the indemnity and medical benefits provided under the workers’ compensation system in Texas, as well as the expenses associated with providing these benefits. Companies that choose to use the loss costs as a basis for their rates file a loss cost multiplier (LCM), which contemplates any other expenses associated with providing workers’ compensation insurance, such as agents’ commissions, profits and taxes for the company. You will note that the relativity is higher than the loss cost for each classification. The ultimate impact of the different rate bases on final rates charged on a workers’ compensation policy will depend primarily on the company adjustment, in the form of the deviation factor for relativities or the LCM for loss costs. Texas employers are assigned one or more classifications based on the type of business. Each employee´s payroll is then assigned to the appropriate classification. The total payroll for each classification is then multiplied by the company’s rate for that classification (rate per $100 payroll) to determine premium. The employer´s basic premium is the sum of the individual classification premiums. The Texas classifications may differ significantly from those used in other states because they are specific to Texas businesses. Companies must use Texas classifications, but the rates for the individual classifications differ from one company to another. To determine the rate for a specific classification, you multiply the relativity by the deviation factor for a specific company or multiply the loss cost by the LCM for a specific company. For example, the June 1, 2011, relativity for Code 5551 (Roofing) is 17.96. If a company files a deviation factor of .95, then the rate for Code 5551 using relativities is 17.06 (17.96 X .95 = 17.06) per $100 payroll. The June 1, 2012, loss cost for Code 5551 (Roofing) is 7.25. If a company files an LCM of 1.50, then the rate for Code 5551 using the loss cost is 10.88 (7.25 X 1.50 = 10.88) per $100 payroll. There are other factors that may be utilized to increase or decrease the employer´s premium. An experience rating modifier that reflects the employer´s past loss history may be applied to the premium. The employer may be able to negotiate the experience modifier downward if it has improved loss ratios or implemented improved safety programs. A schedule rating debit or credit may be applied to the premium depending on individual characteristics of the employer´s business that may not be reflected in the rate. In addition, there are optional rating plans that may reduce premiums, such as deductibles or retrospective rating, which are available to eligible insureds. The Basis of Rates Tables list the relativities established by the Commissioner and the loss costs filed by NCCI. The Listing of Companies by Group & Filing Information is arranged alphabetically by company group and lists each company that has made a rate filing. This section indicates the company’s basis for calculating workers’ compensation rates, such as (i) relativities established by the Commissioner and the company’s deviation factor, (ii) independent company-specific relativities developed by the company and its deviation factor or (iii) loss costs filed by NCCI and the company’s LCM. This section also indicates the maximum and minimum schedule rating debit or credit percentages that each company has filed. Schedule rating is optional and allows the company to adjust the premium based on individual characteristics of the business. The criteria and debits and credits do not have to be standard between companies. The Company/Group Index lists each company alphabetically and indicates the name of the group each company is in. This rate guide is updated periodically based on the filings made by companies. If you want to ask a specific company about getting a quote, call the number shown in the rate guide and ask for a quote or contact your insurance agent. We furnish toll-free numbers, where possible. The number shown in the guide may be an out-of-state office, so be sure to say you are calling for a Texas quote. Each company within a group may have different rates, so check to see if your business qualifies for coverage with the company that offers the lowest rates. We hope you find this rate guide helpful. GIVE US FEEDBACK:The Texas Department of Insurance is working hard to provide you with information you need to make informed choices about workers´ compensation insurance. If you have any questions, comments or suggestions about this rate guide, we would like to hear from you.CALL US:(512) 322-3495, WC Classification and Premium Calculation Office.If you are hearing or speech impaired, you may call 1-800-735-2989 (TDD). WRITE US:Texas Department of InsuranceWC Classification and Premium Calculation Office, MC 105-2A P. O. Box 149104 Austin, Texas 78714-9104  Return to TopContact Information and Other Helpful Links Translation by WorldLingo Workers' Compensation ClassificationsResearch | Statistical Plan | Workers' Comp Coverage | Workers' Comp Manual DownloadsWorkers' Compensation Research
Statistical Plan
Workers' Compensation Coverage
SubscribeSubscribe to Property & Casualty Bulletins via eNews.For workers' compensation claims information, contact: WorkersCompCustomerServices For coverage information, contact: WorkersComp@tdi.state.tx.us Texas Workers' Compensation ManualUpdated: June 15, 2011
Texas WC Retrospective Rating Plan Manual (6,141KB, PDF) Requesting P&C Filings / Information Highlights
Research
Networks
Classifications
Shopping for Workers' Compensation
Insurance | Office of Injured Employee Counsel | Workplace Safety |
Self-Insurance
Regulation
Reporting a Workplace Safety Violation | Health Care Networks for Injured Employees | Complaint Resolution form
For more information contact: WorkersComp@tdi.state.tx.us Last updated: 09/24/2012 Contact Information and Other Helpful Links Translation by WorldLingo MCQA Office HomeThe Health & Workers' Compensation Networks (HWCN) Certification and Quality Assurance Office has become the Managed Care Quality Assurance (MCQA) Office.The MCQA Office is made up of knowledgeable staff members who provide assistance to injured employees, enrollees, certify and regulate HMO Carriers, certified WC Networks, Utilization Review Agents (URAs), Independent Review Organizations (IROs), industry representatives and other members of the public. Health Maintenance Organization (HMO)On the HMO homepage, you will be able to find a variety of important information, including a listing of HMOs, HMO licensing information, a link to HMO forms and other HMO-related information.Workers' Compensation Networks (WCN)The MCQA Office regulates Texas Workers' Compensation Networks which provide health care services to injured employees through certified health care networks. The office is responsible for the certification and regulation of the health care networks. In Texas, an employer may elect to use, but is not required to use, a certified workers’ compensation network.The Division of Workers' Compensation (DWC) oversees the state-regulated insurance program that pays medical bills and replaces some lost wages for employees who are injured at work or who have work-related diseases or illnesses. Independent Review Organization (IRO)Independent Review Organizations (IRO) are independent third parties certified by the Texas Department of Insurance to review the utilization reviewer's decision that health care services are not medically necessary or appropriate or that health care services are experimental or investigational. If a health benefit plan or workers' compensation carrier refuses to pay for a treatment because it does not consider the treatment medically necessary or appropriate or because it considers the treatment to be experimental or investigational, you may be able to have an IRO review the decision.Utilization Review Agent (URA)Utilization Review Agents (URA) are registered or licensed entities that review requests for health care services being provided (concurrent), proposed to be provided (prospective) or already provided (retrospective). URAs determine whether services are medically necessary and appropriate and may also determine if services are experimental and investigational. The MCQA Office processes applications for entities seeking registration, licensure or licensure renewal as a URA within the state of Texas.Third Party Administrator (TPA)On the Third Party Administrator (TPA) homepage, you will be able to find a variety of information, including a listing of TPAs, TPA licensing information, a link to TPA forms and other TPA-related information.Highlights
HMOs & TPAs
For more information contact: HWCN@tdi.state.tx.us Last updated: 03/22/2012 Contact Information and Other Helpful Links Translation by WorldLingo Workers' Compensation Health Care Networks (WCNet)
Latest News
Rules and RegulationsOpen Conference Calls
More WCNet Information
Contact Information and Other Helpful Links Translation by WorldLingo
Workers' Compensation Health Care Networks (WCNet)
Latest News
Rules and RegulationsOpen Conference Calls
More WCNet Information
Contact Information and Other Helpful Links Translation by WorldLingo WC Research and Evaluation Group - WC REGHighlights
Latest News
REG Research Agenda
REG Reports and Studies
House Bill 28 (78th Legislature, third called session, 2003) created a new workers' compensation research function at the Texas Department of Insurance (TDI) by transferring the research function of the former Research and Oversight Council on Workers' Compensation (ROC) to the agency. Per Chapter 405 of the Texas Labor Code, the Workers' Compensation Research and Evaluation Group (REG) is responsible for conducting professional studies and research on various system issues, including:
Also AvailablePublications | Forms | Data Calls
For more information contact: WCResearch@tdi.state.tx.us Last updated: 11/12/2012 Contact Information and Other Helpful Links Translation by WorldLingo WC Research and Evaluation Group - WC REGHighlights
Latest News
REG Research Agenda
REG Reports and Studies
House Bill 28 (78th Legislature, third called session, 2003) created a new workers' compensation research function at the Texas Department of Insurance (TDI) by transferring the research function of the former Research and Oversight Council on Workers' Compensation (ROC) to the agency. Per Chapter 405 of the Texas Labor Code, the Workers' Compensation Research and Evaluation Group (REG) is responsible for conducting professional studies and research on various system issues, including:
Also AvailablePublications | Forms | Data Calls
For more information contact: WCResearch@tdi.state.tx.us Last updated: 11/12/2012 Contact Information and Other Helpful Links Translation by WorldLingo |
|||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
 | |
| |
|
| |
| |
|
