- The vast majority of workers’ compensation and Texas injury benefit program claims do not involve catastrophic injury. For these typical claims, all reasonable and necessary medical expenses are paid in full. However, most employees covered by Texas injury benefit programs are eligible for wage replacement benefits that are higher than workers’ compensation benefits (even after adjusting for any applicable taxes). Texas injury benefit wage replacement benefits commonly start sooner, are paid at a higher percentage and with a higher (or no) weekly dollar cap.
- Texas injury benefit programs often pay more defined levels of compensation faster in catastrophic claims. For example, death and dismemberment benefits in Texas injury benefit programs are typically paid in a lump sum or installments over three years instead of weekly payments strung out over many more years.
- In some cases, Texas injury benefit programs may pay fewer benefits for catastrophic injury claims because of the opportunity for additional recoveries due to any employer negligence that caused the injury. This Texas negligence liability exposure is very real, with over 100 identified settlements or judgments of $1 million or more involving employers that do not provide workers’ compensation insurance coverage.