Why is Texas Workers' Compensation so unfair to Texas Workers?
If you are an injured worker in Texas and employer carries workers' compensation insurance you have probably noticed how unfair you have been treated by your worker compensation insurance company. Your medical procedures have probably been denied or delayed. You have been told that the Insurance Company disputes that your injuries are related to your work accident. Many of you who had a back injury at work have probably been told that your injuries are not related to the accident. If you were lucky enough to get an MRI the insurance company probably claims that your injury was from a preexisting injury or the result of a degenerative disk disease. This is true even though you were fine before the accident and after the accident you have severe pain and limited mobility that did not exist before your injury. Why does the insurance company do this to you? There is a very simple reason: because they can with no or very little consequence.
Worker's Compensation use to be a fair system designed to compensate injured workers for their injuries and get them the proper medical care they needed to return to work. But this changed. You can trace these changes back to two events. The first was the workers' compensation reform law which changed dramatically the workers' compensation laws by the 1989 legislature. This change dramatically changed workers' compensation because business and the insurance industry basically got control of the Texas Legislature and were able to put in place a workers' compensation act that made it almost impossible to find a workers' compensation lawyer and limited dramatically the benefits that Texas injured workers could receive. The goal of these insurance companies and corporations was to lower the rates of workers' compensation insurance and increase their profits at the expense of injured workers. They were very successful in achieving these goals. However to add insult to injury (pun intended) the elected Texas Supreme Court was taken over by the insurance industry and corporations. (See https://www.americanprogress.org/wp-content/uploads/issues/2012/08/pdf/statecourts.pdf) We now have a Texas Supreme Court that is made up exclusively of Republicans that have again and again made it their goal to rule in the favor of insurance companies and corporations and against fired and injured workers. To explain why this is so important to injured workers you need to look no further than the 2012 case of Texas Mutual Insurance Co. v. Ruttiger, 381 S.W.3d 430 (Tex. 2012). In that case the Texas Supreme Court held that there is no right for an injured worker to make a claim that the insurance company is acting in bad faith in its investigation, handling and settling of workers' compensation claims. Basically the insurance company can do whatever it wants to you with little fear of any penalty. So what do they have to lose? Virtually, nothing. It has gotten so bad that In 2015 the Court held that an insurance company that filed criminal charges against a severely injured worker (because it wrongly thought he was not going to gym that was prescribed by his doctor and covered by his workers' compensation policy) could not be sued for bad faith or maliciousness prosecution. It did not matter that the insurance company put this poor man through hell by having him wrongly imprisioned. (https://www.texastribune.org/2015/02/27/insurance-companies-score-new-victory-supreme-cour/).
In other words the Texas Supreme Court believes that if your workers' compensation insurance carrier goes so far as to falsely have you criminally prosecuted to gain an advantage over you in the claims process you have no right what so ever to sue the insurance company or the agent. Think about that, every single Supreme Court Judge made this finding. Every single one. They have overruled decades of cases in Texas cases that held that Insuance Companies must act in good faith and fair dealings when handling a claim. So if you want to know why you are getting such a hard time from your workers' compensation insurance carrier look no further to the elected Texas Supreme Justices and the Texas Legislature and Governor. If you are having a difficult time getting your medical approved or compensation paid it is not your fault. The Texas Supreme Court, the Texas Legislature and Governor have intentionally made a system to deny you your benefits. Sorry to tell you this, but you might as well hear the truth instead of thinking you did something wrong or are getting bad advice.