What Injuries Qualify for Workers’ Comp in Texas?



Workers’ compensation is a crucial safety net for employees in the Lone Star State who suffer injuries or illnesses while on the job. Understanding which injuries qualify for workers’ comp in Texas can help both employers and employees navigate the complexities of the system.

In our state, the Texas Workers’ Compensation Act and related laws are designed to provide benefits to employees who are injured in the course of their employment. However, it’s important that you know that not all injuries may be covered.

Let’s take a look at what injuries that qualify for workers’ comp in Texas

Understanding How Texas Workers’ Compensation Works

To understand the specific types of injuries that qualify for workers’ comp and why, it’s important to have a basic understanding of how the system works in Texas.

Workers’ compensation is a type of insurance that provides wage replacement and medical benefits to employees who are injured on the job.

While, in other jurisdictions, states may require most employers to have this insurance coverage, Texas is a bit different. Our state is the only one that, according to the Texas Department of Insurance, does not require most private employers to have workers’ compensation insurance.

However, public entities and some businesses must provide workers’ compensation, including those that enter into construction-related contracts with a governmental entity. Employers that do provide workers’ compensation are called “subscribers.”

What Are Qualifying Injuries for Texas Workers’ Comp Benefits?

Our work injury lawyers have the experience and understanding of Texas workers’ compensation law to help you seek the justice and compensation you deserve following a qualifying workplace injury. We want you to know that qualifying injuries for workers’ comp in Texas include:

  • Accidental Injuries: These injuries, which occur suddenly and unexpectedly while an employee is performing job-related duties, are among the most common types of impairments covered by workers’ compensation in Texas. Examples of accidental injuries that may qualify for workers’ comp include slips and falls, strains and sprains, and injuries caused by falling objects.
  • Occupational Diseases: Workers’ compensation in Texas also covers certain occupational diseases, which are illnesses or medical conditions that are caused or aggravated by the conditions of employment. Examples of occupational diseases that may allow you to qualify for workers’ comp include repetitive stress injuries, hearing loss due to workplace noise, and respiratory illnesses caused by exposure to hazardous chemicals or substances.
  • Pre-Existing Conditions: Our state’s workers’ comp may also cover pre-existing conditions that are aggravated or exacerbated by your performance of work-related activities. For example, if an employee has a pre-existing back injury that was worsened by lifting heavy objects at work, they may be eligible for workers’ comp benefits. However, proving that a pre-existing condition was aggravated by someone’s job can sometimes be challenging, so it’s important to seek legal advice if you’re unsure about your eligibility.
  • Mental Health Conditions: In recent years, there has been growing recognition of the impact of work-related stress and trauma on mental health. In Texas, workers’ compensation may cover mental health conditions such as anxiety, depression, and post-traumatic stress disorder (PTSD) if they are directly related to the employee’s job duties. However, proving a causal link between a mental health condition and your work can be complex, so it’s essential to consult with a qualified attorney for guidance.
  • Fatal Injuries: Tragically, some workplace accidents result in fatalities. In Texas, workers’ compensation may provide death benefits to the surviving dependents of employees who are killed on the job. These benefits typically include compensation for funeral expenses and ongoing financial support for the deceased employee’s dependents. Surviving dependents should consult with an attorney who regularly takes on wrongful death claims to ensure they receive the full benefits they are entitled to under Texas law.

Possible Texas Workers’ Comp Injury Exclusions

While Texas workers’ compensation benefits cover a wide range of injuries and illnesses, there are some exceptions and exclusions to be aware of.

These typically include:

  • Intoxication: Injuries sustained while under the influence of drugs or alcohol are generally excluded from workers’ compensation coverage in Texas. If an employee’s intoxication is found to be a contributing factor to the injury, they may not be eligible for benefits.
  • Employee Misconduct: Injuries that result from an employee’s intentional misconduct or violation of workplace safety rules may be excluded from workers’ compensation coverage. Employers have the right to deny benefits if it can be proven that the injury occurred due to the employee’s willful disregard for safety protocols.
  • Horseplay: Injuries sustained during horseplay or other non-work-related activities may not be covered by workers’ compensation in Texas. Employers have the discretion to deny benefits if they can demonstrate that the injury occurred as a result of recreational or unauthorized activities.
  • Independent Contractors: Independent contractors are generally not eligible for workers’ compensation benefits in Texas. Unlike employees, independent contractors are considered self-employed individuals and are responsible for obtaining their own insurance coverage for work-related injuries.
  • Fraudulent Claims: Workers’ compensation benefits may be denied if the employer or insurance carrier suspects fraudulent activity or misrepresentation on the part of the employee. Engaging in fraudulent behavior, such as falsifying injury claims or providing misleading information, can result in the denial of benefits and potential legal consequences.
  • Off-Duty Injuries: Injuries that occur while an employee is off-duty and not engaged in work-related activities are typically not covered by workers’ compensation in Texas. The injury must occur within the scope of employment for it to be eligible for benefits.
  • Voluntary Participation Waivers: In some cases, employers may offer voluntary participation waivers for workers’ compensation coverage. Employees who voluntarily opt out of coverage may not be eligible for benefits in the event of a work-related injury or illness.
  • Federal Employees: Federal employees, including those working for the federal government or certain federal agencies, are covered under separate workers’ compensation programs and are not subject to Texas state laws regarding workers’ comp.

Understanding these exceptions and exclusions is essential for both employers and employees to navigate the workers’ compensation system effectively in Texas. It’s important to consult with legal professionals to ensure compliance with state laws and to understand individual rights and responsibilities regarding workers’ comp coverage.

Getting Help After Suffering an Injury on the Job in Texas

When available, workers’ compensation is a vital safety net for employees in Texas who suffer injuries or illnesses while on the job.

By understanding what injuries qualify for workers’ comp, both employers and employees can ensure they receive the benefits they are entitled to under Texas law. From accidental injuries to occupational diseases to mental health conditions, workers’ comp covers a wide range of workplace-related injuries and illnesses.

However, navigating the workers’ compensation system can be complex, so it’s essential to seek legal advice if you have questions or concerns about your eligibility for benefits.

Our experienced workplace injury attorneys can answer any questions you may have about how workers’ comp works in Texas. Additionally, our team at Barrera Law Group LLC may be able to assist you in filing a claim if you’re eligible to do so,