The go-to annual research report on trends in workers’ compensation benefits, costs, and coverage is published by the National Academy of Social Insurance. The 2022 NASI report was released in November. As seen in Appendix D starting at page 95, Texas workers’ compensation benefits stack up favorably when compared to other state system waiting periods, minimum and maximum benefits, etc.

Regrettably (as noted on report pages 71 and 91), NASI has not yet made an effort to understand and incorporate data on injury benefit programs maintained as an alternative to traditional workers’ compensation. These programs are maintained by tens of thousands of private employers in Texas and Wyoming, transportation companies across the U.S., many public entities in Tennessee, state universities in Alabama, and within other areas of industry. NASI’s rationale is that some of these programs provide, in addition to contractual benefit entitlements, damages that workers can receive in tort suits against employers because of negligence. “Tort suits do not meet the definition of a workers’ compensation program, since the recoveries are not based on a statutory remedy and/or because the recoveries require the employer to be negligent.” This is an unfortunate semantic from a research and transparency perspective. It is a well-known fact that for more than three decades, such injury benefit coverages have often outperformed traditional workers’ compensation systems in the key areas of benefit levels paid, faster return to work, fewer disputed claims, faster injured worker recovery, and lower employer costs.  

Another glaring omission in workers’ compensation research is the need to not only compare the performance of state workers’ compensation systems, but to call out and advocate for proliferation of those system features that achieve better outcomes for injured workers. Just as it is inevitable that technology will continue to transform the world around us, the workers’ compensation industry will begin to fill in some of these blind spots in much-needed research and innovation.

 If you want to learn how injury benefit programs in Texas operate, check out the “Innovation Series” from the Association for Responsible Alternatives to Workers’ Compensation. Partially in response to criticism from workers’ comp interest groups between 2014 and 2017, ARAWC (“A-Rock”) also developed and rolled out specific standards for Texas injury benefit programs in 2021. See what it takes to earn the prestigious “QCARE” designation for a Qualified Compensation Alternative for Recovering Employees.

 We look forward to future NASI workers’ compensation reports and will continue to encourage other respected industry researchers (like the Workers’ Compensation Research Institute) to take a fresh look at how lessons from Texas injury benefit programs can be incorporated into higher performing workers’ comp systems. In the meantime, OccMD will continue to do just that in the medical management of injury claims in more states.

 State-by-State Cost Comparisons

Another helpful, easy-to-read report focused strictly on state cost comparisons is available from the State of Oregon. Since 1986, this report has analyzed workers’ compensation premium rates in all U.S. states and the District of Columbia. In 1988, the Oregon report showed that Texas employers paid the 10^th-highest workers’ compensation premium rates in the nation. The latest 2022 Oregon report indicates that Texas employers now pay the 43^rd-highest workers’ comp premium rates in the nation. That’s great news for Texas employers!  And it didn’t happen by accident.

Key factors contributing to this dramatic improvement include:

1.    Legislative reforms enacted in 1999, 2003 and 2005,

2.    Workplace safety improvements, and

3.    Free-Market Competition between workers’ comp and Texas injury benefit programs.

Small Texas employers tend to have low on-the-job injury frequency and be a good fit for joining the Texas workers’ compensation system at a low, fully insured cost. Many larger employers have more injury frequency and self-fund all or part of the costs. These companies tend to be a good fit for a Texas injury benefit program and the significant advantages they offer. But the choice of coverage continues to drive competition among insurance carriers and service providers that is healthy for employers, injured workers, and the Texas economy.

OccMD physician medical management and nurse case management have been the single biggest, day-to-day, consistent factor in the success of most large Texas injury benefit programs.  We continue to extend lessons learned within these Texas programs to other state workers’ compensation systems.  Ask us how and see why more large employers turn to OccMD’s Medical Director Model to deliver best-in-class results.

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