reglab/statecodes huggingface dataset:
2023 Texas Statutes › Labor Code › Title 5 - Workers' Compensation › Subtitle A - Texas Workers' Compensation Act › Chapter 404 - Office of Injured Employee Counsel › Subchapter C. General Powers and Duties of Office › Section 404.104. Authority to Appear or Intervene

Sec. 404.104.  AUTHORITY TO APPEAR OR INTERVENE.  The public counsel:
(1)  may appear or intervene, as a party or otherwise, as a matter of right before the commissioner, commissioner of insurance, division, or department on behalf of injured employees as a class in matters involving rules, agency policies, and forms affecting the workers' compensation system that the commissioner or the commissioner of insurance adopts or approves;
(2)  may intervene as a matter of right or otherwise appear in a judicial proceeding involving or arising from an action taken by an administrative agency in a proceeding in which the public counsel previously appeared under the authority granted by this chapter;
(3)  may appear or intervene, as a party or otherwise, as a matter of right on behalf of injured employees as a class in any proceeding in which the public counsel determines that the interests of injured employees as a class are in need of representation, except that the public counsel may not intervene in an enforcement or parens patriae proceeding brought by the attorney general; and
(4)  may appear or intervene before the commissioner, commissioner of insurance, division, or department, as a party or otherwise, on behalf of injured employees as a class in a matter involving rates, rules, agency policies, or forms affecting injured employees as a class in any proceeding in which the public counsel determines that injured employees are in need of representation.
Added by Acts 2005, 79th Leg., Ch. 265 (H.B. 7), Sec. 3.016, eff. September 1, 2005.
2023 Texas Statutes › Labor Code › Title 5 - Workers' Compensation › Subtitle A - Texas Workers' Compensation Act › Chapter 404 - Office of Injured Employee Counsel › Subchapter C. General Powers and Duties of Office › Section 404.105. Authority to Assist Individual Injured Employees in Administrative Procedures

Sec. 404.105.  AUTHORITY TO ASSIST INDIVIDUAL INJURED EMPLOYEES IN ADMINISTRATIVE PROCEDURES.  (a)  The office, through the ombudsman program, may appear before the commissioner, division, or State Office of Administrative Hearings to provide assistance to an individual injured employee during:
(1)  a workers' compensation administrative dispute resolution process; or
(2)  an enforcement action by the department or division against an employee for a violation of the Texas Workers' Compensation Act.
(b)  This chapter may not be construed as requiring or allowing legal representation for an individual injured employee by an office attorney or ombudsman in any proceeding.
Added by Acts 2005, 79th Leg., Ch. 265 (H.B. 7), Sec. 3.016, eff. September 1, 2005.
Amended by:
Acts 2009, 81st Leg., R.S., Ch. 1261 (H.B. 673), Sec. 2, eff. September 1, 2009.
2023 Texas Statutes › Labor Code › Title 5 - Workers' Compensation › Subtitle A - Texas Workers' Compensation Act › Chapter 404 - Office of Injured Employee Counsel › Subchapter C. General Powers and Duties of Office › Section 404.106. Legislative Report

Sec. 404.106.  LEGISLATIVE REPORT.  (a)  The office shall report to the governor, lieutenant governor, speaker of the house of representatives, and the chairs of the legislative committees with appropriate jurisdiction not later than January 1 of each odd-numbered year.  The report must include:
(1)  a description of the activities of the office;
(2)  identification of any problems in the workers' compensation system from the perspective of injured employees as a class, as considered by the public counsel, with recommendations for regulatory and legislative action; and
(3)  an analysis of the ability of the workers' compensation system to provide adequate, equitable, and timely benefits to injured employees at a reasonable cost to employers.
(b)  The office shall coordinate with the workers' compensation research and evaluation group to obtain needed information and data to make the evaluations required for the report.
(c)  The office shall publish and disseminate the legislative report to interested persons, and may charge a fee for the publication as necessary to achieve optimal dissemination.
Added by Acts 2005, 79th Leg., Ch. 265 (H.B. 7), Sec. 3.016, eff. September 1, 2005.
Amended by:
Acts 2011, 82nd Leg., R.S., Ch. 289 (H.B. 1774), Sec. 7, eff. September 1, 2011.
2023 Texas Statutes › Labor Code › Title 5 - Workers' Compensation › Subtitle A - Texas Workers' Compensation Act › Chapter 404 - Office of Injured Employee Counsel › Subchapter C. General Powers and Duties of Office › Section 404.107. Access to Information by Public Counsel

Sec. 404.107.  ACCESS TO INFORMATION BY PUBLIC COUNSEL.  The public counsel:
(1)  is entitled to the same access as a party, other than division staff or department staff, to division or department records available in a proceeding before the commissioner, commissioner of insurance, division, or department under the authority granted to the public counsel by this chapter; and
(2)  is entitled to obtain discovery under Chapter 2001, Government Code, of any nonprivileged matter that is relevant to the subject matter involved in a proceeding or submission before the commissioner, commissioner of insurance, division, or department as authorized by this chapter.
Added by Acts 2005, 79th Leg., Ch. 265 (H.B. 7), Sec. 3.016, eff. September 1, 2005.
2023 Texas Statutes › Labor Code › Title 5 - Workers' Compensation › Subtitle A - Texas Workers' Compensation Act › Chapter 404 - Office of Injured Employee Counsel › Subchapter C. General Powers and Duties of Office › Section 404.108. Legislative Recommendations

Sec. 404.108.  LEGISLATIVE RECOMMENDATIONS.  The public counsel may recommend proposed legislation to the legislature that the public counsel determines would positively affect the interests of injured employees as a class.
Added by Acts 2005, 79th Leg., Ch. 265 (H.B. 7), Sec. 3.016, eff. September 1, 2005.
2023 Texas Statutes › Labor Code › Title 5 - Workers' Compensation › Subtitle A - Texas Workers' Compensation Act › Chapter 404 - Office of Injured Employee Counsel › Subchapter C. General Powers and Duties of Office › Section 404.109. Injured Employee Rights; Notice

Sec. 404.109.  INJURED EMPLOYEE RIGHTS; NOTICE.  The public counsel shall adopt, in the form and manner prescribed by the public counsel and after consultation with the commissioner of workers' compensation, a notice of injured employee rights and responsibilities to be distributed by the division as provided by commissioner or commissioner of insurance rules.  A right or responsibility adopted under this section must be consistent with the requirements of this subtitle and division rules.  This section may not be construed as establishing an entitlement to benefits to which the claimant is not otherwise entitled under this subtitle.
Added by Acts 2005, 79th Leg., Ch. 265 (H.B. 7), Sec. 3.016, eff. September 1, 2005.
Amended by:
Acts 2009, 81st Leg., R.S., Ch. 1261 (H.B. 673), Sec. 3, eff. September 1, 2009.
2023 Texas Statutes › Labor Code › Title 5 - Workers' Compensation › Subtitle A - Texas Workers' Compensation Act › Chapter 404 - Office of Injured Employee Counsel › Subchapter C. General Powers and Duties of Office › Section 404.110. Applicability to Public Counsel of Confidentiality Requirements

Sec. 404.110.  APPLICABILITY TO PUBLIC COUNSEL OF CONFIDENTIALITY REQUIREMENTS.  (a)  Confidentiality requirements applicable to examination reports and to the commissioner of insurance under Sections 401.058, 401.105, 401.106, 441.201, and 501.158, Insurance Code, as applicable, and Section 404.111, apply to the public counsel.
(b)  An employee of the office may not be compelled to disclose information communicated to the employee by a claimant on any matter relating to the claimant's claim. This subsection does not prohibit or alter the office's duty to notify and cooperate with appropriate law enforcement authorities under Section 404.1015(c).
Added by Acts 2005, 79th Leg., Ch. 265 (H.B. 7), Sec. 3.016, eff. September 1, 2005.
Amended by:
Acts 2009, 81st Leg., R.S., Ch. 1261 (H.B. 673), Sec. 4, eff. September 1, 2009.
2023 Texas Statutes › Labor Code › Title 5 - Workers' Compensation › Subtitle A - Texas Workers' Compensation Act › Chapter 404 - Office of Injured Employee Counsel › Subchapter D. Ombudsman Program › Section 404.151. Ombudsman Program

Sec. 404.151.  OMBUDSMAN PROGRAM.  (a)  The office shall maintain an ombudsman program as provided by this subchapter to assist injured employees and persons claiming death benefits in obtaining benefits under this subtitle.
(b)  An ombudsman shall:
(1)  meet with or otherwise provide information to injured employees;
(2)  investigate complaints;
(3)  communicate with employers, insurance carriers, and health care providers on behalf of injured employees;
(4)  assist unrepresented claimants to enable those persons to protect their rights in the workers' compensation system; and
(5)  meet with an unrepresented claimant privately for a minimum of 15 minutes prior to any informal or formal hearing.
Acts 1993, 73rd Leg., ch. 269, Sec. 1, eff. Sept. 1, 1993.  Amended by Acts 1995, 74th Leg., ch. 980, Sec. 1.31, eff. Sept. 1, 1995.
Redesignated from Labor Code, Section 409.041 and amended by Acts 2005, 79th Leg., Ch. 265 (H.B. 7), Sec. 3.017, eff. September 1, 2005.
2023 Texas Statutes › Labor Code › Title 5 - Workers' Compensation › Subtitle A - Texas Workers' Compensation Act › Chapter 404 - Office of Injured Employee Counsel › Subchapter D. Ombudsman Program › Section 404.152. Designation as Ombudsman; Eligibility and Training Requirements; Continuing Education Requirements

Sec. 404.152.  DESIGNATION AS OMBUDSMAN; ELIGIBILITY AND TRAINING REQUIREMENTS; CONTINUING EDUCATION REQUIREMENTS.  (a)  At least one specially qualified employee in each division office shall be an ombudsman designated by the office of injured employee counsel, who shall perform the duties under this subchapter as the person's primary responsibility.
(b)  To be eligible for designation as an ombudsman, a person must:
(1)  demonstrate satisfactory knowledge of the requirements of:
(A)  this subtitle and the provisions of Subtitle C that relate to claims management;
(B)  other laws relating to workers' compensation; and
(C)  rules adopted under this subtitle and the laws described under Subdivision (1)(B);
(2)  have demonstrated experience in handling and resolving problems for the general public; and
(3)  possess strong interpersonal skills.
(c)  The public counsel shall by rule adopt training guidelines and continuing education requirements for ombudsmen.  Training provided under this subsection must:
(1)  include education regarding this subtitle, rules adopted under this subtitle, and decisions of the appeals panel, with emphasis on benefits and the dispute resolution process;
(2)  require an ombudsman undergoing training to be observed and monitored by an experienced ombudsman during daily activities conducted under this subchapter; and
(3)  incorporate the requirements of Section 404.103(b).
Acts 1993, 73rd Leg., ch. 269, Sec. 1, eff. Sept. 1, 1993.  Redesignated from Labor Code Sec. 409.041(c) and amended by Acts 1995, 74th Leg., ch. 980, Sec. 1.31, eff. Sept. 1, 1995.  Amended by Acts 1997, 75th Leg., ch. 1443, Sec. 8, eff. Sept. 1, 1997.
Redesignated from Labor Code, Section 409.042 and amended by Acts 2005, 79th Leg., Ch. 265 (H.B. 7), Sec. 3.017, eff. September 1, 2005.
Amended by:
Acts 2017, 85th Leg., R.S., Ch. 1056 (H.B. 2060), Sec. 1, eff. June 15, 2017.
2023 Texas Statutes › Labor Code › Title 5 - Workers' Compensation › Subtitle A - Texas Workers' Compensation Act › Chapter 404 - Office of Injured Employee Counsel › Subchapter D. Ombudsman Program › Section 404.1525. First Responder Liaison

Sec. 404.1525.  FIRST RESPONDER LIAISON.  (a)  In this section, "first responder" has the meaning assigned by Section 504.055.
(b)  The public counsel shall designate an employee of the office to act as first responder liaison.
(c)  The first responder liaison shall assist an injured first responder and, if applicable, the ombudsman assigned to the first responder's case, during a workers' compensation administrative dispute resolution process.
(d)  The first responder liaison:
(1)  must meet the qualifications for designation as an ombudsman under this subchapter; and
(2)  is subject to the training and education requirements for an ombudsman under this subchapter.
Added by Acts 2017, 85th Leg., R.S., Ch. 465 (H.B. 2082), Sec. 1, eff. September 1, 2017.
2023 Texas Statutes › Labor Code › Title 5 - Workers' Compensation › Subtitle A - Texas Workers' Compensation Act › Chapter 404 - Office of Injured Employee Counsel › Subchapter D. Ombudsman Program › Section 404.153. Employer Notification; Administrative Violation

Sec. 404.153.  EMPLOYER NOTIFICATION; ADMINISTRATIVE VIOLATION.  (a)  Each employer shall notify its employees of the ombudsman program in the manner prescribed by the office.
(a-1)  An employer that employs first responders or supervises volunteer first responders shall notify the first responders of the first responder liaison in the manner prescribed by the office.  In this subsection, "first responder" has the meaning assigned by Section 504.055.
(b)  An employer commits an administrative violation if the employer fails to comply with this section.
Acts 1993, 73rd Leg., ch. 269, Sec. 1, eff. Sept. 1, 1993.  Redesignated from Labor Code Sec. 409.041(d) and amended by Acts 1995, 74th Leg., ch. 980, Sec. 1.31, eff. Sept. 1, 1995.
Redesignated from Labor Code, Section 409.043 and amended by Acts 2005, 79th Leg., Ch. 265 (H.B. 7), Sec. 3.017, eff. September 1, 2005.
Amended by:
Acts 2017, 85th Leg., R.S., Ch. 465 (H.B. 2082), Sec. 2, eff. September 1, 2017.
2023 Texas Statutes › Labor Code › Title 5 - Workers' Compensation › Subtitle A - Texas Workers' Compensation Act › Chapter 404 - Office of Injured Employee Counsel › Subchapter D. Ombudsman Program › Section 404.154. Public Information

Sec. 404.154.  PUBLIC INFORMATION.  The office shall widely disseminate information about the ombudsman program.
Acts 1993, 73rd Leg., ch. 269, Sec. 1, eff. Sept. 1, 1993.  Renumbered from Labor Code Sec. 409.042 by Acts 1995, 74th Leg., ch. 980, Sec. 1.31, eff. Sept. 1, 1995.
Redesignated from Labor Code, Section 409.044 and amended by Acts 2005, 79th Leg., Ch. 265 (H.B. 7), Sec. 3.017, eff. September 1, 2005.
2023 Texas Statutes › Labor Code › Title 5 - Workers' Compensation › Subtitle A - Texas Workers' Compensation Act › Chapter 404 - Office of Injured Employee Counsel › Subchapter D. Ombudsman Program › Section 404.155. Cost for Certain Copies of Medical Records; Administrative Violation

Sec. 404.155.  COST FOR CERTAIN COPIES OF MEDICAL RECORDS; ADMINISTRATIVE VIOLATION.  (a)  At the written request of an ombudsman designated under this subchapter who is assisting a specific injured employee, a health care provider shall provide copies of the injured employee's medical records to the ombudsman at no cost to the ombudsman or the office.
(b)  The workers' compensation insurance carrier is liable to the health care provider for the cost of providing copies of the employee's medical records under this section.  The insurance carrier may not deduct that cost from any benefit to which the employee is entitled.
(c)  The amount charged for providing copies of an injured employee's medical records under this section is the amount prescribed by rules adopted by the commissioner for copying medical records.
(d)  A health care provider may not require payment for the cost of providing copies of an injured employee's medical records under this section before providing the copies to the ombudsman.
(e)  The public counsel may adopt rules regarding a time frame for the provision of copies of an injured employee's medical records under this section and any other matter relating to provision of those copies.
(f)  A health care provider or insurance carrier that fails to comply with the requirements of this section or rules adopted under this section commits an administrative violation.  The commissioner shall enforce a violation under this subsection in accordance with Chapter 415.
Added by Acts 2007, 80th Leg., R.S., Ch. 1009 (H.B. 888), Sec. 1, eff. June 15, 2007.
2023 Texas Statutes › Labor Code › Title 5 - Workers' Compensation › Subtitle A - Texas Workers' Compensation Act › Chapter 405 - Workers' Compensation Research › Section 405.001. Definition

Sec. 405.001.  DEFINITION.  In this chapter, "group" means the workers' compensation research and evaluation group.
Added by Acts 2003, 78th Leg., 3rd C.S., ch. 10, Sec. 1.01, eff. Oct. 20, 2003.
Amended by:
Acts 2005, 79th Leg., Ch. 265 (H.B. 7), Sec. 3.018, eff. September 1, 2005.
2023 Texas Statutes › Labor Code › Title 5 - Workers' Compensation › Subtitle A - Texas Workers' Compensation Act › Chapter 405 - Workers' Compensation Research › Section 405.002. Workers' Compensation Research Duties of Department

Sec. 405.002.  WORKERS' COMPENSATION RESEARCH DUTIES OF DEPARTMENT.
(a)  The workers' compensation research and evaluation group is located within the department and serves as a resource for the commissioner of insurance on workers' compensation issues.
(b)  The department may apply for and spend grant funds to implement this chapter.
(c)  The department shall ensure that all research reports prepared under this chapter or by the former Research and Oversight Council on Workers' Compensation are accessible to the public through the Internet to the extent practicable.
Added by Acts 2003, 78th Leg., 3rd C.S., ch. 10, Sec. 1.01, eff. Oct. 20, 2003.
Amended by:
Acts 2005, 79th Leg., Ch. 265 (H.B. 7), Sec. 3.019, eff. September 1, 2005.
2023 Texas Statutes › Labor Code › Title 5 - Workers' Compensation › Subtitle A - Texas Workers' Compensation Act › Chapter 405 - Workers' Compensation Research › Section 405.0025. Research Duties of Group

Sec. 405.0025.  RESEARCH DUTIES OF GROUP.  (a)  The group shall conduct professional studies and research related to:
(1)  the delivery of benefits;
(2)  litigation and controversy related to workers' compensation;
(3)  insurance rates and ratemaking procedures;
(4)  rehabilitation and reemployment of injured employees;
(5)  the quality and cost of medical benefits;
(6)  employer participation in the workers' compensation system;
(7)  employment health and safety issues; and
(8)  other matters relevant to the cost, quality, and operational effectiveness of the workers' compensation system.
(b)  Repealed by Acts 2021, 87th Leg., R.S., Ch. 670 (H.B. 1753), Sec. 3(3), eff. June 15, 2021, and Acts 2021, 87th Leg., R.S., Ch. 856 (S.B. 800), Sec. 25(12), eff. September 1, 2021.
(c)  Repealed by Acts 2021, 87th Leg., R.S., Ch. 670 (H.B. 1753), Sec. 3(3), eff. June 15, 2021, and Acts 2021, 87th Leg., R.S., Ch. 856 (S.B. 800), Sec. 25(12), eff. September 1, 2021.
Added by Acts 2005, 79th Leg., Ch. 265 (H.B. 7), Sec. 3.020, eff. September 1, 2005.
Amended by:
Acts 2021, 87th Leg., R.S., Ch. 670 (H.B. 1753), Sec. 3(3), eff. June 15, 2021.
Acts 2021, 87th Leg., R.S., Ch. 856 (S.B. 800), Sec. 25(12), eff. September 1, 2021.
2023 Texas Statutes › Labor Code › Title 5 - Workers' Compensation › Subtitle A - Texas Workers' Compensation Act › Chapter 405 - Workers' Compensation Research › Section 405.0026. Research Agenda

Sec. 405.0026.  RESEARCH AGENDA.  (a)  The group shall prepare and publish annually in the Texas Register a proposed workers' compensation research agenda for the commissioner of insurance review and approval.
(b)  The commissioner of insurance shall:
(1)  accept public comments on the research agenda; and
(2)  hold a public hearing on the proposed research agenda if a hearing is requested by interested persons.
Added by Acts 2005, 79th Leg., Ch. 265 (H.B. 7), Sec. 3.020, eff. September 1, 2005.
2023 Texas Statutes › Labor Code › Title 5 - Workers' Compensation › Subtitle A - Texas Workers' Compensation Act › Chapter 405 - Workers' Compensation Research › Section 405.003. Funding; Maintenance Tax

Sec. 405.003.  FUNDING;  MAINTENANCE TAX.  (a)  The group's duties under this chapter are funded through the assessment of a maintenance tax collected annually from all insurance carriers, and self-insurance groups that hold certificates of approval under Chapter 407A, except governmental entities.
(b)  The department shall set the rate of the maintenance tax based on the expenditures authorized and the receipts anticipated in legislative appropriations.  The tax rate for insurance companies may not exceed one-tenth of one percent of the correctly reported gross workers' compensation insurance premiums.  The tax rate for certified self-insurers may not exceed one-tenth of one percent of the total tax base of all certified self-insurers, as computed under Section 407.103(b).  The tax rate for self-insurance groups described by Subsection (a) may not exceed one-tenth of one percent of the group's gross premium for the group's retention, excluding premium collected by the group for excess insurance.
(c)  The tax imposed under Subsection (a) is in addition to all other taxes imposed on those insurance carriers for workers' compensation purposes.
(d)  The tax on insurance companies and on self-insurance groups described by Subsection (a) shall be assessed, collected, and paid in the same manner and at the same time as the maintenance tax established for the support of the department under Chapter 255, Insurance Code.  The tax on certified self-insurers shall be assessed, collected, and paid in the same manner and at the same time as the self-insurer maintenance tax collected under Section 407.104.
(e)  Amounts received under this section shall be deposited in the general revenue fund in accordance with Section 251.004, Insurance Code, to be used:
(1)  for the operation of the group's duties under this chapter; and
(2)  to reimburse the general revenue fund in accordance with Section 201.052, Insurance Code.
(f)  Section 403.095, Government Code, does not apply in relation to amounts received under this section or to any special account into which the amounts are deposited.
Added by Acts 2003, 78th Leg., 3rd C.S., ch. 10, Sec. 1.01, eff. Oct. 20, 2003.
Amended by:
Acts 2005, 79th Leg., Ch. 265 (H.B. 7), Sec. 3.021, eff. September 1, 2005.
Acts 2005, 79th Leg., Ch. 728 (H.B. 2018), Sec. 11.136, eff. September 1, 2005.
2023 Texas Statutes › Labor Code › Title 5 - Workers' Compensation › Subtitle A - Texas Workers' Compensation Act › Chapter 405 - Workers' Compensation Research › Section 405.004. Coordination With Other State Agencies; Confidentiality

Sec. 405.004.  COORDINATION WITH OTHER STATE AGENCIES;  CONFIDENTIALITY.  (a)  As required to fulfill the group's objectives under this chapter, the group is entitled to access to the files and records of:
(1)  the division;
(2)  the Texas Workforce Commission;
(3)  the Department of Assistive and Rehabilitative Services;
(4)  the office of injured employee counsel;
(5)  the State Office of Risk Management; and
(6)  other appropriate state agencies.
(b)  A state agency shall assist and cooperate in providing information to the group.
(c)  Information that is confidential under state law is accessible to the department under rules of confidentiality and remains confidential.
(d)  Except as provided by this subsection, the identity of an individual or entity selected to participate in a survey conducted by the group or who participates in such a survey is confidential and is not subject to public disclosure under Chapter 552, Government Code.  This subsection does not prohibit the identification of a workers' compensation health care network in a report card issued under Section 1305.502, Insurance Code, provided that the report card may not identify any injured employee or other individual.
(e)  A working paper, including all documentary or other information, prepared or maintained by the group in performing the group's duties under this chapter or other law to conduct an evaluation and prepare a report is excepted from the public disclosure requirements of Section 552.021, Government Code.
(f)  A record held by another entity that is considered to be confidential by law and that the group receives in connection with the performance of the group's functions under this chapter or another law remains confidential and is excepted from the public disclosure requirements of Section 552.021, Government Code.
(g)  The commissioner of insurance shall adopt rules as necessary to establish data reporting requirements to support the research duties under this chapter.  This section may not be construed as requiring additional reporting requirements on nonsubscribing employers.
Added by Acts 2003, 78th Leg., 3rd C.S., ch. 10, Sec. 1.01, eff. Oct. 20, 2003.
Amended by:
Acts 2005, 79th Leg., Ch. 265 (H.B. 7), Sec. 3.022, eff. September 1, 2005.
2023 Texas Statutes › Labor Code › Title 5 - Workers' Compensation › Subtitle A - Texas Workers' Compensation Act › Chapter 406 - Workers' Compensation Insurance Coverage › Subchapter A. Coverage Election; Security Procedures › Section 406.001. Definition

Sec. 406.001.  DEFINITION.  In this subchapter, "employer" means a person who employs one or more employees.
Acts 1993, 73rd Leg., ch. 269, Sec. 1, eff. Sept. 1, 1993.
2023 Texas Statutes › Labor Code › Title 5 - Workers' Compensation › Subtitle A - Texas Workers' Compensation Act › Chapter 406 - Workers' Compensation Insurance Coverage › Subchapter A. Coverage Election; Security Procedures › Section 406.002. Coverage Generally Elective

Sec. 406.002.  COVERAGE GENERALLY ELECTIVE.  (a)  Except for public employers and as otherwise provided by law, an employer may elect to obtain workers' compensation insurance coverage.
(b)  An employer who elects to obtain coverage is subject to this subtitle.
Acts 1993, 73rd Leg., ch. 269, Sec. 1, eff. Sept. 1, 1993.
2023 Texas Statutes › Labor Code › Title 5 - Workers' Compensation › Subtitle A - Texas Workers' Compensation Act › Chapter 406 - Workers' Compensation Insurance Coverage › Subchapter A. Coverage Election; Security Procedures › Section 406.003. Methods of Obtaining Coverage

Sec. 406.003.  METHODS OF OBTAINING COVERAGE.  An employer may obtain workers' compensation insurance coverage through a licensed insurance company or through self-insurance as provided by this subtitle.
Acts 1993, 73rd Leg., ch. 269, Sec. 1, eff. Sept. 1, 1993.
2023 Texas Statutes › Labor Code › Title 5 - Workers' Compensation › Subtitle A - Texas Workers' Compensation Act › Chapter 406 - Workers' Compensation Insurance Coverage › Subchapter A. Coverage Election; Security Procedures › Section 406.004. Employer Notice to Division

Sec. 406.004.  EMPLOYER NOTICE TO DIVISION.  (a)  An employer who does not obtain workers' compensation insurance coverage shall notify the division in writing, in the time and as prescribed by commissioner rule, that the employer elects not to obtain coverage.
(b)  The commissioner shall prescribe forms to be used for the employer notification and shall require the employer to provide reasonable information to the division about the employer's business.
(c)  The division may contract with the Texas Workforce Commission or the comptroller for assistance in collecting the notification required under this section.  Those agencies shall cooperate with the division in enforcing this section.
(d)  The employer notification filing required under this section shall be filed with the division in accordance with Section 406.009.
(e)  An employer commits an administrative violation if the employer fails to comply with this section.
Acts 1993, 73rd Leg., ch. 269, Sec. 1, eff. Sept. 1, 1993.  Amended by Acts 1995, 74th Leg., ch. 76, Sec. 9.47(a), eff. Sept. 1, 1995.
Amended by:
Acts 2005, 79th Leg., Ch. 265 (H.B. 7), Sec. 3.023, eff. September 1, 2005.
2023 Texas Statutes › Labor Code › Title 5 - Workers' Compensation › Subtitle A - Texas Workers' Compensation Act › Chapter 406 - Workers' Compensation Insurance Coverage › Subchapter A. Coverage Election; Security Procedures › Section 406.005. Employer Notice to Employees; Administrative Violation

Sec. 406.005.  EMPLOYER NOTICE TO EMPLOYEES;  ADMINISTRATIVE VIOLATION.  (a)  An employer shall notify each employee as provided by this section whether or not the employer has workers' compensation insurance coverage.
(b)  The employer shall notify a new employee of the existence or absence of workers' compensation insurance coverage at the time the employee is hired.
(c)  Each employer shall post a notice of whether the employer has workers' compensation insurance coverage at conspicuous locations at the employer's place of business as necessary to provide reasonable notice to the employees.  The commissioner may adopt rules relating to the form and content of the notice.  The employer shall revise the notice when the information contained in the notice is changed.
(d)  An employer who obtains workers' compensation insurance coverage or whose coverage is terminated or canceled shall notify each employee that the coverage has been obtained, terminated, or canceled not later than the 15th day after the date on which the coverage, or the termination or cancellation of the coverage, takes effect.
(e)  An employer commits an administrative violation if the employer fails to comply with this section.
Acts 1993, 73rd Leg., ch. 269, Sec. 1, eff. Sept. 1, 1993.
Amended by:
Acts 2005, 79th Leg., Ch. 265 (H.B. 7), Sec. 3.024, eff. September 1, 2005.
2023 Texas Statutes › Labor Code › Title 5 - Workers' Compensation › Subtitle A - Texas Workers' Compensation Act › Chapter 406 - Workers' Compensation Insurance Coverage › Subchapter A. Coverage Election; Security Procedures › Section 406.006. Insurance Coverage and Claim Administration Reporting Requirements; Administrative Violation

Sec. 406.006.  INSURANCE COVERAGE AND CLAIM ADMINISTRATION REPORTING REQUIREMENTS;  ADMINISTRATIVE VIOLATION.  (a)  An insurance company from which an employer has obtained workers' compensation insurance coverage, a certified self-insurer, a workers' compensation self-insurance group under Chapter 407A, and a political subdivision shall file notice of the coverage and claim administration contact information with the division not later than the 10th day after the date on which the coverage or claim administration agreement takes effect, unless the commissioner adopts a rule establishing a later date for filing.  Coverage takes effect on the date on which a binder is issued, a later date and time agreed to by the parties, on the date provided by the certificate of self-insurance, or on the date provided in an interlocal agreement that provides for self-insurance.  The commissioner may adopt rules that establish the coverage and claim administration contact information required under this subsection.
(b)  The notice required under this section shall be filed with the division in accordance with Section 406.009.
(c)  An insurance company, a certified self-insurer, a workers' compensation self-insurance group under Chapter 407A, or a political subdivision commits an administrative violation if the person fails to file notice with the division as provided by this section.
(d)  In this section, "political subdivision" has the meaning assigned by Section 504.001.
Acts 1993, 73rd Leg., ch. 269, Sec. 1, eff. Sept. 1, 1993.  Amended by Acts 1995, 74th Leg., ch. 76, Sec. 9.48(a), eff. Sept. 1, 1995;  Acts 1999, 76th Leg., ch. 954, Sec. 2.
Amended by:
Acts 2005, 79th Leg., Ch. 265 (H.B. 7), Sec. 3.025, eff. September 1, 2005.
2023 Texas Statutes › Labor Code › Title 5 - Workers' Compensation › Subtitle A - Texas Workers' Compensation Act › Chapter 406 - Workers' Compensation Insurance Coverage › Subchapter A. Coverage Election; Security Procedures › Section 406.007. Termination of Coverage by Employer; Notice

Sec. 406.007.  TERMINATION OF COVERAGE BY EMPLOYER;  NOTICE.  (a)  An employer who terminates workers' compensation insurance coverage obtained under this subtitle shall file a written notice with the division not later than the 10th day after the date on which the employer notified the insurance carrier to terminate the coverage.  The notice must include a statement certifying the date that notice was provided or will be provided to affected employees under Section 406.005.
(b)  The notice required under this section shall be filed with the division in accordance with Section 406.009.
(c)  Termination of coverage takes effect on the later of:
(1)  the 30th day after the date of filing of notice with the division under Subsection (a); or
(2)  the cancellation date of the policy.
(d)  The coverage shall be extended until the date on which the termination of coverage takes effect, and the employer is obligated for premiums due for that period.
Acts 1993, 73rd Leg., ch. 269, Sec. 1, eff. Sept. 1, 1993.  Amended by Acts 1995, 74th Leg., ch. 76, Sec. 9.49(a), eff. Sept. 1, 1995.
Amended by:
Acts 2005, 79th Leg., Ch. 265 (H.B. 7), Sec. 3.026, eff. September 1, 2005.
Acts 2017, 85th Leg., R.S., Ch. 467 (H.B. 2112), Sec. 2, eff. June 9, 2017.
2023 Texas Statutes › Labor Code › Title 5 - Workers' Compensation › Subtitle A - Texas Workers' Compensation Act › Chapter 406 - Workers' Compensation Insurance Coverage › Subchapter A. Coverage Election; Security Procedures › Section 406.008. Cancellation or Nonrenewal of Coverage by Insurance Company; Notice

Sec. 406.008.  CANCELLATION OR NONRENEWAL OF COVERAGE BY INSURANCE COMPANY; NOTICE.  (a)  An insurance company that cancels a policy of workers' compensation insurance or that does not renew the policy by the anniversary date of the policy shall deliver notice of the cancellation or nonrenewal to the division, and by certified mail, in person, or by electronic means in accordance with Chapter 35, Insurance Code, to the employer, not later than:
(1)  the 30th day before the date on which the cancellation or nonrenewal takes effect; or
(2)  the 10th day before the date on which the cancellation or nonrenewal takes effect if the insurance company cancels or does not renew because of:
(A)  fraud in obtaining coverage;
(B)  misrepresentation of the amount of payroll for purposes of premium calculation;
(C)  failure to pay a premium when due;
(D)  an increase in the hazard for which the employer seeks coverage that results from an act or omission of the employer and that would produce an increase in the rate, including an increase because of a failure to comply with:
(i)  reasonable recommendations for loss control; or
(ii)  recommendations designed to reduce a hazard under the employer's control within a reasonable period; or
(E)  a determination made by the commissioner of insurance that the continuation of the policy would place the insurer in violation of the law or would be hazardous to the interest of subscribers, creditors, or the general public.
(b)  The notice required under this section shall be filed with the division.
(c)  Failure of the insurance company to give notice as required by this section extends the policy until the date on which the required notice is provided to the employer and the division.
Acts 1993, 73rd Leg., ch. 269, Sec. 1, eff. Sept. 1, 1993.  Amended by Acts 1995, 74th Leg., ch. 76, Sec. 9.50(a), eff. Sept. 1, 1995.
Amended by:
Acts 2005, 79th Leg., Ch. 265 (H.B. 7), Sec. 3.027, eff. September 1, 2005.
Acts 2017, 85th Leg., R.S., Ch. 467 (H.B. 2112), Sec. 3, eff. June 9, 2017.
2023 Texas Statutes › Labor Code › Title 5 - Workers' Compensation › Subtitle A - Texas Workers' Compensation Act › Chapter 406 - Workers' Compensation Insurance Coverage › Subchapter A. Coverage Election; Security Procedures › Section 406.009. Collecting and Maintaining Information; Monitoring and Enforcing Compliance

Sec. 406.009.  COLLECTING AND MAINTAINING INFORMATION; MONITORING AND ENFORCING COMPLIANCE.  (a)  The division shall collect and maintain the information required under this subchapter and shall monitor compliance with the requirements of this subchapter.
(b)  The commissioner may adopt rules as necessary to enforce this subchapter.
(c)  The commissioner may designate a data collection agent, implement an electronic reporting and public information access program, and adopt rules as necessary to implement the data collection requirements of this subchapter.  The commissioner may establish the form, manner, and procedure for the transmission of information to the division.  A data collection agent designated under this subsection must be qualified and may collect fees in the manner described by Section 401.024.
(d)  The division may require an employer or insurance carrier subject to this subtitle to identify or confirm an employer's coverage status and claim administration contact information as necessary to achieve the purposes of this subtitle.
(e)  An employer or insurance carrier commits an administrative violation if that person fails to comply with Subsection (d).
Acts 1993, 73rd Leg., ch. 269, Sec. 1, eff. Sept. 1, 1993.  Amended by Acts 1995, 74th Leg., ch. 76, Sec. 9.51(a), eff. Sept. 1, 1995;  Acts 1999, 76th Leg., ch. 954, Sec. 3, eff. Sept. 1, 1999.
Amended by:
Acts 2005, 79th Leg., Ch. 265 (H.B. 7), Sec. 3.028, eff. September 1, 2005.
Acts 2011, 82nd Leg., R.S., Ch. 410 (S.B. 800), Sec. 2, eff. June 17, 2011.
2023 Texas Statutes › Labor Code › Title 5 - Workers' Compensation › Subtitle A - Texas Workers' Compensation Act › Chapter 406 - Workers' Compensation Insurance Coverage › Subchapter A. Coverage Election; Security Procedures › Section 406.010. Claims Service; Administrative Violation

Sec. 406.010.  CLAIMS SERVICE;  ADMINISTRATIVE VIOLATION.  (a)  An insurance carrier shall provide claims service:
(1)  through offices of the insurance carrier located in this state;  or
(2)  by other resident representatives with full power to act for the insurance carrier.
(b)  Each insurance carrier shall designate persons to provide claims service in sufficient numbers and at appropriate locations to reasonably service policies written by the carrier.  If an insurance carrier uses the services of a person required to hold a certificate of authority under Chapter 4151, Insurance Code, the carrier must comply with the requirements of that chapter.
(c)  The commissioner by rule shall further specify the requirements of this section.
(d)  A person commits an administrative violation if the person violates a rule adopted under this section.
Acts 1993, 73rd Leg., ch. 269, Sec. 1, eff. Sept. 1, 1993.
Amended by:
Acts 2005, 79th Leg., Ch. 265 (H.B. 7), Sec. 3.029, eff. September 1, 2005.
Acts 2007, 80th Leg., R.S., Ch. 1176 (H.B. 472), Sec. 3.01, eff. September 1, 2007.
2023 Texas Statutes › Labor Code › Title 5 - Workers' Compensation › Subtitle A - Texas Workers' Compensation Act › Chapter 406 - Workers' Compensation Insurance Coverage › Subchapter A. Coverage Election; Security Procedures › Section 406.011. Austin Representative; Administrative Violation

Sec. 406.011.  AUSTIN REPRESENTATIVE; ADMINISTRATIVE VIOLATION.  (a)  The commissioner by rule may require an insurance carrier to designate a representative in Austin to act as the insurance carrier's agent before the division in Austin.  Notice to the designated agent constitutes notice to the insurance carrier.
(b)  A person commits an administrative violation if the person violates a rule adopted under this section.
Acts 1993, 73rd Leg., ch. 269, Sec. 1, eff. Sept. 1, 1993.
Amended by:
Acts 2005, 79th Leg., Ch. 265 (H.B. 7), Sec. 3.030, eff. September 1, 2005.
2023 Texas Statutes › Labor Code › Title 5 - Workers' Compensation › Subtitle A - Texas Workers' Compensation Act › Chapter 406 - Workers' Compensation Insurance Coverage › Subchapter A. Coverage Election; Security Procedures › Section 406.012. Enforcement of Subchapter

Sec. 406.012.  ENFORCEMENT OF SUBCHAPTER.  The commission shall enforce the administrative penalties established under this subchapter in accordance with Chapter 415.
Acts 1993, 73rd Leg., ch. 269, Sec.  1, eff. Sept. 1, 1993.
2023 Texas Statutes › Labor Code › Title 5 - Workers' Compensation › Subtitle A - Texas Workers' Compensation Act › Chapter 406 - Workers' Compensation Insurance Coverage › Subchapter B. Coverage Requirements › Section 406.031. Liability for Compensation

Sec. 406.031.  LIABILITY FOR COMPENSATION.  (a)  An insurance carrier is liable for compensation for an employee's injury without regard to fault or negligence if:
(1)  at the time of injury, the employee is subject to this subtitle;  and
(2)  the injury arises out of and in the course and scope of employment.
(b)  If an injury is an occupational disease, the employer in whose employ the employee was last injuriously exposed to the hazards of the disease is considered to be the employer of the employee under this subtitle.
Acts 1993, 73rd Leg., ch. 269, Sec. 1, eff. Sept. 1, 1993.
2023 Texas Statutes › Labor Code › Title 5 - Workers' Compensation › Subtitle A - Texas Workers' Compensation Act › Chapter 406 - Workers' Compensation Insurance Coverage › Subchapter B. Coverage Requirements › Section 406.032. Exceptions

Sec. 406.032.  EXCEPTIONS.  An insurance carrier is not liable for compensation if:
(1)  the injury:
(A)  occurred while the employee was in a state of intoxication;
(B)  was caused by the employee's wilful attempt to injure himself or to unlawfully injure another person;
(C)  arose out of an act of a third person intended to injure the employee because of a personal reason and not directed at the employee as an employee or because of the employment;
(D)  arose out of voluntary participation in an off-duty recreational, social, or athletic activity that did not constitute part of the employee's work-related duties, unless the activity is a reasonable expectancy of or is expressly or impliedly required by the employment;  or
(E)  arose out of an act of God, unless the employment exposes the employee to a greater risk of injury from an act of God than ordinarily applies to the general public;  or
(2)  the employee's horseplay was a producing cause of the injury.
Acts 1993, 73rd Leg., ch. 269, Sec. 1, eff. Sept. 1, 1993.
2023 Texas Statutes › Labor Code › Title 5 - Workers' Compensation › Subtitle A - Texas Workers' Compensation Act › Chapter 406 - Workers' Compensation Insurance Coverage › Subchapter B. Coverage Requirements › Section 406.033. Common-Law Defenses; Burden of Proof

Sec. 406.033.  COMMON-LAW DEFENSES;  BURDEN OF PROOF.  (a)  In an action against an employer by or on behalf of an employee who is not covered by workers' compensation insurance obtained in the manner authorized by Section 406.003 to recover damages for personal injuries or death sustained by an employee in the course and scope of the employment, it is not a defense that:
(1)  the employee was guilty of contributory negligence;
(2)  the employee assumed the risk of injury or death; or
(3)  the injury or death was caused by the negligence of a fellow employee.
(b)  This section does not reinstate or otherwise affect the availability of defenses at common law, including the defenses described by Subsection (a).
(c)  The employer may defend the action on the ground that the injury was caused:
(1)  by an act of the employee intended to bring about the injury;  or
(2)  while the employee was in a state of intoxication.
(d)  In an action described by Subsection (a), the plaintiff must prove negligence of the employer or of an agent or servant of the employer acting within the general scope of the agent's or servant's employment.
(e)  A cause of action described in Subsection (a) may not be waived by an employee before the employee's injury or death.  Any agreement by an employee to waive a cause of action or any right described in Subsection (a) before the employee's injury or death is void and unenforceable.
(f)  A cause of action described by Subsection (a) may not be waived by an employee after the employee's injury unless:
(1)  the employee voluntarily enters into the waiver with knowledge of the waiver's effect;
(2)  the waiver is entered into not earlier than the 10th business day after the date of the initial report of injury;
(3)  the employee, before signing the waiver, has received a medical evaluation from a nonemergency care doctor; and
(4)  the waiver is in a writing under which the true intent of the parties is specifically stated in the document.
(g)  The waiver provisions required under Subsection (f) must be conspicuous and appear on the face of the agreement.  To be conspicuous, the waiver provisions must appear in a type larger than the type contained in the body of the agreement or in contrasting colors.
Acts 1993, 73rd Leg., ch. 269, Sec. 1, eff. Sept. 1, 1993.  Amended by Acts 2001, 77th Leg., ch. 1456, Sec. 16.01, eff. June 17, 2001.
Amended by:
Acts 2005, 79th Leg., Ch. 265 (H.B. 7), Sec. 3.031, eff. September 1, 2005.
Acts 2011, 82nd Leg., R.S., Ch. 1108 (S.B. 1714), Sec. 1, eff. September 1, 2011.
2023 Texas Statutes › Labor Code › Title 5 - Workers' Compensation › Subtitle A - Texas Workers' Compensation Act › Chapter 406 - Workers' Compensation Insurance Coverage › Subchapter B. Coverage Requirements › Section 406.034. Employee Election

Sec. 406.034.  EMPLOYEE ELECTION.  (a)  Except as otherwise provided by law, unless the employee gives notice as provided by Subsection (b), an employee of an employer waives the employee's right of action at common law or under a statute of this state to recover damages for personal injuries or death sustained in the course and scope of the employment.
(b)  An employee who desires to retain the common-law right of action to recover damages for personal injuries or death shall notify the employer in writing that the employee waives coverage under this subtitle and retains all rights of action under common law.  The employee must notify the employer not later than the fifth day after the date on which the employee:
(1)  begins the employment;  or
(2)  receives written notice from the employer that the employer has obtained workers' compensation insurance coverage if the employer is not a covered employer at the time of the employment but later obtains the coverage.
(c)  An employer may not require an employee to retain common-law rights under this section as a condition of employment.
(d)  An employee who elects to retain the right of action or a legal beneficiary of that employee may bring a cause of action for damages for injuries sustained in the course and scope of the employment under common law or under a statute of this state.  Notwithstanding Section 406.033, the cause of action is subject to all defenses available under common law and the statutes of this state unless the employee has waived coverage in connection with an agreement with the employer.
Acts 1993, 73rd Leg., ch. 269, Sec. 1, eff. Sept. 1, 1993.
Amended by:
Acts 2011, 82nd Leg., R.S., Ch. 1108 (S.B. 1714), Sec. 2, eff. September 1, 2011.
2023 Texas Statutes › Labor Code › Title 5 - Workers' Compensation › Subtitle A - Texas Workers' Compensation Act › Chapter 406 - Workers' Compensation Insurance Coverage › Subchapter B. Coverage Requirements › Section 406.035. Waiver of Compensation Prohibited

Sec. 406.035.  WAIVER OF COMPENSATION PROHIBITED.  Except as provided by this subtitle, an agreement by an employee to waive the employee's right to compensation is void.
Acts 1993, 73rd Leg., ch. 269, Sec. 1, eff. Sept. 1, 1993.