Impacts of COVID-19 and the WC System

On Dec. 6, 2021, DWC extended its mandatory data call through June 30, 2022, for certain information related to COVID-19 injuries reported to selected insurance carriers on or after Dec. 1, 2019.  

There were several key findings according to the latest DWC report, COVID-19 in the Texas Workers’ Compensation System, as of Feb. 6, 2022: 

  • Although COVID-19 caused a brief shutdown and moved some to remote work, the total number of workers’ compensation claims reported to DWC during two years of the pandemic (January 2020 through December 2021) was 15% higher than the two years prior to the pandemic (January 2018 through December 2019). This interrupted a 20-year trend in Texas of fewer WC claims reported each year. 
  • From January 1, 2020, through Feb. 6, 2022, insurance carriers reported a total of 78,299 COVID-19 claims to DWC.  
  • The greatest number of COVID-19 claims were reported in January 2022, followed by July 2020, December 2020, and August 2021. 
  • COVID-19 claims: As of Feb. 6, 2022, insurance carriers reported more than 78,000 COVID-19 claims and 422 fatalities to DWC. Nearly half of these claims (48%) and slightly more than half of the fatalities (52%) involve first responders and correctional officers.
  • Claims with positive test or diagnosis: Most claims (61%) involved injured employees who tested positive or were diagnosed with COVID-19. Insurance carriers accepted slightly more than half (52%) of COVID-19 positive test claims. 
  • COVID-19 claims with benefits: In 2020 and 2021, one-third (33%) of COVID-19 claims filed had medical or indemnity benefit payments associated with them. 
  • Denials and disputes: Insurance carriers denied nearly half (45%) of COVID-19 positive test claims. Despite more than 18,000 denials of COVID-19 claims with positive tests or diagnoses, there were only 166 disputes filed with DWC as of Feb. 6, 2022.
  • Claims with post-COVID conditions: About one out of five claims that received professional, or hospital/facility services received these services beyond one-month post-injury. 

DWC Resumes Texas Labor Code Provisions and DWC Rules Suspended During COVID-19 Pandemic 

On July 2, 2021, DWC issued Commissioners Bulletin #B-0018-21, informing workers’ compensation system participants that they would be resuming Texas Labor Code provisions and DWC rules related to work search compliance standards for supplemental income benefits (SIBs) and certain designated doctor (DD) examinations and required medical examinations (RMEs) that were suspended due to the COVID-19 pandemic. Effective Aug. 2, 2021, injured employees are required to meet at least one of the work search requirements to be able to get SIBs. And effective Aug. 2, 2021, DWC resumed processing requests for DD examinations and RMEs for all issues, including return to work or disability as a direct result of a compensable injury.