Employers are required to report injuries and illnesses to its insurance carrier within 8 days
Specifically, they need to report any:
- work-related injury resulting in the employee’s absence from work for more than one day;
- occupational disease of which the employer has knowledge; and
- work-related fatality.
Employers should report these injuries and illnesses using the DWC Form-001, Employer’s First Report of Injury or Illness. An employer must keep a record of all work-related injuries, illnesses and fatalities for at least 5 years after the date the record was created, or for the period of time required by the Occupational Safety and Health Administration (OSHA), whichever is longer.
The employer must also provide a copy of the completed DWC Form-001 to the injured employee, along with a copy of the Notice of the Injured Employee Rights and Responsibilities in the Texas Workers’ Compensation System. The employee’s notice of rights and responsibilities may be obtained from the TDI website at http://www.oiec.texas.gov/resources/ierightsresp.html. Both forms may also be obtained by calling 1-800-252-7031.
The employer has the burden of proving that good cause existed if the employer failed to file the report on time.
- If a report has not been received by the carrier, the employer has the burden of proving that the report was filed within the required time frame.
- An employer who fails to file the report without good cause may be assessed an administrative penalty.
- An employer who fails to file the report without good cause waives the right to reimbursement of voluntary benefits even if no administrative penalty is assessed
Once the employer has completed all information pertaining to the injury the employer should maintain the copy of this report to serve as the Employer’s Record of Injury required by Section 409.00.
This report may not be considered admission or evidence against the employer or the insurance carrier in any proceeding before the Division or a court in which facts set out in the report are contradicted by the employer or insurance carrier.
Some Frequently Asked Questions about Employers in Texas Reporting Injuries and Illnesses
When is a workplace incident that causes injury to one of my employees not payable under my workers’ compensation policy?
An insurance carrier is not liable for benefits if:
- your employee was injured while in a state of intoxication;
- the injury was caused by the employee’s willful attempt to injure himself or unlawfully injure another person;
- a person that is not your employee injures your employee for a personal reason and not directed at the employee as an employee or because of employment;
- your employee was injured while participating in a voluntary off-duty recreation, social, or athletic activity that was not part of the employee’s duties unless the activity is a reasonable expectancy of or is expressly or implicitly required by the employment;
- the injury 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
- horseplay was a producing cause of the injury.
How does an employee report an unsafe work environment?
Employees can report an unsafe work environment by contacting the Safety Violations Hotline at 1-800-452-9595 or by e-mail. Reports are taken in both English and Spanish and can be made anonymously.
How can I find workplace injury and illness data for my type of business or industry?
Workers’ compensation claims data, Bureau of Labor Statistics (BLS) Annual Survey of Occupational Injuries and Illnesses, and BLS Census of Fatal Occupational Injuries data is collected by DWC. Interested parties can create customized reports from the online database, or choose from various statistic data reports by visiting the TDI website.
What is fraud under Texas workers’ compensation?
A person who knowingly or intentionally makes a false or misleading statement to either deny or obtain workers’ compensation benefits or insurance coverage, or who, with such a purpose, misrepresents or conceals a material fact, fabricates, alters, conceals or destroys a material document or conspires to commit such acts commits an administrative violation that may result in a sanction.
DWC investigators are available for presentations that include tips on identifying fraud, making fraud referrals, as well as the investigation process and confidentiality. To request a presentation for your organization, please contact the Speakers Bureau at 512-804-4578 , or by fax at 512-804-4201 .
For additional information on Texas workers’ compensation fraud, visit the Fraud page.
To learn more about Texas Workers’ Compensation Claims and Compensation for Injured Workers, please call Houston Work Injury Attorney Hector L. Sandoval. Sandoval Law Firm, PLLC helps injured workers. Call (346) 347-7777 for a free and informative consultation!