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What Is Workers' Compensation Insurance?

Workers' compensation is a state-regulated insurance program designed to provide benefits to employees who suffer qualifying work-related injuries or illnesses.  Depending on the circumstances and applicable Texas workers' compensation rules, benefits may include:

• Medical care for a work-related injury or illness
• Certain income benefits when an employee loses income because of a qualifying injury or illness
• Certain benefits for qualifying permanent impairment or disability
• Death benefits for eligible family members following a covered work-related death

Texas Department of Insurance explains that workers' compensation pays medical benefits for covered work-related injuries and illnesses and can replace some lost wages when a qualifying injury or illness causes an employee to lose income.

Coverage and benefits are subject to Texas law and the applicable workers' compensation policy.

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Does Texas Require Workers' Compensation Insurance?

This Is an Important Question for Texas Business Owners

Unlike many states, Texas generally does not require most private employers to carry workers' compensation insurance.

Private employers can generally choose whether to provide workers' compensation coverage.  Businesses that provide coverage are often referred to as subscribers.

Businesses that choose not to provide workers' compensation coverage are generally referred to as non-subscribers.

However, choosing not to carry workers' compensation does not mean there are no responsibilities or risks.  Texas non-subscribers have notification and reporting requirements, including notifying employees that they do not have workers' compensation coverage and providing required notices to the Texas Division of Workers' Compensation. 

There may also be situations where coverage is required.

For example, certain government contracts and public construction projects can require contractors to provide workers' compensation coverage for employees working on the project.

If you're unsure whether your business needs workers' compensation coverage, don't guess. Talk with an insurance professional and review the requirements that apply to your business and contracts.

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Why Carry Workers' Compensation Insurance If Texas Doesn't Require It?

The fact that coverage isn't required for most private employers doesn't mean it's unnecessary.  Workers' compensation can provide important benefits for both employees and employers.

• For Your Employees

A covered employee who suffers a qualifying work-related injury or illness may receive benefits that can help with:

Medical treatment

Workers' compensation can provide medical benefits for qualifying work-related injuries and illnesses.

Lost income

Qualifying employees who lose income because of a work-related injury or illness may be eligible for income benefits under Texas workers' compensation rules.

Recovery

Access to appropriate medical care can help an injured employee focus on recovery and returning to work when medically appropriate.

• For Your Business

Workers' compensation can also provide important protection for employers.

Texas Department of Insurance notes that, except in cases such as gross negligence resulting in a fatality, workers' compensation coverage limits an employer's liability if an employee sues the business for damages. That means workers' compensation can be more than an employee benefit.  It can also be an important component of your company's overall risk-management strategy.

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What Does Workers' Compensation Cover?

Workers' compensation generally addresses qualifying work-related injuries and illnesses.  Examples can include:

Workplace Accidents

An employee is injured while performing their normal job duties.

Slips, Trips & Falls

An employee suffers an injury from a qualifying workplace fall.

Lifting Injuries

An employee develops a qualifying injury while lifting or moving materials.

Repetitive-Motion Injuries

Certain injuries or illnesses that develop over time may qualify if they are work-related.

Occupational Illnesses

Certain illnesses caused or aggravated by workplace conditions may qualify.

Construction Injuries

Construction employees can face significant workplace hazards involving equipment, falls, lifting, vehicles and other exposures.

Workplace Equipment Injuries

Employees operating machinery or other equipment can face serious injury risks.

Whether a particular injury or illness qualifies for workers' compensation benefits is determined under applicable Texas law and the circumstances of the claim.

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Workers' Compensation for Small Businesses

You don't need to have hundreds of employees to face workplace injury risks.  A small business may have:

• 2 employees
• 5 employees
• 10 employees
• 25 employees
• 50 employees

Even one serious workplace injury can create significant consequences for an employer and employee.  Workers' compensation may be especially worth considering for businesses where employees perform physical or higher-risk work.

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Workers' Compensation for Contractors

Contractors often face additional considerations.  A general contractor, subcontractor or other construction-related business may encounter:

• Employee injury exposures
• Subcontractor insurance requirements
• General contractor requirements
• Certificate of insurance requests
• Contractual insurance requirements
• Government-contract requirements
• Project-specific requirements

A client or general contractor may require proof of workers' compensation coverage even when Texas law doesn't require every private employer to carry it. Texas Department of Insurance specifically notes that some clients may require contractors to have workers' compensation insurance. 

Don't wait until you're awarded a contract to discover that your insurance doesn't meet the requirements.

If you're bidding on a project, send us the insurance requirements so we can help you identify the coverage you may need.

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Workers' Compensation for Government Contractors

This is an especially important consideration for businesses pursuing government contracts.  Certain public contracts can require workers' compensation coverage, even though Texas generally does not require most private employers to carry it.

Texas Department of Insurance specifically identifies certain building and construction employers contracting with governmental entities as being subject to workers' compensation requirements for employees working on qualifying public projects.

Sams One Stop also provides government contracting consulting services, which means workers' compensation can fit naturally into the broader insurance and contracting conversation.

Before submitting a bid, check:

• Required workers' compensation coverage
• Employer's liability requirements
• Coverage limits
• Certificate of insurance requirements
• Additional insured requirements where applicable
• Contract-specific insurance provisions
• State or federal contract requirements

Insurance requirements are contract-specific. Always review the actual solicitation, contract and applicable regulations.

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What Happens When an Employee Is Injured?

If an employee suffers a work-related injury, the employer and employee have responsibilities under the Texas workers' compensation system.  The exact procedures depend on the circumstances.

Generally, an employer should:

1. Take the Injury Seriously

Make sure the employee receives appropriate medical attention.

2. Document the Incident

Record relevant details about what happened.

3. Notify the Appropriate Parties

Follow the applicable workers' compensation reporting requirements and policy procedures.

4. Cooperate With the Claims Process

Provide requested information to the insurance carrier and claims administrator.

5. Follow Texas Requirements

Texas workers' compensation claims are regulated by the Division of Workers' Compensation.

For specific claim-handling questions, employers and employees should consult the Texas Division of Workers' Compensation or their claims professional.

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How Can You Reduce Workplace Injuries?

Insurance is only one part of managing workers' compensation risk.  A strong workplace safety program can help reduce injuries and improve employee safety. Consider:

Employee Training

Make sure employees understand the hazards associated with their jobs.

Proper Equipment

Provide appropriate safety equipment and ensure employees know how to use it.

Written Safety Procedures

Establish clear procedures for hazardous tasks.

Incident Reporting

Encourage employees to report hazards and injuries promptly.

Regular Safety Reviews

Periodically review workplace conditions and identify potential hazards.

Texas DWC also provides safety resources and consultations for employers.

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Why Choose Us?

Insurance + Business + Real Estate Experience

Workers' compensation is only one part of a business owner's risk-management strategy.  At Sams One Stop, our broader services include:

Insurance & Bonds

Real Estate Support

Property Management Support

Loan Servicing

Business Consulting

Government Contracting Consulting

That broader perspective can be valuable when insurance requirements intersect with:

Business Operations → Real Estate → Employees → Contracts → Government Contracting

Our goal is to help you understand your insurance options in the context of your actual business.

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Our Workers' Compensation Insurance Process

1. Tell Us About Your Business

We'll ask about your business, employees, operations and locations.

2. Review Your Employee Classifications

We'll gather information about the types of work your employees perform.

3. Review Your Payroll & Risk Information

We'll use the information required by the applicable insurance carrier to evaluate available options.

4. Compare Available Coverage

We'll help you understand the coverage options, limits, pricing and other important considerations.

5. Choose Your Coverage

Once you've reviewed the available options, you can decide how you want to manage your workers' compensation exposure.

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Protect Your Employees. Protect Your Business.

Whether you operate a small office, contracting company, construction business, retail store, restaurant, property management company, professional practice or government-contracting business, workers' compensation can be an important part of your overall risk-management strategy.

GET A WORKERS' COMPENSATION QUOTE

Sams One Stop/Sams Insurance Group

4063 East Houston St

San Antonio, Texas

Phone: (210) 788-1034
Email: aaron@samsonestop.com

Serving qualifying businesses in San Antonio and throughout Texas.