Citation

Boggess B, Scott B, Pompeii L. New Solut. 2017; 27(2): 154-175.

Affiliation

Department of Epidemiology, Human Genetics and Environmental Sciences, University of Texas School of Public Health, Houston, TX, USA.

Copyright

(Copyright © 2017, Baywood Publishing)

DOI

10.1177/1048291117710781

PMID

28530473

Abstract

Texas' unique elective system of workers' compensation (WC) coverage is being discussed widely in the United States as a possible model to be adopted by other states. Texas is the only state that does not mandate that employers provide state-certified WC insurance. Oklahoma passed legislation for a similar system in 2013, but it was declared unconstitutional by the Oklahoma Supreme Court in 2016. This study examined 9523 work-related hospitalizations that occurred in Texas in 2012 using Texas Department of State Health Services data. We sought to examine work-related injury characteristics by insurance source. An unexpected finding was that among those with WC, 44.6% of the hospitalizations were not recorded as work related by hospital staff. These unrecorded cases had 1.9 (1.6-2.2) times higher prevalence of a severe risk of mortality compared to WC cases that were recorded as work related. Uninsured and publicly insured workers also had a higher prevalence of severe mortality risk. The hospital charges for one year were $615.2 million, including at least $102.8 million paid by sources other than WC, and with $29.6 million that was paid for by injured workers or by taxpayers. There is an urgent need for more research to examine how the Texas WC system affects injured workers.

Language: en

Keywords

Texas; occupational safety and health; opt-out models; workers’ compensation