Texas Labor Code, Title 5 (Workers' Compensation)

What this document is

Texas Labor Code, Title 5 (Workers' Compensation): chs. 409, 410, 411, 415 and 451, each complete (Secs. 409.001-409.024, 410.002-410.308, 411.001-411.110, 415.001-415.036, 451.001-451.003) is a state statute published by Texas Legislative Council (statutes.capitol.texas.gov; document host tcss.legis.texas.gov). It is one of the Texas documents that insurance license exam questions are written from, including texas property & casualty, texas claims adjuster practice questions. This page summarizes it and points to the official version, which is the text to rely on.

Sections cited in practice questions

Each practice answer shows the exact passage it comes from. These are sections of this document that questions cite, with a short excerpt from the source text.

• Tex. Labor Code § 411.003(a), (b) (Immunity From Certain Liability)

  “Sec. 411.003. IMMUNITY FROM CERTAIN LIABILITY. (a) An insurance company, the agent, servant, or employee of the insurance company, or a safety consultant who performs a safety consultation under this chapter has no liability for an accident, injury, or occupational disease based on an allegation...”

• Tex. Labor Code § 409.021(c) (Initiation of Benefits; Insurance Carrier's Refusal)

  “(c) If an insurance carrier does not contest the compensability of an injury on or before the 60th day after the date on which the insurance carrier is notified of the injury, the insurance carrier waives its right to contest compensability. The initiation of payments by an insurance carrier does...”

• Tex. Labor Code § 415.008(a) (Fraudulently Obtaining or Denying Benefits; Administrative Violation)

  “Sec. 415.008. FRAUDULENTLY OBTAINING OR DENYING BENEFITS; ADMINISTRATIVE VIOLATION. (a) A person commits an administrative violation if the person, to obtain or deny a payment of a workers' compensation benefit or the provision of a benefit for the person or another, knowingly or intentionally: (1)...”

• Tex. Labor Code § 451.002 (Remedies; Burden of Proof)

  “Sec. 451.002. REMEDIES; BURDEN OF PROOF. (a) A person who violates Section 451.001 is liable for reasonable damages incurred by the employee as a result of the violation. (b) An employee discharged in violation of Section 451.001 is entitled to reinstatement in the former position of employment....”

• Tex. Labor Code § 409.021(a) (Initiation of Benefits; Insurance Carrier's Refusal)

  “Sec. 409.021. INITIATION OF BENEFITS; INSURANCE CARRIER'S REFUSAL; ADMINISTRATIVE VIOLATION. (a) An insurance carrier shall initiate compensation under this subtitle promptly. Not later than the 15th day after the date on which an insurance carrier receives written notice of an injury, the...”

• Tex. Labor Code § 409.022(a), (b) (Refusal to Pay Benefits; Notice)

  “Sec. 409.022. REFUSAL TO PAY BENEFITS; NOTICE; ADMINISTRATIVE VIOLATION. (a) An insurance carrier's notice of refusal to pay benefits under Section 409.021 must specify the grounds for the refusal. (b) The grounds for the refusal specified in the notice constitute the only basis for the insurance...”

• Tex. Labor Code § 409.002 (Failure to File Notice of Injury)

  “Sec. 409.002. FAILURE TO FILE NOTICE OF INJURY. Failure to notify an employer as required by Section 409.001(a) relieves the employer and the employer's insurance carrier of liability under this subtitle unless: (1) the employer, a person eligible to receive notice under Section 409.001(b), or the...”

• Tex. Labor Code § 409.008 (Failure to File Employer Report of Injury; Limitations Tolled)

  “Sec. 409.008. FAILURE TO FILE EMPLOYER REPORT OF INJURY; LIMITATIONS TOLLED. If an employer or the employer's insurance carrier has been given notice or has knowledge of an injury to or the death of an employee and the employer or insurance carrier fails, neglects, or refuses to file the report...”

• Tex. Labor Code § 409.007(c) (Death Benefit Claims)

  “(c) A separate claim must be filed for each legal beneficiary unless the claim expressly includes or is made on behalf of another person.”

• Tex. Labor Code § 409.0091(d) (Reimbursement Procedures for Certain Entities)

  “A subclaimant may not be reimbursed for payment for any health care that was previously denied by a workers' compensation insurance carrier under: (1) a preauthorization review of the specific service or medical procedure; or (2) a medical necessity review that determined the service was not...”

• Tex. Labor Code § 409.021(a-1) (Initiation of Benefits; Insurance Carrier's Refusal; Administrative Violation)

  “(a-1) An insurance carrier that fails to comply with Subsection (a) does not waive the carrier's right to contest the compensability of the injury as provided by Subsection (c) but commits an administrative violation subject to Subsection (e).”

• Tex. Labor Code § 410.021 (Purpose)

  “A benefit review conference is a nonadversarial, informal dispute resolution proceeding designed to: (1) explain, orally and in writing, the rights of the respective parties to a workers' compensation claim and the procedures necessary to protect those rights; (2) discuss the facts of the claim,...”

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Questions about this source

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