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| (210) 995-4430 |
| Center for Injured Workers, Inc. A Non-Profit Corporation |
STOP Injucide!
When Texas Legislators first started workers’ compensation in 1913, they understood that workers’ compensation legislation had to
carry out its evident purpose of compensating injured employees and their dependents for compensable injuries sustained in the
course of employment. The employee agreed to relinquish his common law rights against his employer and the workers’
compensation insurance carrier agreed to compensate the employee for injuries sustained in the course of employment.
The 1917 Texas law created the Texas Industrial Accident Board (TIAB) to administer workers' compensation laws in the state. As
time went by, insurance carriers started abusing the provisions of the 1917 Act and plaintiff attorneys made sure that injured employee
workers’ compensation benefits were not jeopardized by the shady tactics employed by powerful insurance defense lawyers. Plaintiff
attorneys won landmark decisions in 1929, 1936, and 1939 over the injured employees’ right to workers’ compensation benefits, the
right to speedy, equitable relief for injuries sustained in the course of employment, and the basis for the constitutionality of the
Workers’ Compensation Act. Southern Casualty Co. v. Morgan, 12 S.W.2d 200, 201 (Tex.Comm’n App. 1929, judgm’t adopted); Texas
Employers’ Insurance Ass’n v. Wright, 128 Tex. 242, 97 S.W.2d 171, 172 (1936); and Huffman v. Southern Underwriters, 133 Tex. 354,
359, 128 S.W.2d 4, 6 (1939).
The continued reckless care, haphazard handling of claims, and unreasonable expedience and faithfulness in fulfilling agreed upon
provisions by insurance carriers gave Plaintiff attorneys additional significant victories in 1947, 1948, 1960, 1983, and 1987 over the
duty of insurance carriers to deal fairly and in good faith with injured employees in the processing and payment of claims. Montgomery
Ward & Co. v. Scharrenbeck, 146 Tex. 153, 157, 204 S.W.2d 508, 510 (1947) (emphasis added); Burroughs v. Bunch, 210 S.W.2d 211,
214-215 (Tex.Civ.App.-El Paso 1948, writ ref’d); American Standard Life Ins. Co. v. Redford, 337 S.W.2d 230, 231 (Tex.Civ.App.-Austin
1960, writ ref’d n.r.e.); English v. Fischer, 660 S.W.2d 521, 524 (Tex. 1983) (Spears, J. concurring); and Arnold v. National County
Mutual Fire Ins. Co., 725 S.W.2d 165, 167 (1987).
The intent of carriers to abuse injured employees by using powerful defense attorneys and everything else they had at their command
were diffused by Plaintiff Attorneys who demanded that insurance carriers deal fairly and in good faith when handling injured
employees’ workers’ compensation claims. The tremendous losses incurred by greedy insurance carriers caused a sharp rise in the
cost of workers’ compensation premiums to employers.
The carriers complained to the Texas Industrial Accident Board (TIAB) that the greed of Plaintiff attorneys was the cause of the sharp
rise in the cost of workers’ compensation in Texas. The insurance carriers also advised their lobbyist to pressure the State
Legislators to reform the workers’ compensation act and aired massive TV and other media to portray plaintiff attorneys as the villains
responsible for the rising cost of employers’ workers’ compensation premiums.
Legislators knew that the rising cost of workers’ compensation was not caused by plaintiff attorneys as the insurance carriers
charged. If that had been the case the State Legislators would have enacted provisions in the Act that would have punished
unscrupulous attorneys. But that was not the case. Carriers demanded a way to legally delay and/or deny workers’ compensation
benefits to injured workers in order to reduce the cost of workers’ compensation.
The Legislators found a way to make it hard for injured employees to find a plaintiff attorney who would take their case. They wrote a
provision in the Act which mandated that legal fees for attorney services had to be paid out of the injured employee’s indemnity
benefits. Other provisions made it easy for a carrier to dispute a claim as not being compensable; thereby preventing an injured
employee from entitlement to indemnity benefits. If the injured employee was not being paid indemnity benefits, they could not be
charged any attorney fees. No attorney fees meant that representation from a plaintiff attorney was not possible.
Next, they needed to insure that those few injured employees who could find an attorney would have great difficulty in finding a way to
take their case all the way to the Supreme Court of Texas. The Legislators included a requirement in the provisions that mandated that
the Act’s goal was to produce a cost-effective program to reduce workers’ compensation premiums to employers, not to provide
medical-effective benefits or indemnity benefits to injured employees. This meant that the liberal construction of the provisions of the
Act had to favor the insurance carrier.
The Texas Legislature adopted the Texas Worker's Compensation Act (Senate Bill 1) on Dec. 13, 1989. The Act was immediately
challenged in court but it was upheld eventually by the Texas Supreme Court and became effective on January 1, 2001. The Texas
Workers' Compensation Commission (TWCC) was created under the Act to administer the workers' compensation system, replacing
the Texas Industrial Accident Board. The TIAB failed to please the insurance carriers.
Injured employees would now face the insurance carriers’ brutal, powerful defense attorneys without plaintiff attorney representation.
The Texas Legislators tried to soften their hideous intentions by allowing injured employees to be assisted free of charge, not by a
TWCC attorney, but by an overloaded and inadequately trained TWCC Ombudsman. How did Texas Legislators justify that an
Ombudsman who cannot represent an injured employee was equal to a licensed, high power insurance carrier attorney? It was a
farce. Ombudsmen were no match for the carriers’ autocratic Czars.
Legislators knew that the unequal power of representation would reduce the number of workers’ compensation claims that would be
adjudicated through the DWC dispute resolution process. The Legislators did not care that due process of injured employees was
shredded or what happened to the well being of injured employees. They expected that lower claims would mean lower cost of
workers’ compensation.
In Fulton v. Associated Indemnity Corp., 46 S.W.3d 364, 370 (Tex.App.-Austin 2001), the Supreme Court stated: “We liberally construe
workers’ compensation legislation to carry out its evident purpose of compensating injured workers and their dependents.” The Court
stressed that it looked to Texas Workers’ Compensation Commission v. Garcia, 893 S.W.2d 504 (Tex. 1995), for guidance. To date,
the Supreme Court of Texas has held to the liberal construction in favor of the injured employee.
TWCC had to turn a blind eye to the outrageous abuse of governmental activities designed to safeguard the legal rights of injured
employees because workers’ compensation insurance companies fund TWCC operations! Under Section 403.002 of the Act, “each
insurance carrier, other than a governmental entity, shall pay an annual maintenance tax to pay the costs of administering this subtitle
and to support the prosecution of workers' compensation insurance fraud in this state.” TWCC could face the same fate as TIAB. The
1989 Act is proof of the power of the insurance lobbyists.
The Act and the ineffectiveness of TWCC encouraged unscrupulous insurers to take advantage of defenseless injured employees.
Insurance carriers have deep pockets so they used their unlimited access to the best defense lawyers, claims adjusters, medical
doctors, peer review doctors, claims investigators, case managers, expert witnesses, court reporters, subpoena capability, and
whatever they needed to squash injured employees who dared to claim that they sustained an injury in the course and scope of
employment. They have not care how much they spend because they can always pass the increase on to the employers as the
expense of doing business. The extravagant spending resulted in the rise of the cost of workers’ compensation even though injured
employee claims went down. The insurance carriers blamed the health care providers for the increase in workers’ compensation
expenditures.
The Texas Legislature enacted House Bill. 7 in 2005 to reform the administration of the workers' compensation system and
implement major changes in the delivery of benefits to injured workers. H.B. 7 provided that the newly-created Division of Workers'
Compensation (DWC), Texas Department of Insurance would be overseen by a Commissioner of Workers' Compensation appointed
by the Governor. TWCC was abolished, meeting the same fate as TIAB, for not satisfying the requirements of the insurance carriers.
H.B. 7 also established a new state agency, the Office of Injured Employee Counsel (OIEC), to be administered by a Public Counsel
appointed by the Governor. This gave the appearance that injured employees would now have legal representation, but it was not the
case. Overworked and understaffed Ombudsman still assist injured workers through the DWC dispute resolution process. Health
care networks, similar to those found in group health insurance, were also instituted to contain the rise in the cost of workers’
compensation the insurance carriers attributed to the claimants’ health care providers. They were to begin operations in 2006;
however, they have not been well received by employers and injured employees
H.B. 7 emboldened insurance carriers to continue committing violations of the Act which in the end deny the injured worker due
process by the manner administrative procedures are implemented within the workers' compensation system. The ultimate test of
due process of law in an administrative procedure is the presence or absence of the rudiment of fair play. Any procedure which is
unjust and wrong to the Claimant does not satisfy the minimum due process requirements of the Law.
H.B. 7 resulted in many health care providers refusing to treat injured employees. Many plaintiff attorneys also stopped taking workers’
compensation cases. Without plaintiff attorneys to stand up to the abusive and aggressive powerful insurance defense attorneys and
without sufficient treating doctors who are willing to stand by their medical oath to provide reasonable and necessary health care to
safely return injured employees back to work, the injured employee is not realizing the benefits anticipated from the workers’
compensation system they agreed upon in return for relinquishing their common law rights.
The injured worker does not have the ability or the money to challenge these violations, so carrier abuses keep increasing. The
majority of injured employees find that they are unable to return to work after their injury. They are forced to rely on social security
disability, food stamps, public assistance, or aid to families with dependent children in order to survive.
People of conscience must stand up and unite under a common banner to stop “injucide”, the relentless, uncontrolled, outrageous
abuse of injured employees. The unscrupulous strategies practiced by insurance carriers and their powerful defense attorneys are
not only causing the rise in the cost of workers’ compensation but are also making it very difficult for the few health care providers and
plaintiff attorneys to help injured employees to not only receive indemnity and health care benefits but also to safely return to work and
become productive employees.
CIW has been on the forefront fighting for the human rights of injured employees. CIW has been working on the establishment of the
CIW Workers' Compensation Network. It consists of doctors and other healthcare providers, plaintiff attorneys, social service
providers, pre-authorization services, lobbyists, spiritual counselors, research, analyses, and oversight division, outside advocate
organizations, and a Board of Advisors to maximize the support needed to adequately help injured employees..
But that is not enough. Texas needs a Statewide grass roots advocacy in order to influence and elect Legislators who will enact a
workers’ compensation act that will be fair and cost effective by holding each party liable and responsible for their duty to deal fairly and
in good faith with injured employees in the processing and payment of claims and providing reasonable expedient health care benefits.
CIW is experiencing a sharp rise in the demand for case intervention services. CIW needs financial help to continue championing the
quest of injured employees to get insurance carriers to abide by the duty of good faith and fair dealings in the execution of workers’
compensation benefits.
Can we count on your help? Please click here and send a generous financial contribution, which is tax-deductible, to CIW, P.O. Box
691494, San Antonio, TX 78269-1494.
Contact Carolyn Arambula, Executive Director, at 210-995-4430.
carry out its evident purpose of compensating injured employees and their dependents for compensable injuries sustained in the
course of employment. The employee agreed to relinquish his common law rights against his employer and the workers’
compensation insurance carrier agreed to compensate the employee for injuries sustained in the course of employment.
The 1917 Texas law created the Texas Industrial Accident Board (TIAB) to administer workers' compensation laws in the state. As
time went by, insurance carriers started abusing the provisions of the 1917 Act and plaintiff attorneys made sure that injured employee
workers’ compensation benefits were not jeopardized by the shady tactics employed by powerful insurance defense lawyers. Plaintiff
attorneys won landmark decisions in 1929, 1936, and 1939 over the injured employees’ right to workers’ compensation benefits, the
right to speedy, equitable relief for injuries sustained in the course of employment, and the basis for the constitutionality of the
Workers’ Compensation Act. Southern Casualty Co. v. Morgan, 12 S.W.2d 200, 201 (Tex.Comm’n App. 1929, judgm’t adopted); Texas
Employers’ Insurance Ass’n v. Wright, 128 Tex. 242, 97 S.W.2d 171, 172 (1936); and Huffman v. Southern Underwriters, 133 Tex. 354,
359, 128 S.W.2d 4, 6 (1939).
The continued reckless care, haphazard handling of claims, and unreasonable expedience and faithfulness in fulfilling agreed upon
provisions by insurance carriers gave Plaintiff attorneys additional significant victories in 1947, 1948, 1960, 1983, and 1987 over the
duty of insurance carriers to deal fairly and in good faith with injured employees in the processing and payment of claims. Montgomery
Ward & Co. v. Scharrenbeck, 146 Tex. 153, 157, 204 S.W.2d 508, 510 (1947) (emphasis added); Burroughs v. Bunch, 210 S.W.2d 211,
214-215 (Tex.Civ.App.-El Paso 1948, writ ref’d); American Standard Life Ins. Co. v. Redford, 337 S.W.2d 230, 231 (Tex.Civ.App.-Austin
1960, writ ref’d n.r.e.); English v. Fischer, 660 S.W.2d 521, 524 (Tex. 1983) (Spears, J. concurring); and Arnold v. National County
Mutual Fire Ins. Co., 725 S.W.2d 165, 167 (1987).
The intent of carriers to abuse injured employees by using powerful defense attorneys and everything else they had at their command
were diffused by Plaintiff Attorneys who demanded that insurance carriers deal fairly and in good faith when handling injured
employees’ workers’ compensation claims. The tremendous losses incurred by greedy insurance carriers caused a sharp rise in the
cost of workers’ compensation premiums to employers.
The carriers complained to the Texas Industrial Accident Board (TIAB) that the greed of Plaintiff attorneys was the cause of the sharp
rise in the cost of workers’ compensation in Texas. The insurance carriers also advised their lobbyist to pressure the State
Legislators to reform the workers’ compensation act and aired massive TV and other media to portray plaintiff attorneys as the villains
responsible for the rising cost of employers’ workers’ compensation premiums.
Legislators knew that the rising cost of workers’ compensation was not caused by plaintiff attorneys as the insurance carriers
charged. If that had been the case the State Legislators would have enacted provisions in the Act that would have punished
unscrupulous attorneys. But that was not the case. Carriers demanded a way to legally delay and/or deny workers’ compensation
benefits to injured workers in order to reduce the cost of workers’ compensation.
The Legislators found a way to make it hard for injured employees to find a plaintiff attorney who would take their case. They wrote a
provision in the Act which mandated that legal fees for attorney services had to be paid out of the injured employee’s indemnity
benefits. Other provisions made it easy for a carrier to dispute a claim as not being compensable; thereby preventing an injured
employee from entitlement to indemnity benefits. If the injured employee was not being paid indemnity benefits, they could not be
charged any attorney fees. No attorney fees meant that representation from a plaintiff attorney was not possible.
Next, they needed to insure that those few injured employees who could find an attorney would have great difficulty in finding a way to
take their case all the way to the Supreme Court of Texas. The Legislators included a requirement in the provisions that mandated that
the Act’s goal was to produce a cost-effective program to reduce workers’ compensation premiums to employers, not to provide
medical-effective benefits or indemnity benefits to injured employees. This meant that the liberal construction of the provisions of the
Act had to favor the insurance carrier.
The Texas Legislature adopted the Texas Worker's Compensation Act (Senate Bill 1) on Dec. 13, 1989. The Act was immediately
challenged in court but it was upheld eventually by the Texas Supreme Court and became effective on January 1, 2001. The Texas
Workers' Compensation Commission (TWCC) was created under the Act to administer the workers' compensation system, replacing
the Texas Industrial Accident Board. The TIAB failed to please the insurance carriers.
Injured employees would now face the insurance carriers’ brutal, powerful defense attorneys without plaintiff attorney representation.
The Texas Legislators tried to soften their hideous intentions by allowing injured employees to be assisted free of charge, not by a
TWCC attorney, but by an overloaded and inadequately trained TWCC Ombudsman. How did Texas Legislators justify that an
Ombudsman who cannot represent an injured employee was equal to a licensed, high power insurance carrier attorney? It was a
farce. Ombudsmen were no match for the carriers’ autocratic Czars.
Legislators knew that the unequal power of representation would reduce the number of workers’ compensation claims that would be
adjudicated through the DWC dispute resolution process. The Legislators did not care that due process of injured employees was
shredded or what happened to the well being of injured employees. They expected that lower claims would mean lower cost of
workers’ compensation.
In Fulton v. Associated Indemnity Corp., 46 S.W.3d 364, 370 (Tex.App.-Austin 2001), the Supreme Court stated: “We liberally construe
workers’ compensation legislation to carry out its evident purpose of compensating injured workers and their dependents.” The Court
stressed that it looked to Texas Workers’ Compensation Commission v. Garcia, 893 S.W.2d 504 (Tex. 1995), for guidance. To date,
the Supreme Court of Texas has held to the liberal construction in favor of the injured employee.
TWCC had to turn a blind eye to the outrageous abuse of governmental activities designed to safeguard the legal rights of injured
employees because workers’ compensation insurance companies fund TWCC operations! Under Section 403.002 of the Act, “each
insurance carrier, other than a governmental entity, shall pay an annual maintenance tax to pay the costs of administering this subtitle
and to support the prosecution of workers' compensation insurance fraud in this state.” TWCC could face the same fate as TIAB. The
1989 Act is proof of the power of the insurance lobbyists.
The Act and the ineffectiveness of TWCC encouraged unscrupulous insurers to take advantage of defenseless injured employees.
Insurance carriers have deep pockets so they used their unlimited access to the best defense lawyers, claims adjusters, medical
doctors, peer review doctors, claims investigators, case managers, expert witnesses, court reporters, subpoena capability, and
whatever they needed to squash injured employees who dared to claim that they sustained an injury in the course and scope of
employment. They have not care how much they spend because they can always pass the increase on to the employers as the
expense of doing business. The extravagant spending resulted in the rise of the cost of workers’ compensation even though injured
employee claims went down. The insurance carriers blamed the health care providers for the increase in workers’ compensation
expenditures.
The Texas Legislature enacted House Bill. 7 in 2005 to reform the administration of the workers' compensation system and
implement major changes in the delivery of benefits to injured workers. H.B. 7 provided that the newly-created Division of Workers'
Compensation (DWC), Texas Department of Insurance would be overseen by a Commissioner of Workers' Compensation appointed
by the Governor. TWCC was abolished, meeting the same fate as TIAB, for not satisfying the requirements of the insurance carriers.
H.B. 7 also established a new state agency, the Office of Injured Employee Counsel (OIEC), to be administered by a Public Counsel
appointed by the Governor. This gave the appearance that injured employees would now have legal representation, but it was not the
case. Overworked and understaffed Ombudsman still assist injured workers through the DWC dispute resolution process. Health
care networks, similar to those found in group health insurance, were also instituted to contain the rise in the cost of workers’
compensation the insurance carriers attributed to the claimants’ health care providers. They were to begin operations in 2006;
however, they have not been well received by employers and injured employees
H.B. 7 emboldened insurance carriers to continue committing violations of the Act which in the end deny the injured worker due
process by the manner administrative procedures are implemented within the workers' compensation system. The ultimate test of
due process of law in an administrative procedure is the presence or absence of the rudiment of fair play. Any procedure which is
unjust and wrong to the Claimant does not satisfy the minimum due process requirements of the Law.
H.B. 7 resulted in many health care providers refusing to treat injured employees. Many plaintiff attorneys also stopped taking workers’
compensation cases. Without plaintiff attorneys to stand up to the abusive and aggressive powerful insurance defense attorneys and
without sufficient treating doctors who are willing to stand by their medical oath to provide reasonable and necessary health care to
safely return injured employees back to work, the injured employee is not realizing the benefits anticipated from the workers’
compensation system they agreed upon in return for relinquishing their common law rights.
The injured worker does not have the ability or the money to challenge these violations, so carrier abuses keep increasing. The
majority of injured employees find that they are unable to return to work after their injury. They are forced to rely on social security
disability, food stamps, public assistance, or aid to families with dependent children in order to survive.
People of conscience must stand up and unite under a common banner to stop “injucide”, the relentless, uncontrolled, outrageous
abuse of injured employees. The unscrupulous strategies practiced by insurance carriers and their powerful defense attorneys are
not only causing the rise in the cost of workers’ compensation but are also making it very difficult for the few health care providers and
plaintiff attorneys to help injured employees to not only receive indemnity and health care benefits but also to safely return to work and
become productive employees.
CIW has been on the forefront fighting for the human rights of injured employees. CIW has been working on the establishment of the
CIW Workers' Compensation Network. It consists of doctors and other healthcare providers, plaintiff attorneys, social service
providers, pre-authorization services, lobbyists, spiritual counselors, research, analyses, and oversight division, outside advocate
organizations, and a Board of Advisors to maximize the support needed to adequately help injured employees..
But that is not enough. Texas needs a Statewide grass roots advocacy in order to influence and elect Legislators who will enact a
workers’ compensation act that will be fair and cost effective by holding each party liable and responsible for their duty to deal fairly and
in good faith with injured employees in the processing and payment of claims and providing reasonable expedient health care benefits.
CIW is experiencing a sharp rise in the demand for case intervention services. CIW needs financial help to continue championing the
quest of injured employees to get insurance carriers to abide by the duty of good faith and fair dealings in the execution of workers’
compensation benefits.
Can we count on your help? Please click here and send a generous financial contribution, which is tax-deductible, to CIW, P.O. Box
691494, San Antonio, TX 78269-1494.
Contact Carolyn Arambula, Executive Director, at 210-995-4430.
| CIW |