GQ Corner
Q. The carrier is doing an audit of a death claim and feels that the date of disability of 4/3/20 should be the same as the date of death (4/2/20). Do you disagree with that statement?
A. Under rule 408.183(a) entitlement to death benefits begins on the day after the date of an employee’s death.
Q. I have a claim for an injured worker, a Project Manager, which lives in Texas, but works out of state. He was hired with our insured in 2018 and was physically in Texas at the time he accepted the position. He has never worked a day in Texas since he was hired on in 2018. He travels back home to Texas on the weekends to spend time with his family. For the past year, he has worked primarily out of state and was recently injured in Wisconsin. Would the claimant qualify for Texas benefits if he lives here and was hired here?
A. The answer is based on Sec. 406.071 of the Texas Labor Code. An employee who is injured while working in another jurisdiction (and thus, not in Texas) is entitled to all rights and remedies under extraterritorial coverage if (1) the injury would be compensable if it had occurred in this state and (2) the employee had significant contacts with this state or the employment is principally located in this state. An employee has significant contacts with this state if the employee was hired or recruited in this state and the employee (1) was injured not later than one year after the date or hire or (2) has worked in this state for at least 10 working days during the last 12 months preceding the date of injury. It appears that the employee was hired or recruited in Texas and that his date of injury is more than one year following his date of hire. Your question indicates that for the past year, the claimant worked primarily outside of Texas. Thus, the question comes down to whether in the year preceding his injury, did the employee work in Texas at least 10 working days? If he did, then he is covered under extraterritorial coverage. If not, then he is not a Texas employee for purposes of Texas workers’ comp coverage.
FOLIO
