“At the end of the day, insurance adjusters are simply denying benefits in an effort to save their own company money at the expense of paying out benefits to workers who are injured or killed within the scope of their employment”
A Husband, Father, and State Employee
The story of Eric Johnson, a 37-year-old husband and father is representative of the injustice of the Texas Workers’ Compensation system, and his story is outlined in the video above.
Johnson, of Madisonville, Texas, died of COVID-19 after losing his battle with the virus.
Although the Texas Department of Criminal Justice listed Johnson’s Death as “in the line of duty”, the State Office of Risk Management denied his surviving family’s claim for workers’ compensation benefits by saying his death did “not occur within the course and scope of his employment”.
“Eric was a veteran officer – that’s the thanks he gets for putting his life on the line all these years,” a family member said. “It doesn’t make sense to me. He was only going to work and home. We know that he was around positive offenders at TDCJ.”
If Johnson’s case was determined to be work-related, the program would cover the cost of medical expenses related to his treatment and care before his death, as well as provide a substantial weekly income for his wife and children.
Proving The Case
“A big problem with these kinds of cases is that the family of the deceased worker must prove that the illness was contracted on the job”, stated Fyodor Clay, a senior associate attorney at Abbott, Clay & Bedoy, LLC, LLC, “and even though there is a likely chance the deceased worker became infected on the job, how does the family go about proving that?”, Clay continued.
In this particular case, Eric Johnson’s surviving spouse still has the option of moving forward with a legal challenge that would likely end up in a hearing before an administrative law judge that would rule on the case. Still, because of strict Texas workers’ comp rules, Johnson’s beneficiaries would have to prove that he was infected on the job, and not through other types of community spread.
Not only does the Texas Prison System lead the nation in Coronavirus infections and prisoner deaths, another tragedy is happening as families of Texas Corrections Officers are routinely being denied workers’ compensation after their loved-ones contract and die from COVID-19 infections.
Existing Benefits for Those Who Die in The Line of Duty
Texas law requires that families of first responders and corrections officers who are deemed to have died in the line of duty are eligible to receive a $500,000 lump sum payment, including funeral expenses and other types of benefits.
Texas State Representative Ana-Maria Ramos (D-Richardson) said, “At the end of the day, when you look at all of this, you’re talking [about] working-class families. They’re not asking for anything that they haven’t earned, that their families haven’t sacrificed for.”
SORM – Texas’ Publicly Owned Third-Party Insurance Administrators
“This basically comes down to the fact that the state’s self-owned insurance company wants to protect its own bottom line. At the end of the day, licensed insurance adjusters are simply denying benefits in an effort to save their own company money at the expense of paying out benefits to workers who are injured or killed within the scope of their employment”, Attorney Clay stated.
The State Office of Risk Management is charged by Chapter 412 of the Texas Labor Code to administer insurance services obtained by state agencies, including the self-insured government employees workers’ compensation insurance program and the state risk management programs. Benefit eligibility is decided by licensed insurance adjusters, whose careers rise and fall based on the amount of money they can save by withholding or limiting benefit payments to workers and their families who file for benefits.
Death benefits under the Texas Workers’ Compensation program would provide 75% of the deceased worker’s average weekly wage to the surviving spouse for the rest of their life, or until they remarry. Additionally, there is no rule that says beneficiaries cannot receive the state-mandated $500,000 payout in addition to workers’ compensation death benefits.