The Texas Division of Workers' Compensation (DWC) published its 89th Legislative Biennial Report, offering a comprehensive update on the state’s workers’ comp system, including recommended law changes aimed at enhancing system efficiency ahead of the 2025 legislative session.

Key trends noted in the report include:

• Workers’ comp rates are down 81% since 2003
• 76% of private employers used workers’ comp in 2024 – notable as Texas does not require workers’ comp coverage
• Health care costs decreased $338 million since 2012
• 82% of claims received initial care in seven days or less in 2022
• The number of prescriptions is down 73% since 2009

Approximately $2.6 billion in direct written premiums were written in 2023, with 304 workers’ comp insurers. The top 10 insurance groups wrote approximately 74% of the market of total premiums, with Texas Mutual Insurance Company writing 41% of the market share.

Regarding access to care, 17,659 physicians participated in the workers’ comp system in 2022, with a 76% retention rate that year.  Approximately 84% of injured employees returned to work within six months of their injury in 2022, with 91% returning within one year, reflecting steady improvement.

On the subject of health care costs and utilization, total care costs decreased 30% since 2012, a drop from $1.15 billion to $812 million in 2022. A contributing factor in this was a decrease in the total number of claims by 20% from 319,000 to 256,000.

Total costs for pharmacy services decreased 71% from 2012-2022, with average cost per pharmacy claim dropping 38%, from $908 to $563. Opioid prescriptions fell 86% from 2009-2022, driven by the adoption of a pharmacy formulary in 2011.

As for legislative recommendations for 2025, the DWC recommends removing outdated references to the expired Approved Doctors List (ADL) to eliminate confusion and align Labor Code requirements with current practices. The DWC also recommends that contested case hearings be allowed by videoconference, to enhance flexibility, reduce travel burdens, and streamlines administrative processes while maintaining hearing integrity.