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Texas Department of Insurance
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Advisory 96-15

REPORTING OCCUPATIONAL DISEASES

Inquiries from employers indicate there is some confusion concerning what occupational diseases must be reported to the insurance carrier and to the Commission. It appears that some employers are wrongly construing the Texas Workers' Compensation Act filing requirements to be the same as comparable reports required by the Occupational Safety and Health Act (OSHA).

The Texas Workers' Compensation Act, Section 409.005, requires employers with workers' compensation insurance to report injuries, including occupational diseases, to the employer's carrier. These injuries, occupational diseases, and fatalities are required to be reported by employers without workers' compensation insurance, to the Commission on a monthly basis, using the TWCC Form 7. These reports are also required if an employee notifies his or her employer of an occupational disease which the employee knew or should have known may be related to the employment.

This reporting criteria should not be confused with the reports of "occupational injuries" required by OSHA. The Federal Occupational Safety and Health Act uses a different term, a different definition and a different reporting standard. The OSHA standard is narrower than the TWCC standard and encompasses only occupational illnesses which have been diagnosed or recognized.

An occupational disease is defined by the Texas Workers' Compensation Act to mean a disease arising out of and in the course of employment that causes damage or harm to the physical structure of the body. This definition includes a repetitive trauma injury. An occupational disease specifically does not include an ordinary disease of life to which the general public is exposed outside of employment except where that disease is related to a compensable injury or occupational disease.

In accordance with the Commission's Appeals Panel decisions and civil court cases, emphasis on reporting occupational diseases is not determined by the actual disease, but on the causal connection of the harm. This means that any damage or harm reported by an employee to the employer which the employee claims is related to the employment should be reported to the Commission.

As stated in the Texas Workers' Compensation Act, a report of injury or occupational disease submitted by an employer, "...may not be considered to be an admission by or evidence against an employer or an insurance carrier in a proceeding before the Commission or a court in which the facts set out in the report are contradicted by the employer or insurance carrier."

If you have questions or require further information, please contact Employee/Employer Field Services at 512-440-3789.

Signed September 24, 1996.

Todd K. Brown, Executive Director