A work injury can cause major disruptions to your life—not only your health, but also to your career, finances, and overall well-being. The Texas workers’ compensation system is designed to compensate you for some of those losses and get you back to work as soon as possible. However, worker’s comp also limits the amount of money you can receive from your employer. (To get these benefits, you will need to file a Texas workers’ compensation claim.)
Texas pays temporary income benefits to workers who are not able to earn their usual wages while they are being treated for their injuries. These benefits are not paid for the first seven days of missed work. However, if you end up needing more than 14 days off work, the first week will be paid retroactively.
Temporary income benefits are 70% of the difference between your average weekly wages and the wages you are able to earn after your injury. For injuries on September 1, 2015 and later, low-wage earners who make less than $10 per hour will receive 75% of the difference in their wages.
However, these benefits are subject to a weekly maximum set by state law each year. As of October 1, 2017, the maximum benefit is $913 per week. (The cap is updated annually in October; you can find a list of the maximums at the website of the Texas Department of Insurance.)
Example: You earn $15 per hour, which is $600 per week. If you are not able to work at all, you will receive 70% of your wage differential ($600-$0), which is $420 per week.
Temporary income benefits last until one of the following events occurs:
Once you have reached maximum medical improvement, your doctor will evaluate you for a permanent disability. If you have one, you will receive impairment income benefits. These benefits are 70% of your average weekly wage, subject to a maximum set by state law. As of October 1, 2017, the maximum benefit is $639 per week.
How long you receive these benefits depends on your impairment rating. After an examination, your doctor will give you an impairment rating stated as a percentage. You will receive three weeks of benefits for each percentage point.
Example: You earn $600 per week and receive a 20% impairment rating. You will receive $420 per week (70% of $600) for 60 weeks (3 weeks x 20).
Texas workers with significant impairment ratings who suffer continuing wage loss may receive supplemental income benefits. To be eligible, you must have:
To calculate your supplemental income benefits, take the difference between 80% of your average weekly wage before your injury and your post-injury wages. You will receive 80% of that amount, subject to the same maximum as impairment income benefits.
Example: Suppose you have a permanent impairment rating of 30%. You used to earn $600 per week before your injury, but now you earn $200 per week. 80% of your pre-injury wage is $480. Subtract your post-injury wage of $200 from that amount, to get $280. You will receive 80% of $280, or $244 per week.
Supplemental income benefits are paid once your impairment income benefits stop. You must apply for them every quarter and provide supporting documentation. As long as you qualify, you can receive these benefits for up to 401 weeks.
If your permanent impairment is severe enough, you can receive lifetime income benefits at a higher rate than impairment income or supplemental income benefits. Only the most serious impairments qualify, such as:
In Texas, lifetime income benefits are 75% of your average weekly wage, subject to the same maximum as temporary income benefits. Every year, you will receive a 3% increase to your benefits, regardless of the state maximum.
Texas workers’ compensation also provides additional benefits, including:
As you can see, workers’ compensation only pays of a portion of your lost wages. Workers’ comp also does not pay anything for the pain and suffering caused by your injury. While this may seem unfair, it is part of the trade-off that is the workers’ comp system. The advantage of workers’ comp is that you can get benefits relatively quickly without needing to file a lawsuit or prove that your employer was at fault for causing your injury. The downside is that you can’t get the full value of your losses.
Texas is one of the only states that does not require your employer to participate in the workers’ compensation system. If your employer opted out, you can sue your employer for your injury in court. While this is usually a longer and more involved process, you can receive the full value of your wage loss and pain and suffering. To learn more, see our personal injury page.