Learn how Texas law calculates workers’ compensation payments when you are unable to work or earn less as a result of a job-related injury.
You should be able to get benefits for an on-the-job accident or sickness if your Texas company has workers’ compensation insurance.
These benefits are meant to assist you in receiving adequate medical treatment, compensating you for part of your financial losses, and assisting you in returning to work. The advantages offered by Texas law are summarized here. (In order to get these benefits, you must first submit a Texas workers’ compensation claim.)
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Medical Workers’ Compensation Benefits
Workers’ compensation covers any essential medical care for a job injury, as long as it is suggested or authorized by your treating physician. (For additional information, check our page on how to seek workers’ compensation medical care.)
How Much Do Temporary Income Workers’ Compensation Benefits Cost in Texas?
If you have to skip work while healing from your injuries, or if your injury prevents you from working, you may be eligible for temporary income assistance. Texas calculates these benefits using the following formula: 70% of the difference between your typical weekly income and the wages you can earn after your injury, or 75% of the gap if you make less than $10 per hour.
For example, if you were earning $15 per hour before to your accident ($600 per week) and are unable to work, the difference between your pre- and post-injury earnings is $600; you would get $420 per week (70% of $600) in temporary income benefits.
These benefits are subject to higher and lower restrictions defined by state legislation. The maximum and lowest amounts are determined by the date of your injury (or, for occupational illnesses, when you started receiving benefits). The maximum is $1,058 per week for injuries occurring between October 2021 and September 2022, while the minimum is $159.
Unless you have to miss two weeks or more, temporary income assistance will not begin until after the first week of missed work. These advantages are valid until the earliest of the following occurrences occurs:
If your doctor thinks your medical condition is unlikely to improve even with more medical treatment (a stage known as “maximum medical improvement”), you may return to your regular employment at the same earnings, or you’ve had temporary income assistance for 104 weeks.
Texas provides for a 104-week extension if you undergo (or will have) spinal surgery within 12 weeks of the deadline.
Your doctor will examine you after you have attained maximal medical improvement to determine if your job injury has resulted in a permanent loss of function or restriction (called an “impairment”). If this is the case, the doctor will assign a severity rating to your disability ranging from 1% to 99%. Benefits will be available to you for a length of time specified by your impairment rating: three weeks for each percentage point. These payments are known as impaired income benefits in Texas (commonly known as partial permanent disability benefits in many other states).
The weekly benefit amount will be 70% of your pre-injury weekly salary. Again, there are constraints. The maximum amount for impairment income benefits for injuries occurring in fiscal year 2022 is $741.
Assume you earned $600 per week before to your accident and had a 20% impairment rating. For 60 weeks, you will get $420 every week (70% of $600). (3 weeks x 20).
How Much Do Supplemental Income Benefits Cost in Texas?
After your impaired income benefits have expired, you may be eligible for supplementary income benefits if you fulfill all of the following criteria:
You are still unable to return to work or earn at least 80% of your prior salary since your permanent impairment rating was 15% or higher.
You did not select to receive your disability income benefits in a lump payment; you are actively seeking for employment or engaging in vocational rehabilitation (more on that below); and you reapply every three months, accompanied by paperwork proving your eligibility.
You may get supplementary income assistance for up to 401 weeks if you qualify. Take the difference between 80% of your pre-injury pay and your post-injury wage to determine your weekly benefit amount. You will get 80% of that amount, with the same maximum and minimum amounts as impaired income benefits.
Let’s say you have a permanent impairment rating of 30%. You used to make $600 a week before your injury, but now you only make $200. Subtract $200 from $480 (80% of your pre-injury pay) to get at $280; you’ll be paid 80% of $280, or $244 each week.
Total Disability Income Benefits for Life
Texas permits lifelong income compensation as well, but only for a few extremely severe impairments:
amputation or total loss of use of both hands or feet, or one of each a spinal injury that caused permanent paralysis in both arms or legs, or one of each complete blindness a traumatic brain injury that resulted in a severe, incurable mental impairment, or third degree burns that cover at least 40% of the body and require a skin graft, or that cover the majority of both hands or a hand and face.
Lifetime income benefits are 75% of your average weekly pay prior to the accident, with the same maximum and minimum as temporary income benefits. However, unlike other forms of benefits, lifetime income benefits are enhanced by 3% each year, regardless of the limit.
Other Texas Workers’ Compensation Benefits
In addition to reimbursement for medical care and a portion of your lost wages, Texas offers various forms of workers’ compensation benefits, such as:
Medical travel costs. Travel expenditures for medical treatment may be reimbursed if it is more than 30 miles distant from your residence and care at a nearby location is not accessible. If you have to go that far for medical examinations, you may be reimbursed for your mileage.
Rehabilitation for the workforce. If you are unable to return to your previous employment, even after reaching maximal medical improvement, you may be sent to a vocational rehabilitation program, where you may get training and aid in finding a new career.
Benefits upon death. When an employee dies as a consequence of a work-related accident or sickness, Texas workers’ compensation will pay death benefits to the surviving spouse, children, or other qualifying family members for a certain amount of time, based on the survivor’s connection to the dead. The payments will be 75% of the dead employee’s pre-injury earnings, with a maximum of the same amount as temporary income benefits. Workers’ compensation will also cover up to $10,000 in funeral costs.
Workers’ Compensation Benefit Restrictions
As you can see, workers’ compensation payments have limitations: you will only get a percentage of your lost income (though it may help to know that workers’ compensation benefits are normally tax-free). Furthermore, you are not entitled to compensation for your pain and suffering as a result of your injuries.
This is part of the workers’ compensation system’s trade-off: you may obtain benefits immediately without having to establish that your employer was at fault for your accident, but you won’t be completely paid for all of your losses.
Texas is one of the few states where private employers are not required to participate in the workers’ compensation system. You may claim for your injuries in court if your employer choose not to carry workers’ compensation insurance.
While this is normally a lengthier and more complicated procedure, you may be compensated for your pay loss as well as your pain and suffering. See our personal injury page for more information. If your business has opted to join in the Texas workers’ compensation system, an expert workers’ compensation lawyer can assist you in obtaining all of the benefits you are entitled to.