Workers’ compensation in Texas is a state-administered insurance system that pays for medical treatment and replaces part of your lost wages if you are hurt on the job — but with a catch that exists in almost no other state: private employers can choose whether to carry the coverage at all. If your employer participates, you file a claim with the Division of Workers’ Compensation (DWC) at the Texas Department of Insurance, and those benefits become your only remedy against the employer. If your employer has opted out, you skip the DWC entirely and sue in civil court. Everything else about how workers’ comp works in Texas — deadlines, doctor choice, benefit amounts, dispute steps — flows from which of those two systems you are in.
Subscribers and Non-Subscribers
Under Texas Labor Code § 406.002, private employers may elect to carry workers’ compensation insurance rather than being required to do so.1State of Texas. Texas Labor Code Section 406.002 – Coverage Generally Elective Public employers must participate. Employers who carry coverage are called subscribers; those who opt out are non-subscribers.
If your employer subscribes, workers’ compensation is your exclusive remedy for an on-the-job injury and you generally cannot sue.2State of Texas. Texas Labor Code Section 408.001 – Exclusive Remedy; Exemplary Damages A narrow exception lets surviving family members sue when the employee’s death resulted from the employer’s intentional act or gross negligence.
If your employer is a non-subscriber, you can file a personal injury lawsuit in civil court, and the employer loses three defenses it would otherwise have: contributory negligence, assumption of risk, and the fellow-servant rule.3State of Texas. Texas Labor Code Section 406.033 – Common-Law Defenses; Burden of Proof The DWC does not handle non-subscriber cases. Everything below in this article applies to subscriber employers.
Your employer must tell you which category it falls into. Written notice is required when you complete your W-4 and I-9 forms at hiring, and the employer must post notices about its coverage status in the workplace.4Cornell Law School. 28 Texas Administrative Code Section 110.101 – Covered and Non-Covered Employer Notices to Employees
How to Check Whether Your Employer Has Coverage
You do not have to rely on what you were told at hiring. For employers insured through a licensed Texas carrier, you can verify coverage through the TXCOMP NCCI website, and a downloadable list of subscribing employers is available on the Texas Open Data Portal.5Texas Department of Insurance. Workers’ Compensation Insurance Coverage Verification Separate tools exist for certified self-insured employers and self-insured government entities.
If those tools do not answer the question, email the DWC at coverage.verification@tdi.texas.gov with your employer’s name, physical address, and date of injury. A representative typically responds within one business day.5Texas Department of Insurance. Workers’ Compensation Insurance Coverage Verification
Reporting the Injury and Filing the Claim
Two deadlines run after a workplace injury, and missing either can end your claim.
The first is 30 days. You (or someone on your behalf) must notify your employer of the injury within 30 days of the date it happened, or within 30 days of learning that an occupational illness may be work-related.6State of Texas. Texas Labor Code Section 409.001 – Notice of Injury to Employer Notice can go to the employer directly or to any supervisor or manager.
Missing that window does not automatically kill the claim. Three exceptions exist: your employer or supervisor already had actual knowledge of the injury, the DWC finds good cause for the delay, or the insurance carrier does not contest the claim.7State of Texas. Texas Labor Code Section 409.002 – Failure to File Notice of Injury Reporting fast is still the safer route.
Once the employer knows about the injury and it causes you to miss more than one day of work, the employer must report it to the insurance carrier within eight days.8State of Texas. Texas Labor Code Section 409.005 – Report of Injury
The second deadline is one year. You must submit DWC Form-041, the Employee’s Claim for Compensation for a Work-Related Injury or Occupational Disease, to the DWC within one year of the injury date or of the date you knew the condition might be work-related.9Texas Department of Insurance. DWC Form-041 – Employee’s Claim for Compensation The form asks for your personal information, your employer’s business details, a description of the incident with date and location, the body parts affected, your wage information, and your treating doctor if you have one. You can download it from the TDI website and submit by mail or fax.
The DWC will assign a claim number for future communications. You can call customer service at 800-252-7031 a week or two after submitting to confirm receipt.10Texas Department of Insurance. TXCOMP Claims and Coverage Systems The insurance carrier then investigates and contacts you about the status of the claim.
Medical Treatment
Workers’ comp covers all reasonable and necessary medical treatment for the workplace injury: doctor visits, surgery, prescriptions, physical therapy, and other care your treating doctor prescribes.
How you pick that doctor depends on whether the carrier uses a workers’ compensation health care network. Inside a network, you must choose a treating doctor from the network’s provider list. You can switch doctors within the network, and workers with chronic or life-threatening injuries can apply to the network’s medical director to see an in-network specialist.11Cornell Law School. 28 Texas Administrative Code Section 10.85 – Selection of Treating Doctor; Change of Treating Doctor Outside a network, you have broader freedom to choose your initial treating doctor, though rules still govern switching providers.
Some non-emergency services need preauthorization from the carrier before they can be provided, and rules about what falls in that category differ between network and non-network claims. If you have to travel more than 30 miles one way for treatment not available closer, you can request mileage reimbursement at the state employee travel rate.12Cornell Law School. 28 Texas Administrative Code Section 134.110 – Reimbursement of Injured Employee for Travel Expenses Incurred
Wage Replacement
Texas workers’ comp pays four types of income benefits, plus death benefits. All are calculated from your average weekly wage (AWW), which uses gross wages including nonpecuniary compensation such as employer-provided benefits that stop after the injury.13Cornell Law School. 28 Texas Administrative Code Section 128.1 – Average Weekly Wage: General Provisions
For injuries occurring between October 1, 2025, and September 30, 2026, weekly income benefits cannot exceed $1,271 or fall below $191.14Texas Department of Insurance. State Average Weekly Wage (SAWW) / Maximum and Minimum Weekly Benefits
A seven-day waiting period applies. Benefits start once you have missed at least eight days of work, and if the injury keeps you out for 14 days or more, the first seven days become retroactively payable.15Texas Department of Insurance. Temporary Income Benefits (TIBs)
Temporary Income Benefits
TIBs replace part of your lost wages while you recover. If you earned $10 or more per hour before the injury, TIBs equal 70% of the difference between your pre-injury AWW and what you can earn after the injury. If you earned less than $10 per hour, TIBs are 75% of that difference for the first 26 weeks, then 70% after.16Cornell Law School. 28 Texas Administrative Code Section 129.3 – Amount of Temporary Income Benefits
TIBs continue until you reach maximum medical improvement (MMI), the point at which your doctor determines your condition has stabilized, or until 104 weeks have passed, whichever comes first.17Texas Department of Insurance. Impairment Income Benefits (IIBs) – DWC Information Sheet
Impairment Income Benefits
Once you reach MMI, a doctor assigns a permanent impairment rating as a percentage. IIBs start the day after MMI and are paid for three weeks per percentage point.18Texas Department of Insurance. Impairment Income Benefits (IIBs) A 10% rating equals 30 weeks. When the weeks run out, IIBs stop automatically.
Supplemental Income Benefits
SIBs can pick up after IIBs end if your impairment rating is 15% or higher and you have not returned to work earning at least 80% of your pre-injury AWW. The carrier pays SIBs monthly, and you have to keep showing you are actively looking for work within your physical capabilities.19Texas Department of Insurance. Supplemental Income Benefits (SIBs) Accepting a lump-sum settlement disqualifies you from SIBs.
Lifetime Income Benefits
The most severe injuries — such as total and permanent loss of sight in both eyes, or permanent and complete paralysis of both arms, both legs, or one arm and one leg — qualify for LIBs.20Texas Department of Insurance. Lifetime Income Benefits (LIBs) – DWC Information Sheet LIBs equal 75% of your AWW and increase 3% each year. The statutory weekly maximum applies only to the first year; the annual increases are not capped by it.21Texas Department of Insurance. Lifetime Income Benefits and Death Benefits in the Texas Workers’ Compensation System
Death Benefits
If a workplace injury causes death, the carrier pays death benefits to legal beneficiaries at 75% of the employee’s AWW, subject to the same maximum and minimum as other income benefits, plus burial expenses.22State of Texas. Texas Labor Code Section 408.181 – Death Benefits Payments can be weekly, monthly by agreement, or through an approved annuity.
Going Back to Work
Your treating doctor reports your work status to the employer and carrier on DWC Form-073, listing restrictions like lifting limits, posture constraints, and medication effects. The form has to be updated whenever your status or restrictions change.23Texas Department of Insurance. DWC Form-073 – Texas Workers’ Compensation Work Status Report
Your employer may offer you a modified or light-duty job that fits those restrictions. For the offer to count as a “bona fide offer of employment,” it must be in writing and include the work location, schedule, wages, a description of physical demands, confirmation that assigned tasks will match the doctor’s restrictions, and a promise to provide training if needed.24Cornell Law School. 28 Texas Administrative Code Section 129.6 – Bona Fide Offers of Employment
Watch this step carefully. If you reject a bona fide offer or fail to respond within seven days, the carrier can treat the offered wages as your post-injury earnings even though you are not working, which cuts or eliminates your TIBs. If you think the offer exceeds your restrictions, talk to your treating doctor before responding.
The DWC also refers employees with certain injuries to the Texas Workforce Commission’s Vocational Rehabilitation Division for help meeting employment goals.25Texas Department of Insurance. Return to Work
When the Carrier Disputes Your Claim
Fights over the extent of the injury, an impairment rating, or the amount owed run through a set process. Before requesting a formal proceeding, the disputing party has to notify the other side and try to resolve it informally.
The first formal step is a Benefit Review Conference (BRC), a non-binding meeting run by a DWC officer, usually by phone or video, where both sides try to reach agreement.26Cornell Law School. 28 Texas Administrative Code Section 141.1 – Requesting and Setting a Benefit Review Conference If that fails, the case moves to a Contested Case Hearing (CCH), a formal evidentiary proceeding where a presiding officer reviews records, hears testimony, and issues a binding decision. Either party can appeal a CCH decision to an internal DWC appeals panel.
If you do not have a lawyer, the Office of Injured Employee Counsel (OIEC) provides free help through its ombudsman program. Ombudsmen are trained to guide unrepresented workers through hearing procedures and help present their side.27Cornell Law School. 28 Texas Administrative Code Section 276.10 – Ombudsman Training and Continuing Education Program
Retaliation
Texas law prohibits an employer from firing you or discriminating against you for filing a workers’ compensation claim in good faith, hiring an attorney, or testifying in a workers’ comp proceeding.28State of Texas. Texas Labor Code Chapter 451 – Discrimination Prohibited This protection applies whether the employer is a subscriber or a non-subscriber.
If retaliation happens, you can sue in district court. Available remedies include reinstatement, reasonable damages from the violation, and an order restraining further retaliation.28State of Texas. Texas Labor Code Chapter 451 – Discrimination Prohibited You carry the burden of proof, so document the timing between filing your claim and any adverse action.
Do You Need a Lawyer
You are not required to hire one. The OIEC ombudsman program can walk unrepresented workers through the dispute process at no cost. If you do hire an attorney, the fee cannot exceed 25% of your recovery.29State of Texas. Texas Labor Code Section 408.221 – Attorney’s Fees Paid to Claimant’s Counsel The fee comes out of your benefits, not on top of them, and the DWC has to approve it. The attorney submits DWC Form-152, and the division decides whether the time and expenses are reasonable before approving, partially approving, or denying the request.