Texas Impairment Rating Chart: Payouts, the 15% Threshold, and Disputes

The Texas impairment rating chart is not a single chart at all. It is the Fourth Edition of the AMA Guides to the Evaluation of Permanent Impairment, a reference book of tables organized by body system, and Texas law requires every workers’ compensation impairment rating to come from it. The number a doctor pulls from those tables controls your money directly: each percentage point equals three weeks of benefit payments at 70% of your average weekly wage. A 10% rating pays 30 weeks. A 20% rating pays 60 weeks. And a rating of 15% or higher opens a door to additional benefits that a 14% rating slams shut.

Which Edition Texas Uses and How It Works

Texas Labor Code § 408.124 requires impairment ratings to follow the AMA Guides.1State of Texas. Texas Labor Code Section 408.124 – Impairment Rating Guidelines The statute defaults to the Third Edition, but the Division of Workers’ Compensation adopted the Fourth Edition by rule. Under 28 TAC § 130.1, the Fourth Edition applies to any certifying examination conducted on or after October 15, 2001.2Cornell Law Institute. 28 Texas Admin Code 130.1 – Certification of Maximum Medical Improvement

The Fourth Edition is a lookup system. Separate chapters cover the musculoskeletal system, nervous system, respiratory system, and others. A doctor measures things like range of motion, sensory loss, or strength, then matches the clinical findings to a percentage in the guide’s tables. That percentage represents loss to the whole person, not just the injured body part. A shoulder injury costing 8% of the arm’s function gets converted to a whole-person percentage through the book’s conversion tables.

The design goal is consistency. Two doctors looking at the same measurements should land on the same number, because the guide dictates the answer instead of leaving it to clinical judgment. Disputes still happen, but they narrow to which table applies and whether the measurements were accurate, rather than a raw disagreement about severity.

You Have to Reach MMI First

No rating can be assigned until you reach maximum medical improvement, the point where your injury has stabilized and no further significant recovery is expected. Texas Labor Code § 401.011(30) sets MMI as the earliest of three dates.3State of Texas. Texas Labor Code Section 401.011 – General Definitions

  • Clinical MMI, the date a doctor determines, based on reasonable medical probability, that no further material recovery can be expected.
  • Statutory MMI, the date 104 weeks after temporary income benefits started accruing.
  • Extended MMI, available when spinal surgery has occurred or been approved within 12 weeks before the 104-week deadline; either side can ask the commissioner to extend that deadline based on medical evidence.4State of Texas. Texas Labor Code LAB 408.104 – Extension of the 104-Week Period

Because the statute uses “the earliest of,” the 104-week mark is a hard backstop. Even if you are still healing, statutory MMI takes effect at two years unless the spinal surgery extension applies. Most workers hit clinical MMI well before that. Minor sprains may stabilize within weeks, fractures within several months, post-surgical recoveries within six to eighteen months. Major spinal injuries can push right up against the 104-week limit.

How Your Rating Turns Into Money

Once your rating is certified, you become eligible for impairment income benefits (IIBs) the day after you reach MMI.5Texas Department of Insurance. Impairment Income Benefits (IIBs) The formula is three weeks of benefits per percentage point, paid at 70% of your average weekly wage.6Texas Department of Insurance. Information for Injured Employees – Impairment Income Benefits

Your average weekly wage is calculated from the 13 weeks of earnings immediately before your injury.7Texas Department of Insurance. Workers’ Compensation Income and Medical Benefits For a worker earning $1,000 per week who receives a 10% rating, the math runs like this:

  • Weeks of benefits: 10 × 3 = 30 weeks
  • Weekly payment: $1,000 × 70% = $700
  • Total: 30 × $700 = $21,000

The payment is capped. For injuries during fiscal year 2026 (October 1, 2025 through September 30, 2026), the maximum weekly IIB is $890, based on a state average weekly wage of $1,271.05.8Texas Department of Insurance. State Average Weekly Wage (SAWW) / Maximum and Minimum Weekly Benefits If 70% of your wage exceeds $890, your check gets trimmed to the cap. The Texas Department of Insurance updates these figures every year.

One feature surprises most workers: impairment income benefits are not wage replacement. You can return to your old job at your old salary and still collect every dollar owed under your rating.6Texas Department of Insurance. Information for Injured Employees – Impairment Income Benefits IIBs compensate you for permanent bodily damage, not lost earnings, so working does not shrink them.

Why 15% Is the Number That Really Matters

A rating of 15% or higher qualifies you to pursue supplemental income benefits (SIBs) once your IIBs run out.9Texas Department of Insurance. Supplemental Income Benefits SIBs exist for workers who still cannot earn their pre-injury wage after the permanent rating is assigned. Anything below 15% disqualifies you entirely, no matter how much the injury actually affects your ability to work.

SIBs are not automatic. You must show active job-search efforts, with the required number of activities varying by county through standards set by the Texas Workforce Commission.9Texas Department of Insurance. Supplemental Income Benefits Eligibility runs out 401 weeks (roughly seven and a half years) from the date of injury.10Texas Department of Insurance. Supplemental Income Benefits Miss four consecutive quarters and you can permanently lose access to any future SIBs.

The gap between 14% and 15% can be enormous in dollar terms. A 14% rating pays 42 weeks of IIBs and stops there. A 15% rating pays 45 weeks of IIBs and puts years of potential supplemental payments on the table. One percentage point on the chart can be worth tens of thousands of dollars.

The 90-Day Deadline to Dispute Your Rating

This is the rule that catches people. Under 28 TAC § 130.12, the first certified impairment rating becomes permanent and final if no one disputes it within 90 days.11Cornell Law Institute. 28 Texas Admin Code 130.12 – Finality of the First Certification The clock starts the day after you receive written notice of the rating through verifiable means, usually a copy of the completed Report of Medical Evaluation (DWC Form-069). Once the window closes, the rating is locked in, and it cannot be extended.

Either you or the insurance carrier can dispute within that window. Two methods are accepted:

Checking “non-concurrence” on the DWC Form-069 does not count as a dispute.11Cornell Law Institute. 28 Texas Admin Code 130.12 – Finality of the First Certification Workers who disagree with their rating and only tick that box think they have preserved their rights. They have not. After 90 days, the rating stands. Filing a BRC request is the safest way to lock in your objection.

Taxes on Impairment Benefits

Impairment income benefits are excluded from federal gross income under 26 U.S.C. § 104(a)(1).14Office of the Law Revision Counsel. 26 USC 104 – Compensation for Injuries or Sickness You owe no federal income tax on them. Texas has no individual income tax, so the state side is a non-issue.

One caveat matters if you also collect Social Security disability. The Social Security Administration may reduce your SSDI payment so that the combined total stays under a threshold, and the portion of your SSDI that gets reduced because of the workers’ comp offset can become taxable, even though the workers’ comp payment itself is not. Wages from a return-to-work or light-duty arrangement are taxed as ordinary income regardless of whether IIBs are still flowing.