Texas workers’ compensation pays medical care and partial wage replacement to employees hurt or made sick by their jobs, but only if the employer chose to buy the insurance. Texas is the one state that lets most private employers skip coverage, so the first thing to find out after an injury is whether your employer is a “subscriber” (carries the policy) or a “non-subscriber” (declined it). Every employer has to post that status at the workplace and tell new hires at the time of hiring.1State of Texas. Texas Labor Code 406.005 The Texas Department of Insurance, Division of Workers’ Compensation (DWC) runs the system.
Subscriber or Non-Subscriber: Why It Matters
Under the Labor Code, private employers can elect whether to participate.2Texas Public Law. Texas Labor Code 406.002 – Coverage Generally Elective If yours subscribes, you file a workers’ compensation claim and collect benefits without having to prove anyone was at fault. The trade-off is that you generally cannot sue the employer for the injury.
If your employer is a non-subscriber, there is no insurance claim to file, but you can sue in civil court. The employer is also barred from using three defenses that normally help defendants in negligence cases: that you were careless yourself, that you knew about and accepted the danger, or that a coworker caused the injury.3State of Texas. Texas Labor Code 406.033 – Common-Law Defenses and Burden of Proof That tilts the odds toward the injured worker and is one reason many employers subscribe anyway.
What Benefits You Can Collect
If your employer subscribes, a successful claim can produce several kinds of payments. Which ones apply depends on how badly you’re hurt and how long you’re out.
Temporary Income Benefits
Temporary income benefits (TIBs) replace lost wages while you recover and have not yet reached maximum medical improvement, the point where your condition has stabilized.4State of Texas. Texas Labor Code 408.101 Nothing is paid for the first seven missed days, but if you’re out longer those days are paid retroactively. The standard rate is 70 percent of the difference between your pre-injury earnings and what you can earn during recovery. Workers earning under $8.50 an hour get 75 percent for the first 26 weeks.5Texas Department of Insurance. Texas Workers Compensation Act – Section 408.103
Impairment Income Benefits
Once you reach maximum medical improvement, a doctor assigns an impairment rating in percentage terms. Impairment income benefits (IIBs) pay 70 percent of your average weekly wage for three weeks per percentage point. A 10 percent rating produces 30 weeks of IIBs.6State of Texas. Texas Labor Code 408.121 – Impairment Income Benefits
Supplemental Income Benefits
Supplemental income benefits (SIBs) pick up after IIBs end, but only if your rating is 15 percent or higher and you’re still earning less than 80 percent of your pre-injury average weekly wage because of the impairment.7State of Texas. Texas Labor Code 408.142 – Supplemental Income Benefits You also have to meet DWC job-search requirements.
Lifetime Income Benefits
The most catastrophic injuries qualify for lifetime income benefits (LIBs), paid until death. Qualifying conditions include total blindness in both eyes; loss of both hands, both feet, or one of each at or above the wrist or ankle; permanent complete paralysis of two limbs from a spinal injury; a traumatic brain injury producing a permanent major neurocognitive disorder that makes you permanently unemployable; and third-degree burns covering at least 40 percent of the body and requiring grafting, or covering specified combinations of the hands, feet, and face. Total and permanent loss of use of a body part counts the same as physical loss.8State of Texas. Texas Labor Code 408.161 – Lifetime Income Benefits
Death and Burial Benefits
If a workplace injury causes death, the carrier pays eligible legal beneficiaries 75 percent of the employee’s average weekly wage.9State of Texas. Texas Labor Code 408.181 – Death Benefits A separate burial benefit covers reasonable funeral expenses up to $10,000.10State of Texas. Texas Labor Code 408.186
Medical Benefits
Medical benefits cover all reasonably necessary care related to the injury, with no deductible and no copay. That includes doctor visits, surgery, prescriptions, and physical therapy.
2026 Weekly Caps
Every income benefit is capped against the state average weekly wage (SAWW), which the DWC updates annually. For injuries between October 1, 2025, and September 30, 2026, the SAWW is $1,271.05, and the maximum weekly amounts are $1,271 for TIBs, $890 for IIBs, $890 for SIBs, $1,271 for LIBs, and $1,271 for death benefits. High earners receive no more than the cap; lower earners get the percentage formulas above, which usually come in below it.
Deadlines and How to File
Two deadlines control every claim, and missing either one can end your benefits.
You have 30 days from the date of injury to notify your employer. For an occupational disease that developed over time, the clock starts when you knew or should have known the condition was work-related.11State of Texas. Texas Labor Code 409.001 – Notice of Injury to Employer Verbal notice is legally sufficient, but written notice creates proof.
You then have one year from the injury date to file DWC Form-041, the Employee’s Claim for Compensation for a Work-Related Injury or Occupational Disease, with the Division of Workers’ Compensation.12State of Texas. Texas Labor Code 409.003 – Claim for Compensation The form asks for your Social Security number, address, how the injury happened, which body parts were affected, and your pre-tax wages at the time of injury.13Texas Department of Insurance. Employee’s Claim for Compensation for a Work-Related Injury or Occupational Disease The wage figure matters because the carrier uses it to calculate benefits.
Mail the completed form to the Division of Workers’ Compensation at P.O. Box 12050, Austin, TX 78711, or fax it to 512-804-4378.14Texas Law Help. Workers Compensation in Texas After the DWC receives it, the insurance carrier gets notice and decides whether to accept or dispute the claim.
Choosing Your Doctor
You can pick your own treating doctor from the DWC-approved list, and no prior approval is needed for that first choice.15State of Texas. Texas Labor Code 408.022 – Selection of Doctor To change doctors later, file DWC Form-053 and explain why. You cannot switch simply to shop for a better impairment rating.
If your employer uses a certified workers’ compensation health care network, you must choose from inside that network, and any out-of-network referral has to be approved by the network.16Texas Department of Insurance. Workers Compensation Health Care Networks
If the Carrier Disputes Your Claim
Disputes usually turn on whether the injury is compensable or how much the carrier owes. Texas works through a sequence of steps before anything reaches a courtroom:
- A benefit review conference (BRC), an informal meeting led by a DWC officer who tries to broker an agreement.
- A contested case hearing, a formal proceeding before a hearing officer who issues a binding decision.
- Appeals Panel review, available to either side after the hearing.
- Judicial review in a Texas district court if the Appeals Panel decision is still contested.
You start the formal process by filing DWC Form-045 to request a BRC.17Texas Department of Insurance. Disputes and Complaints in the Workers Compensation System Thorough documentation from the start matters here, because vague injury descriptions give carriers room to deny.18Texas Department of Insurance. Workers Compensation Disputes
Getting Help, and What It Costs
Attorney fees in Texas workers’ compensation cases are capped at 25 percent of what you recover.19State of Texas. Texas Labor Code 408.221 The cap gives you predictable costs, but it also means some attorneys will pass on smaller claims.
If you can’t find or afford a lawyer, the Office of Injured Employee Counsel (OIEC) assigns free ombudsmen to unrepresented workers. They are not attorneys, but they help you prepare for hearings and work through the system. Reach the OIEC at 866-393-6432.20Texas Department of Insurance. Dispute Resolution for Injured Employees
Can You Be Fired for Filing?
Texas law prohibits employers from firing, demoting, or otherwise punishing you for filing a workers’ compensation claim in good faith, hiring an attorney for the claim, or testifying in a workers’ compensation proceeding.21State of Texas. Texas Labor Code 451.001 – Discrimination Against Employees Prohibited Successful retaliation claims get you reinstatement and reasonable damages, but the burden is on you to show the adverse action was motivated by the workers’ compensation activity rather than a legitimate business reason.22State of Texas. Texas Labor Code 451.002 – Remedies and Burden of Proof
Taxes and Social Security
Workers’ compensation benefits are not subject to federal income tax; the IRS excludes amounts received under a workers’ compensation act from gross income.23Internal Revenue Service. Publication 525 – Taxable and Nontaxable Income A 70 percent wage replacement therefore lands closer to full take-home pay than it looks.
If you also collect Social Security Disability Insurance (SSDI), the combined total cannot exceed 80 percent of your average earnings before the disability. Any overage reduces your SSDI payment, and the offset lasts until full retirement age or until the workers’ compensation benefits stop, whichever comes first.24Social Security Administration. How Workers Compensation and Other Disability Payments May Affect Your Benefits VA benefits and SSI do not trigger the offset.
When Someone Other Than Your Employer Is at Fault
Workers’ compensation does not pay for pain and suffering. If a third party caused or contributed to your injury, you may have a separate personal injury claim against that party, such as a product liability suit over defective equipment, a negligence suit against a driver who hit you while you were on the job, or a claim against another contractor on a shared worksite. A third-party claim requires proof of negligence, but it can recover pain and suffering, full lost wages, and other damages the workers’ compensation system excludes. The Texas statute of limitations for personal injury is generally two years from the accident. You can pursue both a third-party case and a workers’ compensation claim, though the carrier may have a right to be reimbursed from the third-party recovery.