Texas Workers' Compensation: Fast Facts

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Coverage Requirements Under Texas State Law

Texas is one of the rare states where workers' compensation insurance is completely optional for employers to provide. That means there are no state laws requiring any business to provide this benefit for injured workers. However, many employers do provide this coverage for their employees, though some workers are automatically exempt.

If your employer doesn't have Texas workers' compensation insurance, your only option is to file a personal injury claim. Get a free, no-obligation consultation with an experienced personal injury lawyer near you today.

Work-Related Injury or Illness Reporting Requirements

Report your on-the-job injury or illness to your manager immediately, preferably in writing, and before you seek non-emergency medical care. Be sure to write down the time, location, and nature of your accident, including what caused your injury/illness. Within 72 hours, your employer must give you a list of 3 insurance-authorized doctors who can provide ongoing medical care. You must report your incident to your employer within 30 days to qualify for Texas workers' compensation.

Where to Seek Medical Care

If you need urgent medical attention, go to the nearest emergency room. Your employer's responsible for providing all medical care that isn't a life-threatening emergency. That means you should report it first to your employer, then choose a doctor from a list of authorized providers. Your employer should provide a panel of 3 physicians the insurer already approved to treat your work-related injury or illness. If you see an unauthorized provider and it's not a medical emergency, you'll have to pay those doctor's bills yourself.

Waiting Period for Lost-Wage Benefits in Texas

Your first 7 days off are always unpaid unless you cannot work for at least 14 days in a row. Once you need at least 15 days off to recover, then Texas workers' compensation pays for your unpaid week off. If you go back to work in less than a week, then it only pays for your medical expenses.

Texas Workers' Compensation Statute of Limitations

You have one year from your work injury or illness diagnosis date to apply for Texas workers' compensation benefits.

Texas Weekly Compensation Rate

You can receive up to 100% of the state's average weekly wage (AWW), depending on whether you're working or not. Your wage-loss payments in Texas are subject to the state's maximum and minimum benefit amounts.

How Long You Can Receive Texas Workers' Comp Benefits

  • Medical benefits: until you reach maximum medical improvement
  • Death benefits:up to $10,000 for funeral and burial expenses, plus 75% of the deceased worker's AWW divided equally amongst dependents until the surviving spouse remarries, which triggers two years of payments in a lump-sum award, or 364 weeks
  • Temporary Total Disability (TTD):up to 100% of the SAWW until you reach maximum medical improvement, but no more than 104 weeks
  • Permanent Partial Disability (PPD):up to 70% of the SAWW once you reach maximum medical improvement; number of weeks for pay period is 3x your disability percentage
  • Temporary Partial Disability (TPD):up to 70% of the SAWW once your PPD benefits run out; number of weeks for pay period is 3x your disability percentage (which must be at least 15% to qualify for TPD)
  • Permanent Total Disability (PTD):up to 100% of SAWW for the first 12 months if worker has catastrophic disabling injuries; then up to 75% of your AWW thereafter

Texas Workers' Comp Coverage Exemptions

The following employees are automatically exempt from Texas workers' compensation coverage requirements:

  • Federal employees
  • Independent contractors
  • Workers whose injuries arise from intentional self-harm, horseplay, Acts of God, criminal acts, or intoxication from drugs or alcohol

Texas Workers' Compensation Attorney Fees

All Texas workman's comp attorneys work on contingency. This means you only pay if an attorney helps you win your case. If you don't win, then your lawyer gets $0. Texas workers' compensation lawyers cannot charge more than 25% of your final award in legal fees.