Workers' compensation in Texas pays out financial and medical benefits to employees who are injured or sick on the job. However, payments do not begin immediately after an injury. Understanding when benefits start and how the process works can help injured workers navigate their claims effectively.
Filing a Workers' Compensation Claim
The first step to receiving benefits is reporting the injury to your employer. In Texas, it's mandatory that you notify your employer within 30 days of the injury or when you discover a work-related illness. After notification, the employer or the injured worker must file a claim with the TDI-DWC or the Texas Department of Insurance, Division of Workers' Compensation.
Waiting Period for Income Benefits
Workers' compensation income benefits in Texas do not start immediately. There is a seven-day waiting period before benefits begin. This means:
- If you are unable to work for seven days or less, you will not receive income benefits.
- Should you be absent from work for more than 14 days, you will be paid retrospectively for the first seven days.
Types of Workers' Compensation Benefits and Their Start Times
Temporary Income Benefits (TIBs)
- Begin on the eighth day after the injury if the worker cannot earn their regular wages.
- If the worker is out for more than 14 days, the first seven days are reimbursed.
- Paid at 70% of the difference between pre-injury wages and post-injury earnings (or 75% for low-wage earners).
Medical Benefits
- Start immediately after a compensable work-related injury or illness.
- Cover necessary treatments, doctor visits, prescriptions, and rehabilitation.
- No waiting period applies.
Impairment Income Benefits (IIBs)
- Begin after a doctor determines that the worker has reached Maximum Medical Improvement (MMI) and assigns an impairment rating (IR).
- Paid at 70% of the worker's average weekly wage based on the impairment percentage.
Supplemental Income Benefits (SIBs)
- Start after IIBs end, but only if the worker qualifies (e.g., significant impairment preventing a return to work).
Lifetime Income Benefits (LIBs)
- Start when a worker sustains severe permanent injuries (e.g., loss of limbs, blindness, paralysis).
- Paid for life at 75% of the average weekly wage, plus a 3% annual increase.
Conclusion
Workers' compensation payments in Texas depend on the type of benefit and the severity of the injury. While medical benefits begin immediately, income benefits require a waiting period. Understanding these timelines ensures injured workers receive the compensation they deserve.