Texas Workers’ Compensation Benefits Guide: How to Apply

Important: We updated this article in March 2025 after fact checking against the Texas workers’ compensation system annual claim statistics. Understanding how Texas workers’ compensation benefits work can be confusing, especially when you’re dealing with a work-related injury or illness. Workers’ comp benefits in Texas depend entirely on state insurance coverage requirements, and unfortunately, it’s completely optional for most employers.

We explain important information like how much workers’ comp pays in Texas, if there’s a waiting period, and more below.

Texas Workers’ Compensation Benefits: Key Takeaways

• Texas state law does not require workers’ compensation insurance for employers; about 1 in 4 (24%) have no coverage.
• There are strict deadlines at each point in the process of applying for Texas workers’ compensation benefits. Failing to report your injury or file a form on time can hurt your chances for claiming workers’ comp benefits.
• Answering the question “how much does workers’ comp pay in Texas?” depends on your average weekly wage earnings amount. However, the state does set maximum and minimum benefit pay amounts that change every calendar year.
• Workers’ comp benefits in Texas are easier to get if an experienced workers’ compensation attorney handles your claim.

How Texas Workers’ Compensation Law Works

Workers’ compensation is insurance that pays for your medical expenses and, in some cases, some lost wages while you recover. Every state has its own no-fault system that generally covers any eligible employee’s work-related injury or illness. In all 50 states, businesses that employ workers pay for this type of insurance coverage, not the employees themselves.

However, workers’ compensation laws also vary widely from state to state. In Texas, workers’ compensation insurance is 100% optional. While public entities must provide workers’ comp insurance, private employers have no legal requirement to do so. The 2024 annual report shows 24% of private companies in Texas do not provide workers’ comp insurance for their employees. Further, those private companies employ approximately 13% of the Texas workforce. That means nearly 1 in 6 employers in this state do not have Texas workers’ comp insurance.

Which Texas Employers Have Workers’ Compensation Insurance?

Unlike most other U.S. states and territories, Texas state law makes workers’ compensation insurance coverage optional for all private employers. That means if you work for a local, state, or federal government office, then you probably have workers’ compensation insurance. And if your employer offers it as part of your benefits package, these employees are still generally exempt from coverage:  

• Federal employees
• Independent contractors
• Workers whose injuries arise from certain acts that disqualify them from getting benefits, such as:
  • Horseplay (i.e., fighting with coworkers or customers, even while playing around)
  • Intentionally harming yourself, including taking drugs or drinking alcohol at work
  • Committing a criminal act at your place of employment
  • Acts of God (i.e., a lightning strike, earthquake, tornado, hurricane, etc.)

Steps to File a Workers’ Comp Claim in Texas

1. Verify your employer has workers’ comp insurance coverage.

To confirm whether your employer has coverage, go to the Texas Department of Insurance’s website and:

1. Click the blue “accept” button.
2. Type the name of the business you work for in the “Employer Name” field.”
3. Click the “search” button to see if your employer purchased workers’ compensation insurance.

If your employer has insurance coverage, you should file a claim. But if not, then your only option is to get a free case review with a personal injury attorney here.

2. Report your injury or illness to your manager before you see a doctor unless you need emergency medical attention.

Within 72 hours after receiving your report, your employer should give you a list of 3 doctors to choose from. This applies only if your employer belongs to a Workers’ Compensation Health Care Network (Network). The Texas workers’ compensation insurance policy for your employer will automatically approve any of those doctors to treat your injury.

If you see your own doctor or another provider not on this list, you must pay those medical bills yourself. However, if your employer does not have an authorized provider network in place, you can see any doctor you prefer.

Always tell any healthcare provider that treats your injury or illness that it is work-related and how the accident happened.

You must report the injury within 30 days of your job accident to qualify for Texas workers’ compensation benefits.

Important: If your life is in danger, go to the nearest hospital or clinic and get urgent medical care immediately. If you’re unconscious or seriously hurt, you won’t have to pay for this initial visit out of your own pocket.  

3. File Form DWC-01 with the Texas Division of Workers’ Compensation to officially start your workers’ compensation claim.

You can call the Division a week or two later to confirm they received your form, if needed.

You must file Form DWC-01 within one calendar year to qualify for any Texas workers’ compensation benefits. The Division of Workers Compensation will review your claim, and then it’s up to your employer’s insurance company to either approve or deny your claim.

4. If approved, you may qualify for paid time off with a note from your doctor after the required waiting period ends.

In Texas, the required waiting period is one week (7 missed work shifts) before you can qualify for income benefits. Once you miss two full work weeks (14 days), workers’ comp insurance also covers your first week off work.

Pro Tip: If you don’t need at least a week off to recover, then workers’ comp only pays medical benefits.

5. Denied benefits? Contact the insurance adjuster or the Division to dispute the decision and request a benefit review conference.    

You have ninety (90) days to appeal your denial or hire an attorney to help with the dispute resolution process. Unless you have an attorney, the Division will use mediation to try and resolve your dispute with the insurance company.

Texas Workers’ Comp Benefits Available to Eligible Injured Employees

Generally, workers’ compensation benefits in most states cover medical expenses related to your injury or illness. And once you miss enough work due to your job accident, you may also qualify for lost wage benefits. Families of deceased workers killed on the job may also qualify for death benefits.

Medical Benefits

If you are hurt at work, these are the benefits you will most likely qualify for after filing your claim. Medical benefits include anything required to help you recover enough to start working full time again, such as:

• Doctor’s appointments
• Emergency or urgent care (i.e., stitches, X-rays, hospitalization, CT scans, MRIs)
• Surgery (if needed)
• ·Prescription and over-the-counter drugs to treat your injury or illness (i.e., pain or nausea medications, antibiotics)
• Physical therapy
• Travel expenses required to receive care, including mileage reimbursements, toll fees, etc.

Texas workers’ compensation insurance usually pays medical benefits until you reach Maximum Medical Improvement (MMI). If your employer has a return-to-work program, you may receive light duty work or other job restrictions before reaching MMI.

Pro Tip: In Texas, you automatically reach Maximum Medical Improvement 104 weeks after you become eligible for Temporary Income Benefits (TIBs).

Temporary Income Benefits

If you cannot work at all after your workplace accident, then you may qualify for temporary income benefits (TIBs). TIBs pay 70% of your Average Weekly Wage (AWW) earned in the 13 weeks before your work injury. This amount is subject to maximum and minimum amounts in the state for each calendar year, and changes annually.

Important: If you earned less than $10 an hour before your accident, your TIBs may equal 75% of your AWW.

Impairment Income Benefits

Impairment Income Benefits (IIBs) are available if your work injury permanently affects your body and its ability to work. Use the same formula you did to calculate your TIBs amount: 70% of your pre-injury work earnings for 13 weeks.

These benefits usually begin only after you reach Maximum Medical Improvement, which a doctor determines during an exam. (It can happen sooner, but no later than 104 weeks after your TIB payments begin.)

The state estimates this benefit amount based on the permanent disability impairment rating you receive at MMI. For every impairment percentage point the doctor assigns you, you can receive three weeks of IIBs.

For example: Your workers’ comp doctor assigns you a 10% impairment rating because you lost a finger in an industrial accident. That qualifies you for 30 weeks of IIBs payments, which pay the same amount as TIBs.

Once your IIBs end, you may qualify for Supplemental Income Benefits, or SIBs, if you still cannot work full time.

Supplemental Income Benefits

Supplemental income benefits (SIBs) may be available if everything listed below applies to you:

• Received at least a 15% impairment rating after reaching MMI
• Still cannot work full time, or earn less than 80% of AWW that others do working in the same position
• Refused to accept a lump-sum settlement payment for your job injury
• Able to prove you are still looking for work on a regular basis

Your monthly SIB amount should equal 80% of the difference between your AWW before your work accident and any money you earned since that date.

Anyone who collects supplemental income benefits in Texas must reapply every six (6) months for those payments.

Lifetime Income Benefits

If you have a severe or disfiguring bodily injury, you may qualify for lifetime income benefits from Texas workers’ compensation. Lifetime income benefits (LIBs) equal 75% of your AWW earned before your work accident and include an annual 3% increase.

Here are some examples of work injuries that may qualify you for LIBs in Texas:

• Permanent and complete blindness in both eyes
• Loss of two hands or both your feet
• Loss of one hand and one foot, at or above your wrist and ankle
• Complete paralysis in both arms, both legs, or in one arm and leg
• Third-degree burns covering at least 40% of your body, requiring skin graft surgery
• Traumatic brain injury that makes you unable to complete basic daily tasks without help
• A serious bodily injury that happened while working as a first responder in Texas

Death Benefits

Workers’ compensation death benefits can help cover certain costs if you or a loved one dies while on the job:

• Up to $10,000 for funeral and burial expenses
• Death benefits for eligible surviving dependents that equal 75% of the deceased worker’s AWW for 364 weeks (7 years)
• If a surviving spouse remarries, he or she can get 104 weeks of death benefits in a lump-sum payment
• Dependent children can get benefits until they turn 18 (or 25, if they are in college)

In Texas, death benefits are split equally between the surviving spouse and dependent minor children. This remains true until:

• The surviving spouse remarries or dies, or
• Youngest child turns 18 (or 25 if enrolled in an accredited educational institution), or
• Family members receive their lifetime maximum of 364 weeks of benefit payments.

Learn more about Texas death benefits for disabled children, families of first responders, and other dependents.

Important: If you were hurt outside of work or your claim doesn’t qualify, learn about your options for other disability benefits.

Recent Texas Workers’ Compensation Statistics

The U.S. Bureau of Labor Statistics issues annual reports showing workers’ comp claim statistical data for most states. The chart below shows some of the main Texas workers’ compensation claim trends from 2019 to 2013:

As you can see, total workers’ compensation claims fell 27% from 2019 down to “new normal” levels in 2023. Injured workers in service industry jobs tend to file most claims in any given year (ranging from 63% to 83%). It’s also important to note how many injured workers had to miss work, change jobs, or receive restrictions every year. Why? Because this shows how many injured employees filing claims get workers’ compensation income benefits, not just medical benefits.

Statistically, anywhere from 58% to 73% of workers filing claims each year qualify for lost wage benefits in Texas.

How to Get a Free Consultation with a Workers’ Comp Attorney in Your State

Should you work with a workers’ comp lawyer if you’re injured on the job and live in Texas? It’s smart to do so and it’s an easy process. All workers’ compensation lawyers work on contingency, so they charge $0 in legal fees if you aren’t successful. And the same rule applies to personal injury attorneys if your employer doesn’t have workers’ compensation insurance.

Ready to get started? Click the button below now to see if you may qualify:

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