What is Workers’ Compensation?
Workers’ compensation is a form of insurance that allows a worker to receive medical and income benefits if they are injured on the job. Workers’ compensation also allows employers to avoid being sued for a personal injury claim by hiring an insurance company or by becoming self-insured. The laws and rights dictating how workers’ compensation is used are addressed in Title 5 Subtitle A of the Texas State Code.
How Do I Know I’m Covered by Workers’ Compensation if I’m in Texas?
Texas employers are not required to have workers’ compensation (in most cases). However, an employer is required to inform his employees whether or not they are covered. You should be told if you’re covered on your first day of the job, and this is also when your coverage will start. If you are covered by workers’ compensation, then information regarding your coverage and rights should be posted in an easily visible area at work.
Some Texas employers are required by law to have workers’ compensation coverage including:
- Public agencies like the city, county, and state employers must provide workers’ compensation.
- Building and construction contractors for public agencies.
- Liquid propane gas and compressed natural gas dealers.
- Motor carriers (companies that hire people to drive vehicles that provide transportation like buses and taxies)
- Employers of inmates in work for furlough programs.
I’ve Been Injured at Work in Texas, What Should I do?
Here are the steps to receiving workers’ compensation in Texas after an injury:
- If it is an emergency, seek medical attention as soon as possible. After you have been taken care of at the hospital, talk with your employer about filing for workers’ compensation as soon as possible.
- If it is not an emergency, inform your employer that you are injured. You will only have 30 days to inform your employer of an injury from the date you discovered (or should have known about) your injury.
- Fill out a DWC-41 form and give it to the Texas Department of Insurance, Division of Workers’ Compensation (TDI-DWC).
- You will then be able to visit a doctor approved by the TDI-DWC who will determine the extent of your injuries, and provide treatment. This doctor will then be your primary physician for that injury.
- If a doctor confirms your injuries, you should expect to receive payment within a few weeks.
What Kinds of Workers Compensation Benefits Could I Receive in Texas?
There are three types of income benefits for injured workers; Temporary Income Benefits (TIBs), Supplemental Income Benefits (SIBs), Impairment Income Benefits (IIBs), and Lifetime Income.
- Temporary Income Benefits (TIBs) in Texas
You can receive TIBs in Texas if you have diminished or stopped receiving wages for more than seven days as a direct result of your injury. The amount of money that you can get for TIBs is calculated by taking the average weekly wages you earn after your injury, and subtracting them from the wages you earned before your injury. You will then be paid 70 percent of the remaining number. You are eligible for TIBs after the first eight days of your injury. You can only be paid for the first week after your injury if you are unable to receive your old wages after two weeks.
- Impairment Income Benefits (IIBs) in Texas
If your injuries are permanent, you can receive IIBs. Your doctor will determine the extent of your impairment with an “impairment rating.” Your doctor will also determine the date at which your injury will heal as much as it ever will, this is called a “Maximum Medical Improvement” (MMI) date. The amount of money you receive for IIBs is 70 percent of your current average weekly wage. You qualify for IIBs the date of your MMI. How long you will receive IIBs is determined by multiplying your impairment rating by three. That is the amount of weeks you will receive IIBs.
- Supplemental Income Benefits (SIBs) in Texas
You must apply for SIBs every quarter (three months) and meet certain criteria in order to qualify, which are:
- You have an impairment rating of 15 percent or more that will be determined by your doctor.
- You cannot work because of your impairment, or are earning less than 80 percent of you previous average weekly wage because of your impairment.
- You have demonstrated an active pursuit of work that complies with TDI-DWC requirements.
- You did not take your impairment income benefits in a lump sum payment.
SIBs are calculated by taking 80 percent of your previous average weekly wages and subtracting your current earnings from the remainder. Then you will be paid 80 percent of that number. You can have SIBs for up to 401 weeks after your injury (that’s about seven and a half years).
- Lifetime Income Benefits (LIBs) in Texas
You can receive LIBs if you have:
- total and permanent blindness in both eyes
- loss of both feet at or above the ankles
- loss of both hands at or above the wrists
- loss of one foot at or above the ankle, and the loss of a hand at or above the wrist
- a spinal injury that results in the permanent and complete paralysis of both arms, both legs, or an arm and leg.
- a physically traumatic injury that results in incurable insanity or imbecility
- third degree burns that cover at least 40 percent of the body and require grafting
- third degree burns covering the majority of either both hands, or one hand and the face
Payment for LIBs is 70 percent of your average weekly wage with a three percent increase every year.