The Texas workers’ compensation laws provide a broad range of potential benefits to anyone suffering a job-related injury or illness:
Medical Benefits
Medical benefits pay for reasonable and necessary healthcare to treat a compensable work-related injury or illness. Depending on the condition, covered treatment can include doctor visits, hospital care, diagnostic testing, prescription medication, physical therapy, and other medically necessary treatment.
Workers’ compensation healthcare network rules may affect which treating doctor an injured employee can use. Disputes can also arise over whether treatment is related to the compensable injury, medically necessary, properly authorized, or subject to network requirements.
Temporary Income Benefits
Temporary income benefits, or TIBs, provide partial wage replacement when a compensable injury causes an employee to lose some or all wages for more than seven days. The amount depends in part on the employee’s average weekly wage and applicable statutory minimum and maximum amounts.
The first seven days are generally a waiting period. If the employee’s disability lasts at least 14 days, temporary income benefits can also become payable for the initial seven-day period.
Impairment Income Benefits
After an employee reaches maximum medical improvement, a doctor may assign an impairment rating. An employee with a qualifying rating may receive impairment income benefits, or IIBs, based on that rating.
Supplemental Income Benefits
Supplemental income benefits, or SIBs, may be available after impairment income benefits end when an employee has an impairment rating of at least 15%, has not returned to work or earns less than 80% of the employee’s previous average weekly wage because of the work injury, shows an effort to find work, has not received IIBs in a lump sum, and meets the other applicable requirements.
Lifetime Income Benefits
Lifetime income benefits, or LIBs, are limited to specific catastrophic injuries listed by Texas law. These include certain loss of one or more limbs, loss of use of limbs, certain losses of vision, certain paralysis, qualifying traumatic brain injuries, and certain third-degree burn injuries. A permanent injury or inability to return to a former job does not automatically establish eligibility for lifetime income benefits.
Death and Burial Benefits
When a compensable work-related injury or illness causes an employee’s death, certain eligible family members may receive death benefits. Eligibility for those benefits, and their duration, depends on the beneficiary’s relationship to the employee and other requirements.
Burial benefits may reimburse the person who paid qualifying burial expenses. A person may currently request up to $10,000 in burial benefits for a qualifying claim.
