Texas Workers’ Compensation Benefits: What You’re Entitled To

November 27, 2024

If you were hurt on the job in Texas, the benefits you can receive depend first on one question: does your employer carry workers’ compensation insurance? Texas is the only state where most private employers can legally opt out.

If your employer subscribes to the state system, you can access medical coverage, income replacement, and death benefits, all subject to maximum amounts the Texas Department of Insurance (TDI) sets each year. If your employer does not subscribe, you may instead have a direct injury claim against them, which often recovers more than the capped benefits the state system allows.

This guide explains each type of Texas workers’ compensation benefit, who qualifies, and how much the benefits pay under current TDI limits. It also covers what changes when your employer is a non-subscriber, because that single fact can reshape your entire claim.

Key Takeaways

Texas workers’ compensation provides four core benefit types when your employer subscribes: medical coverage with no dollar cap, income benefits, death benefits, and burial benefits.
Income benefits replace 70% to 75% of your average weekly wage, and each type is capped at a weekly maximum TDI resets every October, currently $1,271 for TIBs, LIBs, and death benefits and $890 for IIBs and SIBs.
You must report a work injury within 30 days and generally file a formal claim within one year, or you risk losing your right to benefits entirely.
Lifetime income benefits are the only Texas comp benefit that increases over time, rising 3% each year, but they are limited to specific catastrophic injuries and are heavily disputed.
If your employer is a non-subscriber, the state system does not apply; you can sue directly for negligence, the employer loses key legal defenses, and your recovery is not subject to the benefit caps above.

Medical Benefits Under Texas Workers’ Comp

Medical coverage is the part of a workers’ compensation claim that begins first and lasts longest. Under Texas law, an injured worker is entitled to all health care that is reasonable and necessary to treat the work-related injury, with no deductible and no out-of-pocket cost for approved care. There is no lifetime dollar cap on medical benefits the way there is on income benefits, though the treatment itself must be approved as medically necessary.

Covered care generally includes:

Doctor visits: Evaluation, ongoing treatment, and follow-up appointments related to the injury.
Hospital care: Inpatient and outpatient services, including surgery.
Prescriptions: Medications prescribed to manage pain or support recovery.
Rehabilitation: Physical therapy, occupational therapy, and similar treatment to restore function.
Specialist care: Referrals to specialists when the injury requires expert treatment.

Workers can also be reimbursed for travel to and from medical appointments, such as mileage, when the distance meets TDI’s threshold. The main limitation is that care must be approved by the treating doctor and fall within TDI’s medical guidelines; disputes tend to arise when an insurer questions whether a specific treatment is necessary. If you want a fuller breakdown of what does and does not qualify, see our guide on which injuries workers’ comp covers.

Temporary Income Benefits (TIBs)

Temporary income benefits replace part of your wages while you are recovering and cannot earn what you did before the injury. They begin once you have lost more than seven days of work, though those first seven days are paid retroactively if your disability lasts 14 days or longer.

TIBs are calculated at 70% of your average weekly wage (AWW) for most workers. Workers who earned less than $10 an hour receive 75% of their AWW for the first 26 weeks, then 70% after that. Whatever the formula produces, the payment cannot exceed the state maximum: for injuries occurring between October 1, 2025 and September 30, 2026, the TIBs maximum is $1,271 per week and the minimum is $191 per week. Because these caps are tied to the statewide average weekly wage, TDI updates them every October, so a worker injured in a later period will see different limits.

TIBs end at the earliest of three points:

You return to work at your pre-injury wage
Your doctor determines you have reached maximum medical improvement (MMI, the stage where further recovery is not expected); or
You have received TIBs for 104 weeks

If your TIBs are delayed, reduced, or denied, that decision can be disputed through TDI, and it is a common point where injured workers seek legal help.

Impairment Income Benefits (IIBs)

When you reach maximum medical improvement but the injury leaves lasting damage, a doctor assigns an impairment rating: a percentage that reflects how much permanent physical impairment remains. That rating drives your impairment income benefits.

IIBs are paid at 70% of your average weekly wage, and you receive three weeks of payments for every one percentage point of impairment. A 10% impairment rating produces 30 weeks of IIBs; a 20% rating produces 60 weeks. For injuries in the current benefit period, IIBs are capped at $890 per week. The rating itself is often contested, because a higher rating means more weeks of payment and can affect eligibility for the benefits that follow, so it is worth confirming that the rating was assigned correctly using the AMA Guides.

Supplemental Income Benefits (SIBs)

Once impairment income benefits run out, workers with more serious lasting impairments may qualify for supplemental income benefits. SIBs are meant for people whose injuries keep them from returning to the income they earned before.

To qualify, you generally need an impairment rating of 15% or higher, you must not have taken your IIBs as a lump sum, and you have to show a good-faith effort to find or perform work you are able to do.

SIBs are calculated at 80% of the difference between 80% of your pre-injury AWW and the wages you actually earn now, and they require a new application every quarter with proof of your work search. For the current benefit period, SIBs are capped at $890 per week. Because eligibility is re-evaluated quarterly, SIBs are one of the more frequently disputed benefits in the system, and a missed or incomplete quarterly filing can interrupt payments.

Lifetime Income Benefits (LIBs)

Lifetime income benefits are reserved for the most catastrophic work injuries, the kind that permanently prevent a return to any meaningful work. They are the only Texas workers’ comp benefit that increases over time.

Under Texas Labor Code Section 408.161, LIBs qualify only for specific severe injuries: total and permanent loss of use of both hands, both feet, both eyes, or a combination of two of these; paralysis of both arms, both legs, or one of each; a traumatic brain injury causing permanent severe cognitive impairment; and certain severe third-degree burns.

LIBs pay 75% of your average weekly wage and increase by 3% each year on the anniversary of the date benefits began, an adjustment that applies even beyond the normal weekly maximum. Because these benefits are paid for life and can total a very large sum, insurers dispute them aggressively, often by contesting whether the injury meets the strict statutory definition.

Death and Burial Benefits

When a worker dies from a job-related injury or illness, the state system provides two separate benefits to survivors.

Death benefits replace income for eligible beneficiaries, paid at 75% of the deceased worker’s average weekly wage and subject to the same weekly maximum as other income benefits ($1,271 for the current period). Eligible beneficiaries generally include a surviving spouse, minor children, and certain other dependents, with specific rules on how long each can receive payments; a surviving spouse’s eligibility can change upon remarriage, for example. Burial benefits are separate and cover reasonable funeral expenses up to a statutory limit paid to whoever paid for the burial.

It is worth understanding one distinction here. A death benefit through workers’ compensation is capped and does not compensate the family for their own losses, such as the loss of companionship. If the death resulted from a non-subscriber employer’s negligence, the family may instead have a wrongful death claim, which is not subject to these caps and can recover a broader range of damages. Which path applies depends entirely on whether the employer carried coverage.

Other Benefits: Vocational Rehabilitation and Medical Travel

Beyond medical care and wage replacement, the Texas system offers a few additional forms of support.

If your injury prevents you from returning to your old job, vocational rehabilitation through the Texas Workforce Commission can provide retraining, job placement help, and skills programs to move you into work you are physically able to do. Separately, you can be reimbursed for travel to medical appointments, such as mileage to see a treating doctor or specialist, when the trip meets TDI’s distance requirements.

What If Your Employer Doesn’t Have Workers’ Comp?

Because Texas does not require most private employers to carry workers’ compensation, the first thing to establish after a work injury is whether your employer subscribes at all. You can find out by asking your employer or HR directly, checking coverage through the Texas Department of Insurance, or contacting the employer’s insurance carrier. If your employer is a non-subscriber, everything above changes.

A non-subscriber employer is not protected by the “exclusive remedy” rule that normally bars injured workers from suing their employer. That means you can bring a personal injury claim directly against the employer for negligence. And here the law shifts sharply in the worker’s favor: under Texas Labor Code Section 406.033, a non-subscriber employer gives up three defenses it would otherwise rely on.

It cannot argue that your own carelessness caused the injury, it cannot claim you assumed the risk of the job, and it cannot blame a co-worker’s actions. The employer only has to be shown even slightly at fault for you to recover.

The practical difference is significant. State-system benefits are capped, do not include payment for pain and suffering, and follow fixed formulas. A non-subscriber negligence claim carries no statutory benefit caps and can include compensation the comp system never pays. That is why sorting out subscriber status early matters so much, and why these claims are worth reviewing carefully. Our workplace injury attorneys handle non-subscriber claims directly, and you can read more about how these claims work and what a workers’ compensation lawyer does.

Key Texas Workers’ Compensation Rules and Deadlines

A few rules under the Texas Department of Insurance, Division of Workers’ Compensation (TDI-DWC) determine whether you keep your right to benefits at all.

The most important is the reporting deadline. You must report your injury to your employer within 30 days of the date it happened, or within 30 days of the date you knew or should have known the condition was work-related, which matters for injuries like repetitive stress that develop over time. Missing this window can cost you your benefits.

You then generally have one year from the date of injury to file a formal claim (DWC Form-041) with the division. Coverage in Texas is not mandatory, and employers who opt out lose the legal protections that subscribing employers receive. When disputes arise over a claim, TDI-DWC provides a process of benefit review conferences, contested case hearings, and appeals to resolve them.

Protecting Your Right to Workers’ Comp Benefits

The Texas workers’ compensation system can cover a great deal, from medical treatment and lost wages to lifetime support and death benefits, but nearly every benefit comes with caps, deadlines, and eligibility rules that insurers actively enforce. Understanding which Texas workers’ compensation benefits apply to your situation, and whether your employer even participates in the system, is the difference between a claim that pays what it should and one that stalls.

If your benefits have been delayed, reduced, or denied, or if you have learned your employer is a non-subscriber, those are exactly the situations where legal review changes the outcome. Hartley Law represents injured workers across the Dallas area in both benefit disputes and non-subscriber injury claims, and can review the details of your situation and explain the options available to you. Contact us today for a free case review!

Frequently Asked Questions About Texas Workers’ Compensation Benefits

What is the maximum workers’ comp benefit in Texas?

For injuries occurring between October 1, 2025 and September 30, 2026, the maximum weekly benefit is $1,271 for temporary income, lifetime income, and death benefits, and $890 for impairment and supplemental income benefits. TDI resets these caps every October based on the statewide average weekly wage.

How much does workers’ comp pay in Texas?

Income benefits generally replace 70% to 75% of your average weekly wage, up to the state maximum. The exact figure depends on the benefit type, your wages before the injury, and the current TDI cap.

How long do I have to report a work injury in Texas?

You have 30 days from the date of injury, or from when you knew it was work-related, to notify your employer, and generally one year to file a formal claim with TDI-DWC.

What happens if my employer doesn’t carry workers’ comp?

You may be able to sue the employer directly for negligence, and non-subscriber employers lose key legal defenses under Texas law. These claims are not subject to the state’s benefit caps and can recover damages the comp system does not pay.

Can I get workers’ comp for a pre-existing condition?

Sometimes. If work aggravated or accelerated a pre-existing condition, that aggravation may be compensable; our guide on workers’ comp and pre-existing conditions explains how this is evaluated.