How do I file a workers compensation claim in Texas?

Texas workers' compensation is administered by the Texas Department of Insurance, Division of Workers' Compensation (DWC) under Texas Labor Code Title 5, Subtitle A.

1. Texas Is the Only Opt-Out State

Under Tex. Lab. Code § 406.002, private employers in Texas are NOT required to carry workers' compensation insurance (the only state with this rule).

Subscribers: Employers who carry workers' comp insurance and gain immunity from most personal injury lawsuits by employees.

Non-subscribers: Employers without workers' comp; injured employees may sue in civil court, and the employer cannot use the common-law defenses of contributory negligence, assumption of risk, or fellow-servant rule (Tex. Lab. Code § 406.033).

Government employers and most construction contractors on government projects must carry coverage.

2. Who Is Covered

All employees of subscribing employers (Tex. Lab. Code § 401.012).

Independent contractors generally excluded.

Federal employees, railroad workers, and maritime workers are covered by federal schemes.

3. Notice to Employer — 30 Days

Under Tex. Lab. Code § 409.001, you must notify your employer of the injury within 30 days (or within 30 days of knowing the injury was work-related, for occupational diseases).

Failure can bar the claim unless excused for good cause.

4. Filing Deadline — 1 Year

File a DWC Form-041 Employee's Claim for Compensation with the Division of Workers' Compensation (or via the TX DWC online system) within 1 year of injury (Tex. Lab. Code § 409.003).

5. Weekly Benefit Calculation

Temporary Income Benefits (TIBs): 70% of the difference between pre-injury and post-injury average weekly wage (AWW), or 75% if the employee earned less than $10/hour (Tex. Lab. Code § 408.103).

2024 maximum TIBs: approximately $1,123/week (100% of SAWW); minimum: 15% of SAWW.

Impairment Income Benefits (IIBs): 3 weeks per percentage point of impairment.

Supplemental Income Benefits (SIBs): For 15%+ impairment, paid quarterly at 80% of the difference between pre-injury and current wages.

Lifetime Income Benefits (LIBs): 75% of AWW for catastrophic injuries (loss of both eyes, both feet, etc.).

6. Maximum Benefit Period

TIBs: Up to 104 weeks from the date of injury or until maximum medical improvement (Tex. Lab. Code § 408.102).

SIBs: Up to 401 weeks from injury date.

LIBs: Lifetime for catastrophic injuries.

7. Medical Treatment

Carriers may establish a Workers' Compensation Health Care Network; if so, you must use a network doctor.

If no network, you may choose any doctor on the DWC's Approved Doctor List.

Medical benefits are unlimited in duration (no cap).

8. Choice of Doctor

Limited if employer is in a certified network — you choose from network providers.

Outside a network, you choose any approved provider.

9. Attorney Fees

Capped at 25% of recovery under Tex. Lab. Code § 408.221 and subject to DWC approval; hourly rates apply (currently $200/hour for attorneys per DWC rule).

10. Non-Subscriber Lawsuits

If suing a non-subscribing employer, no statutory cap on damages; you must prove negligence, but the employer cannot use traditional defenses.

This is legal information, not legal advice.