How do Texas workers’ compensation income benefits work?

Texas Workers’ Compensation Income Benefits: Here’s What You Need to Know

If you’ve been hurt on the job and your employer subscribes to workers’ compensation coverage, you’re probably eligible to receive several different types of WC benefits.  

• There are four types of Income Benefits (Temporary Income Benefits, Impairment Income Benefits, Supplemental Income Benefits, and Lifetime Income Benefits)
• They are all designed to cover lost wages at various stages of your claim, meaning that each category of Income Benefits provides a wage supplement for a different part of your recovery process.
• There is a cap on how much you can be compensated within these benefits called the State Weekly Average Wage; your Income Benefits will never be more than that amount
• There are steps to follow to make sure you get compensated the right amount of Income Benefits

Four Different Types of Worker’s Compensation Income Benefits

There is line after line in the Texas Labor Code that describes these benefits in detail. Rather than walk you through the needlessly complex text of the law, we’ll summarize it for you.

As mentioned, there are four types of Income Benefits:

1. Temporary Income Benefits. TIBs are money you are paid to cover your lost wages in the beginning of your case… up to the point that your doctor says you’re all better. This point is called Maximum Medical Improvement.
2. Impairment Income Benefits. Once you reach MMI, you stop receiving TIBs and become eligible to receive pay IIBs. These moneys are paid proportionate to the severity of your injury, which is also called your Impairment Rating.
3. Supplemental Income Benefits. Once your workers’ comp claim is more or less complete and you rejoin the workforce, SIBs are paid to fill the gap between what you earned prior to your injury and the lesser amount you now earn, assuming that your injury keeps you from earning the way you once did.
4. Lifetime Income Benefits. LIBs are paid only if you have suffered certain major injuries.

Now, there’s a lot more to it than what is written above. Each type of Income Benefit has its own loopholes and fine print, and, frankly, every attempt that we’ve seen to explain these benefits in plain English has only added more confusion. To fix this problem, we have painstakingly read through the statutes and created the table below to tell you when each type of Income Benefit begins and ends, the formula used to determine the value of payments, how often the payments are made, and we even provide examples. Before you delve into it, the main thing you need to understand is that all of the benefits are formulaic and none of them are particularly generous.

Limitations to Injured Worker Compensation in Income Benefits

Now, it makes sense for you to understand the limitations that come along with the benefits.

• Most importantly, you should know that there are two numbers that determine what Income Benefits compensation you receive. First, your own Average Weekly Wage is used to calculate some of these benefits or if you’re a part-time worker, you’ll be subject to the Part-Time Average Weekly Wage.Secondly, if you don’t have ample work history or you earn a lot more money than the average person, you’re subject instead to the State Average Weekly Wage.Either way, all formulas use one of these two averages to determine your compensation. No benefit payment will ever surpass the state-wide amount though. Think about this for a second: what if you used to make more than the State Average Weekly Wage before your injury? You can probably guess that after your injury, you’ll definitely be earning less than you used to.

• Another realistic limitation is the how long you can actually receive WC benefits. This is a maximum total of 401 weeks. 

• Another limitation within to this system is that if you can go back to work on the eighth day after your injury–meaning you miss only one week of work–then you get no workers’ comp benefits. This is referred to as the Seven Day Grace Period. So, if your injury is minor and you’re only out for a week, you’re paid nothing and your employer doesn’t owe you anything. Your employer’s carrier doesn’t have to pay you until your 8th day off the job.

A System of Steps: Workers’ Compensation Income Benefits

It’s no secret that when lawmakers set up the current workers’ compensation legislation, they created a system of steps. From injury to final compensation of benefits, there is a law for every part of the process. Admittedly, it really is a lot to learn–and its even more difficult when you don’t know where to begin.

source: injuryrelief

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