Federal & State Regulations | Workers’ compensation - Texas

Summary of differences between federal and state regulations

There is no federal workers’ compensation requirement for most private employers.

Insurance requirement: Competitive state fund, self-insurance by private carrier, or individual employers.

Exemptions from WC: Coverage is elective for all.

Medical benefits provided: Full.

Physician selection: Employee selects physician from a list prepared by the Texas Division of Workers Compensation.

Benefits for temporary total disability (TTD): 70 percent of worker’s earnings over $8.50/hour, 75 percent for all others for up to 104 weeks or upon reaching maximum medical improvement, whichever is sooner. 104 week period may be extended if spinal surgery is involved.

Benefits for permanent total disability (PTD): 75 percent of worker’s wage for life for injuries listed in statute as constituting PTD; otherwise 401 weeks.

Benefits for permanent partial disability (PPD): 70 percent of worker’s earnings for up to 300 weeks.

Scheduled awards: None. Impairment benefits (IIBs) are paid after Temporary Income Benefits. IIBs are paid for 3 weeks for each percentage point of impairment.

Disfigurement benefits: 70 percent of employee’s average weekly wages not to exceed the maximum weekly benefit. Any disfigurement is considered in the assignment of an impairment rating in accordance with the AMA Guides.

Death benefits for surviving spouse and children: 75 percent of employee’s wage for period of widow/widowerhood; children until 18. Two-year lump sum payable upon remarriage. Children receive benefits beyond age 18 if disabled, or until age 25 if full-time students.

Maximum burial allowance: $6,000, plus the cost to transport the body if death occurred away from the employee’s usual place of employment.

Waiting period: 7 days. Compensation is retroactive if disability continues for 4 weeks from date of injury.

Rehabilitation: Physical rehabilitation and vocational rehabilitation are covered. Employees must accept physical rehabilitation.

Attorney fees: 25 percent, statute, determined by agency.

Occupational hearing loss statutes: Employee has 1 year from the date of injury or 1 year from the date knew or should have known occupational disease was related to employment. There is no deduction for preexisting loss.

What’s new - www.tdi.texas.gov/wc/news/index.html

Forms - www.tdi.texas.gov/forms/form20.html