When Do Texas Workers’ Comp Checks Start and Stop?

After a job injury, losing a paycheck can quickly put pressure on a household. If the employer has workers’ compensation coverage, an injured employee may qualify for income benefits when the injury reduces or stops the employee’s earnings for more than seven days.

A Texas workers’ comp lawyer can explain when payments should begin and why an insurance carrier may stop them. The answer depends on the type of benefit and the worker’s medical status.

When do temporary income benefit checks begin?

Temporary income benefits, often called TIBs, begin to accrue on the eighth day of disability. Under Texas workers’ compensation law, disability means that a work-related injury keeps an employee from earning the wages the employee earned before the injury. It does not simply mean that a doctor diagnosed an injury.

For an accepted claim, the insurance carrier generally must begin paying no later than seven days after the eighth day of disability. This means eligibility can begin on the eighth day even if the first check arrives later. Delays may occur when the carrier has not received notice or disputes whether the injury is covered.

Will the first seven days be paid?

Texas has a seven-day waiting period for TIBs. If the disability lasts fewer than 14 days, the employee generally will not receive benefits for those first seven days. Payments begin with the eighth day of disability.

If the disability lasts at least 14 days, benefits can also be paid for the first seven days. This rule makes the length of the wage loss important when calculating the amount owed.

How much will each check be?

TIBs are generally 70% of the difference between the wages the employee can earn after the injury and the employee’s average weekly wage. Texas uses special rules for certain lower-paid workers. State minimum and maximum benefit limits also apply.

An employee who returns to modified duty at lower pay may still receive partial TIBs. The carrier must compare the employee’s average weekly wage with the current earnings, so accurate wage records can affect the check amount.

When do temporary checks stop?

TIBs can stop when the employee can again earn the pre-injury average weekly wage. They can also end when a health care provider finds that the employee has reached maximum medical improvement. This is the point when no further significant recovery can reasonably be expected.

Texas also sets a general limit of 104 weeks after the 8th day of disability. Reaching one of these stopping points ends TIBs, but it does not always end every form of workers’ compensation income benefit.

Can another type of benefit begin afterward?

Impairment income benefits may begin after the employee reaches maximum medical improvement and receives an impairment rating. An eligible worker receives three weeks of these benefits for each percentage point in the rating. A 10% rating, for example, produces 30 weeks of impairment benefits.

Some employees with an impairment rating of at least 15% may later qualify for supplemental income benefits. These benefits have added work and earnings requirements. Lifetime income benefits are available only for specific severe injuries listed under Texas law.

What if checks arrive late or stop without warning?

A carrier may dispute whether the injury is work-related or whether the employee has disability. Disagreements can also concern wages, work ability or maximum medical improvement. The written notice from the carrier should state why payment was denied or stopped.

A Texas workers’ comp lawyer can review that notice and the medical records to identify the disputed issue. Because some challenges have firm deadlines, an injured employee should learn when to hire a workers’ comp lawyer rather than assume that the loss of a check is final.

Where can an injured worker get help?

Workers’ compensation checks can change as recovery and earning ability change. Understanding which benefit applies can help an employee spot a missed payment or an early cutoff.

The Law Office of Sandy McCorquodale, P.C. helps injured Texas workers understand their rights and pursue the benefits available under the law. Speak with a Texas workers’ comp lawyer by calling (833) 712-4472 or reaching out online.