Income Benefits

Work Related Injuries: In order for there to be a true workers' compensation case, two basic conditions have to be met: First, the employer must subscribe to the State's workers' compensation system. In Texas, it is not mandatory for an employer to subscribe or secure workers' compensation insurance. Second, there must be an injury, defined under the Act as "... damage or harm to the physical structure of the body and a disease or infection naturally resulting from the damage or harm". (Sec. 401.011(26)). If an injury occurs, the injury must be one that is compensable under the Act, which defines compensability as "...an injury that arises out of and in the course and scope of employment for which compensation is payable". (Sec. 401.011(10)). If even one of these two conditions are not met, then the case is not a workers' compensation claim.

1. Temporary Income Benefits (TIBs):

These are usually the first type of benefits that a workers' compensation claimant will get. These benefits are paid to those claimants who, because of their compensable injury, are unable to return to work at the same level and get paid at the same rate as they were before they sustained the injury. These benefits are paid for as long as the Claimant is unable to make the same amount he or she was making before they got hurt. However, these benefits end two years after the benefits began to accrue, the claimant returns to work and starts making as much as before the injury, the claimant is released by his doctor without restrictions, or the claimant reaches maximum medical impairment (MMI)

2. Impairment Income Benefits (IIBs):

These benefits are paid after temporary income benefits end because the claimant reaches maximum medical improvement and an impairment rating is given. The Act defines maximum medical improvement as "...the earlier of: (A) the earliest date after which, based on reasonable medical probability, further material recovery from or lasting improvement to an injury can no longer reasonably be anticipated; or (B) the expiration of 104 weeks from the date on which income benefits begin to accrue" (Sec. 401.011(30)). An impairment rating is given in percentages and it's supposed to reflect the claimant's whole body permanent impairment. It does not take into consideration any prior pain and suffering the claimant might have experienced.

3. Supplemental Income Benefits (SIBs):

These benefits are available only to those claimants who are given a 15% impairment rating or higher. Those claimants must submit an application on a quarterly basis so that the insurance carrier can determine if the claimant has fulfilled all the other requirements of these benefits. To qualify, the claimant must have not been released to work by any doctor even with restrictions or, if ever released with restrictions, the claimant must perform a pre-determined number of job searches every week. A claimant could also qualify for partial benefits if they return to work but, due to his or her compensable injury, are unable to make as much as they were making before they sustained their injury.