How to File a Workers' Comp Claim in Texas

Texas is the only state where private employers can legally choose not to carry workers' comp insurance ("non-subscribers"). Before you file, you need to know your employer's status:

• - Subscribers (have coverage): Follow the standard workers' comp process below.
• - Non-subscribers (no coverage): You cannot file a workers' comp claim. Instead, you may have the right to sue your employer directly for negligence — which can actually result in higher compensation since non-subscribers lose several legal defenses.

How to check: Ask your employer directly, check for posted workplace notices, or search the Texas Department of Insurance website.

Report your work injury to your employer within 30 days of the injury date. Put it in writing and keep a copy.

Your employer must file a report with their insurance company and TDI-DWC within 8 days of learning about your injury.

What if your employer doesn't report it? You can file directly with TDI-DWC using form DWC-041.

Form DWC-041 ("Employee's Claim for Compensation for a Work-Related Injury or Occupational Disease") is your formal claim. You must file it with TDI-DWC within 1 year of the injury date.

The form asks for: - Your personal information - Employer information - Date, time, and description of injury - Body parts affected - Medical treatment received

File by mail, fax, or in person at a TDI-DWC field office. Keep proof of filing.

In Texas, your employer's insurance company selects the initial treating doctor from an approved doctor list (ADL) or a health care network.

• - You can choose from the list of approved doctors.
• - If you want to change doctors, you need to request a change through the insurer or TDI-DWC.
• - In an emergency, go to the nearest ER.

Required Medical Exams (RME): The insurer may require you to see a doctor of their choice. You must attend, or your benefits may be suspended.

Temporary Income Benefits (TIBs): If you can't work for more than 7 days, you receive about 70% of your average weekly wage (up to a state maximum). The first payment is due within 15 days.

Impairment Income Benefits (IIBs): If you have a permanent impairment rating after reaching Maximum Medical Improvement (MMI), you receive additional payments based on the rating.

Supplemental Income Benefits (SIBs): Additional payments if your impairment rating is 15% or higher and you meet certain requirements.

Lifetime Income Benefits: For the most serious injuries (loss of both hands, both feet, both eyes, or certain brain/spinal cord injuries).

If the insurer denies your claim, you can:

1. Request a Benefit Review Conference (BRC) — An informal meeting with a TDI-DWC mediator to resolve disputes.
2. Request a Contested Case Hearing (CCH) — A formal hearing before a hearing officer if the BRC doesn't resolve it.
3. Appeal to the Appeals Panel — If you disagree with the CCH decision.
4. File in court — Final appeal option.

You must act within 90 days of the denial to preserve your rights.

Common mistakes: - Not checking if your employer is a subscriber or non-subscriber - Missing the 30-day employer notice deadline - Missing the 1-year claim filing deadline - Not attending a Required Medical Exam

When to get a lawyer: - Your employer is a non-subscriber (you may need to file a lawsuit instead) - Your claim is denied - You have a serious permanent injury - You're being pressured to settle

Texas workers' comp attorneys typically charge 25% of your recovery.