Texas Workers Compensation Temporary Income Benefits Guide


Temporary Income Benefits (TIBs) are governed by Tex. Labor Code §§408.101 – 408.105 and Tex. Admin. Code §§129.1 – 129.11.  

If you do not lose any time from work because you are able to continue working at full duty or regular duty, your injury is generally considered to be a no lost time injury and you do not receive temporary income benefits for disability.  You will still be eligible for impairment income benefits based upon any impairment you receive from the injury.  

You may also have a delayed entitlement to temporary income benefits if you initially are able to work but then are taken off work or placed at light duty by your doctor, such as when your doctor decides you will need surgery for your injury.  

Even if you keep working, you may still have disability even though you are working.  If your doctor releases you to light duty or modified duty, you are entitled to the difference between what you were making before the injury and what you are able to make after the injury.  Your earnings before the injury are calculated as your average weekly wage (AWW).  Your earnings after the injury are calculated as your post injury earnings (PIE).   

You may be paid temporary income benefits (TIBs) if your work-related injury or illness causes you to lose all or some of your wages for more than seven (7) days.   The seven days do not have to follow each other in a row.  The seven days of lost time can be scattered, here and there, until they equal seven days.   

The first day that you actually lose from working full duty (because you are at light duty or can not work at all) is considered the first date of disability.  After the seven day period, the eighth day of disability triggers the beginning of payment of your temporary income benefits and also triggers the start date for counting 104 weeks until you are considered to be at maximum medical improvement under the law, called statutory maximum medical improvement, regardless of your actual physical condition, once the date of statutory maximum medical improvement occurs. The date of statutory maximum medical improvement may be extended if you require spinal surgery on a case by case basis.  If the date of statutory maximum medical improvement is not extended, you will  not receive additional temporary income benefits once you are at statutory maximum medical improvement. 

You may also be certified as being at maximum medical improvement by a doctor prior to the statutory maximum medical improvement date. This certification has a ninety day dispute period.  If you fail to properly dispute your certification of maximum medical improvement within the ninety day period, the certification will become final.  There are limited exceptions to this finality based upon the circumstances of your case.  There are also technical rules regarding when the ninety day period expires that are applied on a case by case basis.

 If you work more than one job, you may be paid temporary income benefits (TIBs) if you lose all or some of your wages from other employers. If you were working at more than one job when you were injured, you should let your lawyer know.  Your weekly income benefits may be increased because of your additional pre-injury earnings.

Amount of Temporary Income Benefits

If you earned $8.50 per hour or more before you were injured, your temporary income benefits are paid at 70 percent of the difference between your average weekly wage and the wages you are able to earn after your work-related injury. 

If you earned less than $8.50 per hour before you were injured, your temporary income benefits for the first 26 weeks of payments will equal 75 percent of the difference between your average weekly wage and the wages you are able to earn after your work-related injury. The amount of temporary income benefits is subject to maximum and minimum benefit amounts.  After the first 26 weeks, your payment reverts to 70% of your average weekly wage.  

For example, if your average weekly wage was $200, and your injury or illness caused you to lose all of your income, your TIBs would be $150 a week at 75% and $140 a week at 70%:

 Your average weekly wage$200
 Minus your wages after the injury         $0
 Lost wages $200
 75 percent of $200 (1st 26 weeks) $150
 70 percent of $200 (after 26 weeks) $140

After an injury, your doctor may release you to return to work at modified duty; i.e., changes made to your regular job, or a temporary or alternate work assignment. You may still be entitled to TIBs if your employer provides the modified duty at reduced wages. For example, if your average weekly wage prior to the workrelated injury was $200, and you returned to work doing a modified job after the work-related injury and you are now earning $100 per week, your temporary income benefits would be $70 a week.


 Your average weekly wage $200
 Minus your wages after the injury         $100
 Lost wages $100
 70 percent of $100 $70

By returning to work, you are able to receive a total of $170 per week. This includes the wages you are able to earn ($100) plus the TIBs ($70) paid to you by the insurance carrier for lost wages.

When TIBs Begin and End

You become eligible for TIBs after you miss eight (8) days from work. Remember, disability refers to your inability to earn an income, not to a physical handicap. You have disability if your work-related injury or illness causes you to lose all or some of your usual pay. The first that you lose wages  is a waiting week.  Benefits are paid for this first week of lost wages only if your disability lasts for two (2) weeks (14 days) or more. You should receive the second week of temporary income benefits as your first payment.  You should receive the check for the first week of temporary income benefits at about the same time that you are paid for the third week of temporary income benefits.  If you do not receive all of these checks, you should contact your attorney and let them know that you have not received these checks.  

Temporary Income Benefits (TIBs) end at the earlier of:
• the date you reach maximum medical improvement (the point that your work-related injury or illness has improved as much as it is going to improve);
• the date you are again physically able to earn your average weekly wage which would be the same wages you were earning prior to being injured; or
• at the end of 104 weeks.

Definitions
Average Weekly Wage (AWW) is the average amount of weekly wages you earned during the 13 weeks immediately before your work-related injury or illness occurred. Income and death benefit payments are based on your average weekly wage.  There are many factors included in your average weekly wage other than your straight hourly pay and the calculation of your average weekly wage will depend upon the circumstances of your case.  You should discuss this with your attorney.
Disability occurs when a work-related injury or illness causes you to lose the ability to earn your average weekly wage.
Disability refers to your ability to earn an income, not to a physical handicap.
Maximum Medical Improvement (MMI) is the earlier of:
• the point in time when your work-related injury or illness has improved as much as it is going to  improve or
• 104 weeks from the date you became eligible to receive income benefits.
Maximum Weekly Income Benefit may not exceed 100 percent of the state average weekly wage rounded to the nearest whole dollar. The TDI-DWC will compute the maximum weekly income benefit for October 1 through September 30 of each year no later than October 1st of each year.
Minimum Weekly Income Benefit is 15 percent of the state average weekly wage rounded to the nearest whole dollar. The TDI-DWC will compute the minimum weekly income benefit for October 1 through September 30 of each year no later than October 1st of each year.

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