Benefits (Compensation)

A. Four types of Benefits:

1. Income Benefits -replace a portion of wages a worker loses because of an on-the-job injury or illness.

Four types of income benefits:

 

(1) TIBs(Temporary Income Benefits) – benefits paid for up to 2 years when a work related injury causes you to lose wages for more than 7 days. TIBS are paid for up to 104 weeks of your worker's compensation claim at 70% of your Average Weekly wage, unless your hourly wage is less than $8.50. If your hourly wage is less than $8.50, TIBS are 75% of your Average Weekly Wage (AWW) for the first 26 weeks and then 70% after 26 weeks. The current maximum TIBS check is $750.00 per week, and the minimum is $112.00 per week. Your TIBs will stop after you return to work or when you receive IIBs.

 

(2) IIBs (Impairment Income Benefits) – benefits that start when you receive an impairment rating or when you reach statutory Maximum Medical Improvement (MMI). For each percentage point of impairment you are entitled to 3 weeks of workers' compensation at the IIBS weekly rate. For example, if your impairment rating is 10%, multiply 10 x 3 = 30 weeks of IIBS times your IIBS weekly rate. The maximum IIBs rate is 70% of your Average Weekly Wage.

 

(3) SIBs (Supplemental Income Benefits) – benefits you apply for quarterly and receive monthly payments. Eligible for SIBS if:

• Impairment rating is 15% or more (by adding together whole body impairment and psychological impairment)

• Not returned to work or returned to work and are earning less than 80% of AWW because of impairment

• Complied with Texas Department of Insurance work search requirements

• Did not take your IIBs in a lump sum payment

(4) LIBs (Lifetime Income Benefits) – benefits that equal 75% of AWW, with a 3% increase each year. May be entitled to income benefits for your lifetime if:     

• Loss of eyesight

• Loss of feet above ankle

• Loss of hands above wrist

• Paralysis

• Brain injury leading to insanity or imbecility

• Third degree burns covering 40% of body or on face or hands

2. Medical Benefits–benefits that pay for any medical care that is reasonable and necessary to treat a work related injury or illness. They are paid directly to health care provider.

 

3. DeathBenefits–benefits that replace a portion of the income of family members of workers killed on the job.May be eligible for payments up to $6,000.00.

 

4. BurialBenefits– benefits that pay some of the deceased worker’s funeral expenses.Eligible a day after death of employee.

 

V. Process of Filing a Workers Comp Claim

We recommend that you contact IIHC to guide you through the claims process. Below is some information that employees should be aware of during this process:

• A Worker’s Compensation Claim Form (DWC-041) & Notice of Potential Eligibility must be filed as soon as possible after the injury. Benefits cannot begin until the claims administrator is aware of the injury.

• The employer claims administrator will pay all reasonable and necessary medical care fees arising from your work injury or illness directly to the doctor or hospital so the injured employee will likely never see a bill.

• After you file a worker’s comp claim, all medical records detailing the injury or condition must be released to the employer.

• If the employee can’t work while he is recovering he will receive temporary disability payments amounting to two thirds of the average weekly pay.

• If the injury or illness caused by the work environment results in a death, benefits would then be paid to family members dependent on the deceased worker.

• You have a right to consult with an attorney concerning a work related injury or illness and the fee can be taken out of the benefits received by the worker.

 

Related Topics:

• Texas Employee Rights

• Texas Laws

• Benefits (Compensation)

• If Employer Denies your Claim

• Why Contact IIHC

• FAQs