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Texas Labor Code - Chapter 408 Workers' Compensation BenefitsLegal Research Home > Texas Lawyer > Labor Code > Texas Labor Code - Chapter 408 Workers' Compensation Benefits Sponsored Links(a) Recovery of workers' compensation benefits is the exclusive remedy of an employee covered by workers' compensation insurance coverage or a legal beneficiary against the ... A right of action survives in a case based on a compensable injury that results in the employee's death. Acts 1993, 73rd Leg., ch. 269, ... (a) After an injury, an employer may: (1) initiate benefit payments, including medical benefits; or (2) on the written request or agreement of the employee, ... (a) The commissioner may require an employee to submit to medical examinations to resolve any question about the appropriateness of the health care received by ... (a) At the request of an insurance carrier or an employee, or on the commissioner's own order, the commissioner may order a medical examination to ... (a) The division shall require an injured employee to submit to a single medical examination to define the compensable injury on request by the insurance ... (a) A settlement may not provide for payment of benefits in a lump sum except as provided by Section 408.128. (b) An employee's right to ... (a) It is the express intent of the legislature that nothing in this subtitle shall be construed to limit or expand recovery in cases of ... For purposes of this subtitle, the date of injury for an occupational disease is the date on which the employee knew or should have known ... A heart attack is a compensable injury under this subtitle only if: (1) the attack can be identified as: (A) occurring at a definite time ... (a) An employee who sustains a compensable injury is entitled to all health care reasonably required by the nature of the injury as and when ... (a) Except in an emergency, the division shall require an employee to receive medical treatment from a doctor chosen from a list of doctors approved ... (a) The division shall develop a list of doctors licensed in this state who are approved to provide health care services under this subtitle. A ... (a) The commissioner shall delete from the list of approved doctors a doctor: (1) who fails to register with the division as provided by this ... Except as otherwise provided, and after notice and an opportunity for hearing, the commissioner may relieve an insurance carrier of liability for health care that ... (a) The commissioner by rule shall adopt requirements for reports and records that are required to be filed with the division or provided to the ... (a) The commissioner, by rule and in cooperation with the commissioner of insurance, shall adopt rules regarding the electronic submission and processing of medical bills ... The commissioner by rule may identify areas of this state in which access to health care providers is less available and may adopt appropriate standards, ... Except in a medical emergency, an insurance carrier is liable for medical costs related to spinal surgery only as provided by Section 413.014 and commissioner ... (a) A health care provider shall submit a claim for payment to the insurance carrier not later than the 95th day after the date on ... (a) If the health care services provided to an injured employee are determined by the insurance carrier to be inappropriate, the insurance carrier shall: (1) ... (a) A physician providing care to an employee under this subchapter shall prescribe for the employee any necessary prescription drugs, and order over-the-counter alternatives to ... An insurance carrier may not refuse to reimburse a health care practitioner solely because that practitioner is a nurse first assistant, as defined by Section ... If the division discovers an act or omission by a physician that may constitute a felony, a misdemeanor involving moral turpitude, a violation of a ... (a) Notwithstanding any other provision of this chapter, an injured employee may receive benefits under a workers' compensation health care network established under Chapter 1305, ... The division shall study the issue of required accreditation of interdisciplinary pain rehabilitation programs or interdisciplinary pain rehabilitation treatment facilities that provide services to injured ... (a) Except as otherwise provided by this subtitle, the average weekly wage of an employee who has worked for the employer for at least the ... (a) The average weekly wage of a part-time employee who limits the employee's work to less than a full-time workweek as a regular course of ... (a) For determining the amount of temporary income benefits of a seasonal employee, the average weekly wage of the employee is computed as provided by ... (a) For computing impairment income benefits, supplemental income benefits, lifetime income benefits, or death benefits, the average weekly wage of an employee shall be adjusted ... (a) For purposes of computing income benefits or death benefits under Section 431.104, Government Code, the average weekly wage of a member of the state ... (a) For determining the amount of temporary income benefits of a school district employee under Chapter 504, the average weekly wage is computed on the ... The division may not include nonpecuniary wages in computing an employee's average weekly wage during a period in which the employer continues to provide the ... For purposes of this subchapter and Subchapter D, the determination as to whether employees, services, or employment are the same or similar must include consideration ... (a) On and after October 1, 2006, the state average weekly wage is equal to 88 percent of the average weekly wage in covered employment ... (a) A weekly temporary income benefit may not exceed 100 percent of the state average weekly wage under Section 408.047 rounded to the nearest whole ... (a) The minimum weekly income benefit is 15 percent of the state average weekly wage as determined under Section 408.047, rounded to the nearest whole ... (a) To expedite the payment of income benefits, the commissioner may by rule establish reasonable presumptions relating to the wages earned by an employee, including ... (a) An order to pay income or death benefits accrued but unpaid must include interest on the amount of compensation due at the rate provided ... (a) An employee is entitled to income benefits as provided in this chapter. (b) Except as otherwise provided by this section or this subtitle, income ... (a) Income benefits may not be paid under this subtitle for an injury that does not result in disability for at least one week. (b) ... (a) Except as provided by Subsection (b), an employee's eligibility for temporary income benefits, impairment income benefits, and supplemental income benefits terminates on the expiration ... (a) At the request of the insurance carrier, the commissioner may order that impairment income benefits and supplemental income benefits be reduced in a proportion ... (a) If there is a likelihood that income benefits will be paid, the commissioner may grant an employee suffering financial hardship advances as provided by ... (a) During the period that impairment income benefits or supplemental income benefits are being paid to an employee, the commissioner shall determine at least annually ... (a) An employee is entitled to temporary income benefits if the employee has a disability and has not attained maximum medical improvement. (b) On the ... (a) Temporary income benefits continue until the employee reaches maximum medical improvement. (b) The commissioner by rule shall establish a presumption that maximum medical improvement ... (a) Subject to Sections 408.061 and 408.062, the amount of a temporary income benefit is equal to: (1) 70 percent of the amount computed by ... (a) On application by either the employee or the insurance carrier, the commissioner by order may extend the 104-week period described by Section 401.011(30)(B) if ... (a) In lieu of payment of temporary income benefits under this subchapter, an employer may continue to pay the salary of an employee who sustains ... (a) An employee's entitlement to impairment income benefits begins on the day after the date the employee reaches maximum medical improvement and ends on the ... A claimant may not recover impairment income benefits unless evidence of impairment based on an objective clinical or laboratory finding exists. If the finding of ... (a) To be eligible to serve as a designated doctor, a doctor must meet specific qualifications, including training in the determination of impairment ratings and ... (a) After an employee has been certified by a doctor as having reached maximum medical improvement, the certifying doctor shall evaluate the condition of the ... (a) An award of an impairment income benefit, whether by the commissioner or a court, must be based on an impairment rating determined using the ... (a) If an impairment rating is disputed, the commissioner shall direct the employee to the next available doctor on the division's list of designated doctors, ... Subject to Sections 408.061 and 408.062, an impairment income benefit is equal to 70 percent of the employee's average weekly wage. Acts 1993, 73rd Leg., ... (a) An insurance carrier shall reduce impairment income benefits to an employee by an amount equal to employer payments made under Section 408.003 that are ... (a) An employee may elect to commute the remainder of the impairment income benefits to which the employee is entitled if the employee has returned ... (a) On approval by the commissioner of a written request received from an employee, an insurance carrier shall accelerate the payment of impairment income benefits ... An award of a supplemental income benefit, whether by the commissioner or a court, shall be made in accordance with this subchapter. Acts 1993, 73rd ... (a) The commissioner by rule shall adopt compliance standards for supplemental income benefit recipients that require each recipient to demonstrate an active effort to obtain ... (a) An employee is entitled to supplemental income benefits if on the expiration of the impairment income benefit period computed under Section 408.121(a)(1) the employee: ... (a) After the commissioner's initial determination of supplemental income benefits, the employee must file a statement with the insurance carrier stating: (1) that the employee ... (a) Supplemental income benefits are calculated quarterly and paid monthly. (b) Subject to Section 408.061, the amount of a supplemental income benefit for a week ... An insurance carrier shall pay supplemental income benefits beginning not later than the seventh day after the expiration date of the employee's impairment income benefit ... (a) If an employee earns wages that are at least 80 percent of the employee's average weekly wage for at least 90 days during a ... (a) An insurance carrier may request a benefit review conference to contest an employee's entitlement to supplemental income benefits or the amount of supplemental income ... The commissioner may reinstate supplemental income benefits to an employee who is discharged within 12 months of the date of losing entitlement to supplemental income ... (a) Not more than once in each period of 12 calendar months, an employee and an insurance carrier each may request the commissioner to review ... (a) The division shall refer an employee to the Department of Assistive and Rehabilitative Services with a recommendation for appropriate services if the division determines ... (a) On or after the second anniversary of the date the commissioner makes the initial award of supplemental income benefits, an insurance carrier may not ... (a) Lifetime income benefits are paid until the death of the employee for: (1) total and permanent loss of sight in both eyes; (2) loss ... (a) If a subsequent compensable injury, with the effects of a previous injury, results in a condition for which the injured employee is entitled to ... (a) An insurance carrier shall pay death benefits to the legal beneficiary if a compensable injury to the employee results in death. (b) Subject to ... (a) If there is an eligible child or grandchild and an eligible spouse, half of the death benefits shall be paid to the eligible spouse ... (a) Entitlement to death benefits begins on the day after the date of an employee's death. (b) An eligible spouse is entitled to receive death ... (a) If a legal beneficiary dies or otherwise becomes ineligible for death benefits, benefits shall be redistributed to the remaining legal beneficiaries as provided by ... On settlement of a case in which the insurance carrier admits liability for death benefits but a dispute exists as to the proper beneficiary or ... (a) If the death of an employee results from a compensable injury, the insurance carrier shall pay to the person who incurred liability for the ... (a) If in a claim for death benefits based on an occupational disease an autopsy is necessary to determine the cause of death, the commission ... Benefits are exempt from: (1) garnishment; (2) attachment; (3) judgment; and (4) other actions or claims. Acts 1993, 73rd Leg., ch. 269, § 1, eff. ... Benefits are not assignable, except a legal beneficiary may, with the commissioner's approval, assign the right to death benefits. Acts 1993, 73rd Leg., ch. 269, ... (a) An income or death benefit is subject only to the following lien or claim, to the extent the benefit is unpaid on the date ... (a) An attorney's fee, including a contingency fee, for representing a claimant before the division or court under this subtitle must be approved by the ... (a) The amount of an attorney's fee for defending an insurance carrier in a workers' compensation action brought under this subtitle must be approved by ... Last modified: August 11, 2007 |