To qualify for short-term disability income benefits in Texas, you must have been injured at work, be a state government employee or have private insurance with disability coverage. If you meet one of those requirements, the application process involves gathering information, filling out forms and meeting deadlines.
Texas Workers’ Comp Disability
Temporary income benefits (TIBs) are available to those who have a work-related injury or illness and are unable to work for more than seven days as a result of the injury or illness. If you can work only part-time or in a limited capacity due to your illness or injury, you may also qualify for TIBs. Individuals who qualify and made more than $10 an hour before their injury receive 70 percent of lost wages. Those who made less than $10 an hour receive 75 percent of lost wages.
TIB benefits end when you’re able to return to full-time employment or 105 weeks from the date of disability. Workers’ compensation also provides benefits for medical treatment related to your injury or illness. It’s recommended that you file a workers’ comp claim with your employer as soon as possible. You may lose benefits if you don’t file within 30 days of the injury or when your doctor informed you that your medical condition is work-related.
Start the process by informing your employer of your claim. Your employer should provide you with DWC Form-041 to send to the Texas Department of Insurance, Division of Workers’ Compensation. Read the instructions carefully as you complete this form, since mistakes can delay benefits. If you fail to meet required deadlines noted within the paperwork, such as the need for a second medical evaluation, you may lose your benefits.
Read More: Short-Term Disability Texas Law
Short-Term Disability Income for Texas State Employees
Individuals employed by the state may opt in for long- and short-term disability income as part of their benefits package. You must enroll within 30 days of your hire date or during the annual open enrollment process. Benefits are supplied under the Texas Income Protection Plan (TIPP).
TIPP benefits are available for work-related claims as well as those not related to your job. The maximum short-term disability benefit is 66 percent of your monthly salary for five months, up to $6,600 per month. You must inform your human resources department that you’re taking disability leave, but filing your disability claim is otherwise your responsibility.
To file, follow these steps:
- Visit the TIPP website and fill out the employee section of the disability claim form. Contact TIPP Customer Care at 855-604-6230 if you have questions.
- Ask your benefits coordinator or HR representative to complete the employer portion.
- File as instructed on the form and await a response from the TIPP provider, ReedGroup.
- Complete and return the forms sent to you by ReedGroup within 10 business days.
Private Short-Term Disability Coverage
Unless you’re employed by the state or injured on the job, the only option for short-term disability benefits in Texas is through private insurers. Policies are available to individuals and groups, such as the TIPP for state employees. Most policies require evidence of insurability or good health before you can enroll in a plan. Preexisting conditions may or may not be covered, or there may be a wait time before coverage begins. The amount of short-term disability benefit, the span of coverage and steps for filing a claim vary greatly between insurance companies and the different disability plans they offer. When you enroll, the insurer will provide written documentation regarding your plan's benefits as well as who to contact should you have questions.
- Nolo Disability Secrets: Texas Workers Compensation: Claims, Denials and Appeals
- Texas Department of Insurance: Temporary Income Benefits (TIBs)
- Employees Retirement System of Texas: Disability Insurance (TIPP)
- A.S.K. Benefit Solutions, Growing Family Benefits: Texas Short-Term Disability Application and Rules