The 90-Day Rule in Texas Workers' Comp

Understanding the 90-Day Rule

The 90-day rule in Texas workers' compensation refers to a critical deadline that affects injured workers' rights to medical care and benefits. Under Texas Labor Code Section 408.021, if an injured employee doesn't report their workplace injury within 90 days of the accident or within 90 days of when they knew or should have reasonably known the injury was work-related, they may lose their right to workers' compensation benefits entirely.

This rule is strictly enforced and serves as a statute of limitations for workers' compensation claims in Texas. Unlike some other states with more lenient reporting requirements, Texas maintains this firm 90-day deadline to prevent fraudulent claims and ensure timely reporting of workplace injuries.

When the 90 Day Clock Starts

The 90-day period begins either on the date of the injury for acute injuries like falls, cuts, or accidents or on the date the employee knew or should have known the injury was work-related for occupational diseases or repetitive stress injuries. For example, if a worker develops carpal tunnel syndrome gradually, the 90 days would start when they reasonably understood the condition resulted from their job duties.

For occupational diseases or cumulative trauma injuries, determining the start date can be complex and often requires medical documentation establishing when the connection between work and the condition became apparent.

Exceptions and Extensions

Very limited exceptions exist to the 90-day rule. The deadline may be extended if the employer had actual knowledge of the injury despite lack of formal reporting, or if the employee can prove they were prevented from reporting due to physical or mental incapacity directly caused by the workplace injury.

Additionally, if an employer fails to provide proper notice about workers' compensation coverage or fails to post required workers' compensation information, this might affect the application of the 90-day rule, though such exceptions are rare and difficult to prove.

Consequences of Missing the Deadline

Failing to report within 90 days typically results in complete forfeiture of workers' compensation benefits, including medical care, wage replacement, and disability benefits. This harsh consequence makes the 90-day Rule one of the most critical deadlines in Texas workers' compensation law.

Even if an injury is clearly work-related and well-documented, missing this deadline usually bars any claim for benefits, regardless of the injury's severity or the employee's good faith.

Best Practices for Compliance

Report all workplace injuries immediately, even minor ones that seem insignificant. Many injuries worsen over time, and what appears minor initially may require extensive treatment later. Document everything in writing and keep copies of all reports and communications with supervisors.

Seek medical attention promptly and inform healthcare providers that the injury is work-related. Early documentation from medical professionals can be crucial if questions arise about the timing or work-relatedness of the injury.