Workers' comp claim denied in Texas: what to do next

Call the insurance adjuster about the problem; then call DWC customer service (800-252-7031). If you do not have an attorney, the Office of Injured Employee Counsel (OIEC) can give you a free ombudsman (866-393-6432).

Your employer's insurer, not the state, usually decides first. If they deny or delay, the free help listed here can explain your options.

Checked against official sources: October 31, 2026.

Deadlines are strict. If you are near one, call the state agency or free help today.

If your claim is denied or delayed in Texas

Who decides: Texas Department of Insurance, Division of Workers' Compensation (benefit review officers, administrative law judges and the Appeals Panel)
First step: Call the insurance adjuster about the problem; then call DWC customer service (800-252-7031). If you do not have an attorney, the Office of Injured Employee Counsel (OIEC) can give you a free ombudsman (866-393-6432). If the dispute is not worked out, ask DWC for a benefit review conference on DWC Form-045.
Form: DWC Form-045, Request to Schedule, Reschedule, or Cancel a Benefit Review Conference (BRC)
Deadline: There is no single deadline to request a benefit review conference, but your DWC Form-041 claim must be filed within 1 year of the injury. An appeal of a hearing decision must reach the Appeals Panel within 15 days (not counting weekends and holidays) after you receive the decision, and a court case must be filed within 45 days after the Appeals Panel decision is mailed.
Medical disagreements: If you disagree with the carrier about medical benefits, you can ask DWC for medical dispute resolution. Disputes about impairment ratings and maximum medical improvement can be sent to a designated doctor chosen by DWC; you must go to a scheduled designated doctor exam.
: DWC Form-053, Employee's Request to Change Treating Doctor (non-network)
Appealing the decision: DWC Appeals Panel, then judicial review in state district court.

Talk with the insurance adjuster, and with your ombudsman or attorney if you have one.
Request a benefit review conference (BRC) on DWC Form-045. Include proof of what you did to try to resolve the dispute first.
At the BRC, a DWC benefit review officer meets with you and the carrier to try to reach a written agreement.
If there is no agreement, a contested case hearing is held before a DWC administrative law judge, who issues a written decision. The parties can choose arbitration instead.
To appeal the judge's decision, file a written request with the DWC Appeals Panel within 15 days after you receive it (Saturdays, Sundays and state holidays do not count).
After the Appeals Panel, a party may ask a state court for judicial review within 45 days after the Appeals Panel decision is mailed.

Law: Tex. Lab. Code §§ 410.023, 410.024, 410.202, 410.252

Source: tdi.texas.gov

Sources

The official sources for Texas are listed on the Texas page.

National rules that may also matter

Not covered by state workers' comp?

These federal programs and laws cover some groups of workers instead of, or in addition to, state workers' compensation. If one of them may apply to you, check its rules and deadlines too. They are different from your state's.

Federal Employees' Compensation Act (FECA): Civilian employees of the federal government, including Postal Service employees. Official page

Longshore and Harbor Workers' Compensation Act (Longshore Act): Maritime workers such as longshore workers, harbor workers, ship repairers, shipbuilders and ship-breakers, hurt on navigable waters of the United States or on an adjoining pier, wharf, dry dock, terminal or other area used to load, unload, repair or build ships. Some groups are excluded. Official page
Longshore maximum and minimum for October 1, 2026 to September 30, 2027 (fiscal year 2027): maximum $2,163.92 a week, minimum $540.98 a week.

Law: 33 U.S.C. 906(b); DOL Longshore NAWW table

Defense Base Act: Civilian employees working outside the United States on U.S. military bases or under a contract with the U.S. government for public works or national defense. Claims are handled by the Longshore program. Official page

Federal Black Lung Program: Coal miners who are totally disabled by black lung disease (pneumoconiosis) from coal mine work, and survivors of miners whose deaths were caused by it. Official page

Energy Employees Occupational Illness Compensation Program: Current or former employees of the U.S. Department of Energy and its contractors and subcontractors, and certain uranium miners, millers and ore transporters, who became ill from toxic exposures such as radiation, beryllium or silica at covered work sites, and their survivors. The program is set up by the Energy Employees Occupational Illness Compensation Program Act (EEOICPA). Official page

Railroad workers (Federal Employers' Liability Act): Employees of railroads in interstate commerce. Instead of a workers' compensation claim, a federal law lets an injured railroad worker sue the railroad for damages caused by its negligence.

Seamen (Jones Act): A seaman injured in the course of employment may bring a lawsuit against the employer, with the right to a jury trial, under the same federal rules that apply to railroad workers.

National help

Your state workers' compensation agency answers questions about claims. Many have a free help line, an ombudsman or information officers for injured workers.

The Legal Services Corporation funds 129 nonprofit legal aid organizations in every state, D.C. and the territories. Enter your address on its website to find one near you. You can also look up legal information and free forms at LawHelp.org. Whether a local program handles workers' compensation cases varies.

LawHelp.org