Tex. Codes » Labor Code · TITLE 5. WORKERS' COMPENSATION · SUBTITLE A. TEXAS WORKERS' COMPENSATION ACT · CHAPTER 408. WORKERS' COMPENSATION BENEFITS
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Tex. Lab. Code § 408.124 (2026)

Impairment Rating Guidelines

✓ laws through the 89th Legislature (2025)
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Sec. 408.124. IMPAIRMENT RATING GUIDELINES. (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 impairment rating guidelines described by this section.

(b) For determining the existence and degree of an employee's impairment, the division shall use "Guides to the Evaluation of Permanent Impairment," third edition, second printing, dated February 1989, published by the American Medical Association.

(c) Notwithstanding Subsection (b), the commissioner by rule may adopt the fourth edition of the "Guides to the Evaluation of Permanent Impairment," published by the American Medical Association, or a subsequent edition of those guides, for determining the existence and degree of an employee's impairment.

Acts 1993, 73rd Leg., ch. 269, Sec. 1, eff. Sept. 1, 1993. Amended by Acts 1999, 76th Leg., ch. 1426, Sec. 12, eff. Sept. 1, 1999.

Amended by:

Acts 2005, 79th Leg., Ch. 265 (H.B. 7), Sec. 3.114, eff. September 1, 2005.

Notes of Decisions
Cited in 35 cases, 1995–2019 · leading case: Texas Workers' Comp. Comm'n v. Garcia, 893 S.W.2d 504 (Tex. 1995).
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Texas Workers' Comp. Comm'n v. Garcia, 893 S.W.2d 504 (Tex. 1995). · cites it 4× “Tex.Lab. Code § 408.124. We express no opinion as to whether the Act might violate due course of law as applied to a claimant suffering from a permanent physical ailment that is not rated under the Guides.”
Rodriguez v. Serv. Lloyds Ins. Co., 997 S.W.2d 248 (Tex. 1999). · cites it 2× “See TEX. LAB. CODE §§ 408.124. The doctor expresses the rating as a percentage of permanent impairment to the whole body.”
Fireman's Fund Ins. Co. v. Weeks, 259 S.W.3d 335 (Tex. App.—El Paso 2008). · cites it 3× “See Tex. Lab. Code Ann. § 408.124 (c), as implemented pursuant to 28 Tex.”
Fulton v. Associated Indem. Corp., 46 S.W.3d 364 (Tex. App.—Austin 2001). “Section 408.124 provides that the American Medical Association's "Guides to the Evaluation of Permanent Impairment” shall be used to determine the existence and degree of an employee’s impairment.”
Am. Zurich Ins. Co. v. Samudio, 370 S.W.3d 363 (Tex. 2012). “Law 4865, 4869 (codified at Tex Lab.Code § 408.124(c)). . The Division issued Bulletin B-0033-77 providing that the advisories would no longer be used after we denied the Division's petition for review in Lumbermens.”
Pac. Employers Ins. Co. v. Brown, 86 S.W.3d 353 (Tex. App.—Texarkana 2002). “Tex. Lab. Code Ann. § 408.124 (Vernon Supp.”
Bell v. Zurich Am. Ins. Co., 311 S.W.3d 507 (Tex. App.—Dallas 2010). “See Tex. Lab.Code Ann. § 408.124(a) (Vernon 2006) (“An award of an impairment income benefit, whether by the commissioner or a court must be based on an impairment rating determined using the impairment rating guidelines described by this section.”
Texas Builders Ins. Co. v. Molder, 311 S.W.3d 513 (Tex. App.—El Paso 2009). “Foster was properly appointed as the second designated doctor and whether the IR certified by Dr. Foster is valid. To determine the impairment rating, the certifying doctor evaluates the permanent effect of the employee’s injury according to statutory guidelines.”
Ins. Co. of State of Pennsylvania v. Martinez, 18 S.W.3d 844 (Tex. App.—El Paso 2000). “Tex. Lab. Code Ann. § 408.124 (Vernon 1996) states: (a) An award of an impairment income benefit, whether by the commission or a court, shall be made on an impairment rating determined using the impairment rating guidelines described in this section, (b) The commission shall use…”
Ins. Co. of State of the Pennsylvania v. Moore, 43 S.W.3d 77 (Tex. App.—Fort Worth 2001). “See Tex.Lab.Code Ann. § 408.124 (Vernon 1996 & Supp.”
Am. Zurich Ins. Co. v. Samudio, 317 S.W.3d 336 (Tex. App.—Houston [1st Dist.] 2010). “123(a) (Vernon 2006). All impairment ratings must be assigned by doctors based on a review of medical records and a certifying physical examination performed explicitly to determine MMI and an impairment rating.”
State Off. of Risk Mgmt. v. Elaine E. Banks Joiner, 363 S.W.3d 242 (Tex. App.—Texarkana 2012). “Tex. Lab.Code Ann. § 408.124(b) (West 2006) (“the division shall use ‘Guides to the Evaluation of Permanent Impairment,’.”
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Tex. Lab. Code § 408.124(a): 2 cases
Bell v. Zurich Am. Ins. Co., 311 S.W.3d 507 (Tex. App.—Dallas 2010). “See Tex. Lab.Code Ann. § 408.124(a) (Vernon 2006) (“An award of an impairment income benefit, whether by the commissioner or a court must be based on an impairment rating determined using the impairment rating guidelines described by this section.”
Fireman's Fund Ins. Co. v. Weeks, 259 S.W.3d 335 (Tex. App.—El Paso 2008). “See Tex. Lab. Code Ann. § 408.124 (c), as implemented pursuant to 28 Tex.”
Tex. Lab. Code § 408.124(b): 4 cases
Texas Workers' Comp. Comm'n v. Garcia, 893 S.W.2d 504 (Tex. 1995). “Tex.Lab. Code § 408.124. We express no opinion as to whether the Act might violate due course of law as applied to a claimant suffering from a permanent physical ailment that is not rated under the Guides.”
Fulton v. Associated Indem. Corp., 46 S.W.3d 364 (Tex. App.—Austin 2001). “Section 408.124 provides that the American Medical Association's "Guides to the Evaluation of Permanent Impairment” shall be used to determine the existence and degree of an employee’s impairment.”
State Off. of Risk Mgmt. v. Elaine E. Banks Joiner, 363 S.W.3d 242 (Tex. App.—Texarkana 2012). “Tex. Lab.Code Ann. § 408.124(b) (West 2006) (“the division shall use ‘Guides to the Evaluation of Permanent Impairment,’.”
Am. Zurich Ins. Co. v. Daniel Samudio, No. 01-15-00478-CV (Tex. App.—Houston [1st Dist.] Dec. 18, 2015).
Tex. Lab. Code § 408.124(c): 3 cases
Am. Zurich Ins. Co. v. Samudio, 370 S.W.3d 363 (Tex. 2012). “Law 4865, 4869 (codified at Tex Lab.Code § 408.124(c)). . The Division issued Bulletin B-0033-77 providing that the advisories would no longer be used after we denied the Division's petition for review in Lumbermens.”
Am. Zurich Ins. Co. v. Daniel Samudio, No. 01-15-00478-CV (Tex. App.—Houston [1st Dist.] Dec. 18, 2015).
Rosendo Morales v. Texas Dep't of Ins.-Div. of Workers' Comp., No. 03-14-00808-CV (Tex. App.—Austin May 27, 2015).
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