Texas injury to a child, elderly, or disabled individual defense

Charged or under CPS investigation in Collin, Dallas, Denton, or Tarrant County? Penal Code § 22.04 grades by mental state and result — and the medical evidence is where these cases are won or lost.

Injury to a child, elderly individual, or disabled individual is a Texas felony under Penal Code § 22.04. The grade turns on two things: the defendant’s culpable mental state (intentional or knowing, reckless, or criminally negligent) and the result (serious bodily injury, serious mental impairment, or ordinary bodily injury). It can be committed by an act or, where a duty to act exists, by omission. Intentionally or knowingly causing serious bodily injury is a first-degree felony; the ladder steps down to a state-jail felony for criminal negligence. Below: what the State must prove, the full grading ladder, the defenses we evaluate first, and what to do if you have been charged or contacted by CPS in Collin, Dallas, Denton, or Tarrant County.

Peer Recognition

Martindale-Hubbell® 2026 Honors

Independent peer-review ratings recognizing legal ability and ethical standards.

Awards reflect peer-reviewed ratings only. Past results do not guarantee future outcomes.

What does the State have to prove under § 22.04?

Injury to a child, elderly individual, or disabled individual is one of the most serious non-homicide offenses in the Texas Penal Code, and it is also one of the most frequently over-charged. The statute reaches a wide band of conduct — from a deliberate act of violence to a caregiver’s failure to get a sick child to a doctor — and the exact grade can swing across four felony levels based on a single jury finding about the defendant’s state of mind. That breadth is why an early, evidence-driven defense matters so much. We have seen the same set of facts support a first-degree-felony indictment in one case and a dismissal in another, depending on what the medical records actually show and what the State can prove about intent.

Under Section 22.04(a), a person commits the offense if he intentionally, knowingly, recklessly, or with criminal negligence, by act — or intentionally, knowingly, or recklessly by omission — causes to a child, elderly individual, or disabled individual: (1) serious bodily injury; (2) serious mental deficiency, impairment, or injury; or (3) bodily injury. Three features of that text drive almost every defense decision: the offense is keyed to a result, it recognizes four different mental states, and it can be committed by doing nothing at all when the law imposes a duty to act.

Texas appellate courts have repeatedly held that injury to a child is a result-oriented offense — one “requiring a mental state that relates not to the specific conduct but to the result of that conduct.” Turner v. State, No. 03-12-00285-CR (Tex. App.—Austin June 17, 2014, no pet.) (mem. op.). The Court of Criminal Appeals has said the same, describing § 22.04 offenses as “result-oriented” and “requir[ing] a mental state that relates not to the specific conduct, but to the result of that conduct.” Cyr v. State, No. PD-0257-21 (Tex. Crim. App. Dec. 21, 2022) (quoting Williams v. State, 235 S.W.3d 742, 750 (Tex. Crim. App. 2007)). In plain terms: the State does not get to a first-degree felony just by proving a risky act. It has to prove the defendant’s mind was directed at the injury. That distinction is the spine of many of our defenses.

Elements the State must prove

To convict, the prosecution must prove every element beyond a reasonable doubt. We test each one against the actual record:

A protected complainant

The complainant must be a child (14 years of age or younger), an elderly individual (65 or older), or a disabled individual (older than 14 who is substantially unable to protect themselves or to provide their own food, shelter, or medical care because of age or a physical or mental condition). Status is an element — not a formality.

A culpable mental state directed at the result

Intentional or knowing, reckless, or criminally negligent — as to the result. A person acts intentionally as to a result when it is their conscious objective to cause it, and knowingly when they are aware their conduct is reasonably certain to cause it. Turner v. State, supra (citing Tex. Penal Code § 6.03).

Causation

The defendant’s act or omission must have caused the result. Under Penal Code § 6.04, a person is criminally responsible only if the result would not have occurred but for their conduct, and a concurrent cause that was clearly sufficient on its own — with the defendant’s conduct clearly insufficient — breaks the chain.

A qualifying result

Serious bodily injury, serious mental deficiency or impairment, or bodily injury. “Serious bodily injury” means injury creating a substantial risk of death, or causing death, serious permanent disfigurement, or protracted loss or impairment of a bodily member or organ (§ 1.07(a)(46)). Which tier applies often decides the felony grade.

For omission cases: a duty to act

An omission is an offense only if the defendant had a legal or statutory duty to act, or had assumed care, custody, or control of the complainant (§ 22.04(b)). Without a duty, an omission cannot support the charge at all.

What are the penalties? The § 22.04 grading ladder

There is no single “injury to a child” punishment. The grade is built from the combination of mental state and result, and the difference between two adjacent boxes can be the difference between probation eligibility and a decades-long sentence. The table below sets out the core ladder under § 22.04(e)–(g).

Grades reflect Tex. Penal Code § 22.04(e), (f), and (g). A reckless act causing ordinary bodily injury is generally prosecuted under the assault statutes rather than § 22.04. Punishment can be enhanced by prior felony convictions under the Penal Code’s habitual-offender provisions, and a deadly-weapon finding affects parole eligibility on a prison sentence. None of these figures is a prediction about any particular case — they are the statutory maximums and minimums.

Defenses we evaluate first

No two of these cases are alike, but the analysis follows a disciplined order. We do not lead with a theory and look for facts to fit it; we read the medical and forensic record first and let it tell us which of the following has traction.

Accident and the absence of a culpable mental state

Because § 22.04 is result-oriented, an injury that was genuinely accidental — a fall, a household mishap, a documented seizure — is not a crime no matter how serious it looks. The State must prove the defendant intended, knew of, or consciously disregarded the risk of that injury. Texas courts allow intent to be inferred from the extent of the injuries, the method that produced them, and the relative size and strength of the parties (Turner v. State, supra), which cuts both ways: where the mechanism is consistent with an accident, that inference weakens.

An alternative medical or scientific explanation

Many of these prosecutions rest on a medical opinion that an injury was “non-accidental.” That opinion is not sacrosanct. Conditions that mimic abuse — metabolic and bone-fragility disorders, bleeding and clotting disorders, birth trauma, prior accidental injury, and normal anatomic variants — are real, and they are sometimes missed in the initial work-up. We retain independent pediatric, radiology, and biomechanics experts to test whether the State’s “only explanation is abuse” theory actually holds up against the full chart.

No duty to act in an omission case

If the State proceeds on an omission theory, it must first prove a duty. An omission is punished “only when there is a corresponding duty to act,” and the Penal Code permits omission liability only where a law imposes the duty. Cyr v. State, supra (quoting Billingslea v. State, 780 S.W.2d 271, 274 (Tex. Crim. App. 1989)). Parents have statutory duties to provide medical care and protection (Tex. Fam. Code § 151.001), but a babysitter, relative, or partner who never assumed care, custody, or control may have no duty at all — defeating the omission charge against that person.

Causation — including alternative and concurrent cause

Causation is frequently the weakest link. In an omission-for-medical-care case, the State must prove that the failure caused a separate injury — even a worsening of an existing condition — not merely that care was delayed. Cyr v. State, supra. And the Court of Criminal Appeals distinguishes concurrent causation (someone else also contributed) from alternative causation, which “is simply a different version of the facts, one which negates at least one element of the State’s case,” such as the mental state. Cyr v. State, supra. Where another caregiver, a pre-existing condition, or an intervening event is the real cause, that is a complete defense, not a mitigating factor.

The mental-state gap

Even when an injury occurred and the defendant was responsible for the child, the indicted grade often overreaches. A reckless or criminally negligent act is not a first-degree felony. Pinning the State to proof of intent or knowledge — and showing the evidence supports, at most, a lower mental state — can move a case down the ladder by several felony levels and open the door to probation eligibility.

Common charging and prosecution errors

Patterns recur in how these cases are built, and several of them are exploitable:

• Charging the top grade by default. An indictment alleging intentional or knowing serious bodily injury is easy to return and hard to prove. The State’s own medical timeline often supports only recklessness or negligence.
• Treating “non-accidental” as conclusive. A diagnosis of inflicted injury is an opinion, not a verdict, and it is only as good as the differential that preceded it. Incomplete work-ups get challenged.
• Skipping the duty analysis in omission cases. Prosecutors sometimes charge a non-parent by omission without establishing the legal duty the statute requires.
• Confusing bodily injury with serious bodily injury. The two tiers carry different felony grades, and the line is a factual question the defense can contest.
• Leaning on un-Mirandized or CPS-derived statements. Statements made to a forensic interviewer or caseworker, or during a custodial interrogation, may be suppressible.

An example, clearly hypothetical: a toddler is brought to a Collin County emergency room with a spiral fracture, and a parent is indicted for intentional serious bodily injury. The defense retains a pediatric radiologist who dates the fracture to a documented daycare fall a week earlier and identifies a metabolic finding on the films. The mental-state and causation theories collapse together. We offer that only to show how the analysis works — not as a promise about any result.

Injury vs. abandoning or endangering a child (§ 22.041)

Section 22.04 is about causing harm. A neighboring statute, Penal Code § 22.041 (abandoning or endangering a child), is about risk. A person can violate § 22.041 by abandoning a child younger than 15, or by engaging in conduct (by act or omission) that places the child in imminent danger of death, bodily injury, or physical or mental impairment — even if no injury ever occurs. Endangering a child is generally a state-jail felony; abandonment grades up with the surrounding circumstances and the actor’s intent to return. Because the two statutes overlap at the edges, prosecutors sometimes charge both, and part of the defense is forcing the State to fit the facts to the right statute rather than the most serious available one.

What to do if you are charged or contacted by CPS

These cases almost always run on two tracks at once — a criminal investigation and a Department of Family and Protective Services (CPS) case — and the two are deeply connected. What you say on the civil side can decide the criminal case.

1. Do not give a statement without a lawyer. That includes police, detectives, and CPS caseworkers. “Just explaining what happened” is how most of these cases are made.
2. Do not post about it. Nothing on social media, no texts speculating about cause. Assume everything is discoverable.
3. Preserve the medical record. Write down every provider, urgent-care visit, prior injury, and diagnosis. The defense usually lives in those documents.
4. Identify witnesses early. Daycare staff, relatives, and prior caregivers can establish alternative causes — but memories fade fast.
5. Call counsel before the grand jury meets. Early defense work on the medical evidence, and in some cases a grand-jury packet, can change whether and how a case is indicted.

DFW county notes

We defend these cases throughout North Texas from our Frisco office. The substantive law is identical statewide, but the practical realities differ by county.

• Collin County. Felony cases are handled in the district courts at the Collin County Courthouse in McKinney, with the Collin County District Attorney’s Office prosecuting. Children’s Advocacy Center forensic interviews are common, and the records they generate matter on both tracks.
• Dallas County. Felony matters are heard at the Frank Crowley Courts Building in Dallas. The Dallas County District Attorney’s Office staffs a dedicated family-violence and crimes-against-children function; cases often involve Children’s Medical Center evaluations.
• Denton County. Cases proceed through the district courts at the Denton County Courts Building in Denton, prosecuted by the Denton County Criminal District Attorney.
• Tarrant County. Felony cases are heard at the Tim Curry Criminal Justice Center in Fort Worth, with the Tarrant County Criminal District Attorney’s Office prosecuting, frequently alongside Cook Children’s medical evaluations.

We do not maintain branch offices in any of these cities; we appear in their courts and serve clients across the surrounding counties from Frisco. We make no representations about how any specific judge, prosecutor, or office will handle a given case.

Cost, process, and timeline

A felony injury-to-a-child case follows the standard Texas felony path, with a few wrinkles unique to these matters. After arrest comes magistration and a bond determination; conditions in these cases often include no-contact and no-unsupervised-contact orders involving the complainant and, sometimes, the defendant’s own children. The case is presented to a grand jury, which returns an indictment (or a no-bill). Then come pretrial settings, discovery, expert work, and either a negotiated resolution or trial.

The expert-driven nature of the defense is what most distinguishes the cost and timeline. Independent medical review takes time and resources, and it is frequently the single most important investment in the case. Fees depend on the grade charged, the volume of medical records, the number of experts, and whether the matter resolves pretrial or goes to trial. We discuss fee structure directly and in writing at the consultation. We do not quote a price sight-unseen and do not promise outcomes — what we offer is a clear plan for testing the State’s evidence.