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Top Questions and Answers
Send a completed claim form (DWC Form-041) to the Texas Department of Insurance, Division of Workers' Compensation (TDI-DWC) within one (1) year of the date of injury or date you learned of an illness related to your occupation The form and instructions are at Workers' Compensation Employee Forms, or call TDI-DWC at ...
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Mar 30, 2023 — This is a complete listing of all Division of Workers' Compensation Forms. The forms are also available in individual listings. Alternate forms must use DWC specifications and be approved for use by DWC. To request approval, email a copy of the alternate form to DWC at webstaff@tdi.texas ... Employer Forms ; DWC-7, Employer's Report of Noncovered Employee's Work-Related Injury or Illness, PDF. Claims Forms · Employer's First Report of Injury or Illness (DWC-1) · Employer's Wage Statement (DWC-3) · Supplemental Report of Injury (DWC-6) · Employer's Report ... Workers' Compensation Forms · First Report of Injury or Illness. Must be submitted online through the Origami Portal (link above) · Witness Statement. This form ... Type (or print in black ink) each item on this form. Failure to complete each item may delay the processing of the injury claim. Article 8308 - 5.05, Texas ... WCI Forms. DWC 1 - Employer's First Notice of Injury Form · DWC 6 - Employer's Supplemental Report of Injury · DWC 3 - Employer's Wage Statement. Get the latest workers' compensation insurance forms for Texas. Access common workers' comp forms Texas, applications, guides and helpful manuals for TX. Submit forms online through the Employees' Compensation Operations and Management Portal (ECOMP). ... Simply click on the appropriate form, fill out the form ... Please ensure your injured workers receive this form to get prescriptions filled. Notice to Employees Concerning Workers' Compensation in Texas (Notice 6).
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