Sample Workers Compensation Forms Texas
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FAQ
The employer is required to file an Employer's First Report of Injury or Illness [DWC FORM-001 Rev. 10/05] with the injured worker's insurance carrier, and the injured claimant or the claimant's representative within 8 days after the employee's absence from work or receipt of notice of occupational disease.
Workers' Compensation Claim Form (DWC-1) Form DWC-1 is used to file a workers' compensation claim with your employer.
Texas law doesn't consider alternative policies and coverage bought from unlicensed insurance companies as workers' compensation. This means you lose your legal protection against lawsuits, and an injured employee could sue you for damages resulting from a work-related injury.
On the form, you will need to only fill out the ?Employee? section, which asks for basic information: Name, date, and address. Date and location of injury. Brief description of injury. List of injured body parts. Social Security Number.
A claim can be filed by calling the Texas Department of Insurance Division of Workers' Compensation and informing them that you have been injured and that you need to file a claim. The Division will mail a packet to you with forms to complete and instructions on how to complete the required paperwork.
