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How to fill out the DWC Form 074 online
The DWC Form 074, Description of Injured Employee Employment, is essential for sharing information between an employer and the treating doctor of an injured employee. This guide provides a step-by-step approach to completing the form online, ensuring all necessary information is accurately captured.
Follow the steps to complete the DWC Form 074 online effectively.
- Click ‘Get Form’ button to acquire the DWC Form 074 and open it in the editor for completion.
- Begin by filling in the contact information section. Enter the injured employee's name, date of injury, and employer details, including the employer's address, telephone number, and contact person.
- Provide the injured employee's Social Security number, ensuring to only enter the last four digits.
- In the second section, describe the employee's job functions and duties at the time of the injury. This should be filled out by someone with knowledge of the job.
- Indicate if modifications to the current job may be provided, such as alternate work assignments or schedule changes, and answer the posture and motion details accurately.
- Complete the lift/carry requirements based on the employee’s job, specifying the weight and frequency.
- Fill in the environmental exposure section, detailing the frequency of exposure to heat, noise, cold, and vibration, as relevant.
- Identify the tools, equipment, or machinery used by the employee and their frequency of use.
- In the additional information section, feel free to elaborate on the job functions and physical responsibilities. Attach any supporting documents if necessary.
- Finally, review all the information entered for accuracy. Once confirmed, you can save changes, download, print, or share the completed form with the treating doctor or requestor.
Complete the DWC Form 074 online today to facilitate effective communication regarding the injured employee's job responsibilities.
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To file a workers' comp claim in Texas, start by completing the DWC Form 074. You should gather all pertinent information about your injury, including dates and circumstances. After completing the form, submit it to your employer, who will then send it to their insurance provider. Using US Legal Forms can simplify this process by offering easy access to the necessary documents.
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