Get Employer's Wage Statement (dwc Form-003) - Texas ...

Filling out the Employer's Wage Statement (DWC Form-003) is essential for reporting an employee's wages to the workers' compensation insurance carrier. This guide will assist you in completing the form accurately and effectively, ensuring compliance with the Texas Workers' Compensation Act.

Follow the steps to complete the form online.

1. Press the ‘Get Form’ button to access the form and open it in your document editor.
2. Enter the claim number and the carrier's claim number at the top of the form. Ensure you specify if this is an initial or amended statement.
3. Fill in the employee and employer information. This includes the employee's name, mailing address, and Social Security number, along with the employer's business name and mailing address.
4. Indicate the date of injury and the employee's date of hire. Provide their current work status by selecting one of the provided options regarding their work restrictions or earnings.
5. Designate the person providing the wage information and include their contact details for future reference.
6. In the wage information section, report all wages earned by the employee during the 13 weeks prior to the date of injury. Include pecuniary and nonpecuniary wage information in the appropriate sections.
7. Make sure to complete the tables for both pecuniary and nonpecuniary wages, indicating the dates for each pay period and the respective amounts earned.
8. Review and certify the accuracy of the information provided by signing and dating the form.
9. Once all fields are completed, review the form for completeness and accuracy. Save your changes and download or print the form for submission.
10. Submit the completed form to the workers' compensation carrier, the claimant, and their representative as required within the specified timeframes.

Complete the Employer's Wage Statement (DWC Form-003) online today to ensure timely and accurate reporting of wage information.