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Ompensation DWC Claim # Carrier Claim # Report of Medical Evaluation I. GENERAL INFORMATION 4. Injured Employee's Name (First, Middle, Last) 9. Certifying Doctor's Name and License Type 1. Workers Compensation Insurance Carrier 5. Date of Injury 10. Certifying Doctor's License Number and Jurisdiction 2. Employer s Name 7. Employee's Phone Number 3. Employer s Address (Street or PO Box, City State Zip) 8. Employee s Address (Street or PO Box, City State Zip) 6. Social Securit.

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Related content

DWC Form-069 - Texas Department of Insurance...
DWC069 Rev. 01/15. Page 2 of 3. Frequently Asked Questions. Report of Medical Evaluation...
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fall 2012 newsletter - The Portal to Texas History
rating (it should be on a Form DWC069, Report of Medical ... illness might be work-related...
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MMI is the point in an employee's treatment where the doctor tells them further improvement in their medical condition is no longer possible. This doesn't mean that they are completely healed or as 'good as new. ' It means that whatever their condition is right now is as good as it will ever be.

Texas workers' compensation law allows employers to opt out of carrying workers' compensation insurance, which covers medical expenses, physical therapy expenses and lost wages for employees who get sick or injured at work.

What is a Multiple Mini Interview or MMI? The Multiple Mini Interview (MMI), developed by McMaster University, is an interview format that consists of a series of 6-10 interview stations, each focused on a different question or scenario.

MMI stands for Maximum Medical Improvement. It is defined as the point at which an injured worker's medical condition has stabilized and further functional improvement is unlikely, despite continued medical treatment or physical rehabilitation.

Call 888-489-2667 or email TXCompHelp@tdi.texas.gov for help.

A 0% MMI rating means that you have fully recovered, while anything above indicates a reduction in functionality. The reason for an MMI rating is to allow the DWC to assign a value to your claim. The higher your MMI rating, the more compensation you are entitled to receive.

The term "Maximum medical improvement", or "MMI", is used under workers' compensation law to describe that point in an injured worker's healing process when they are not expected to further improve with generally accepted medical treatment.

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© Copyright 1997-2025
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Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
DMCA Policy
About Us
Blog
Affiliates
Contact Us
Privacy Notice
Delete My Account
Site Map
All Forms
Search all Forms
Industries
Forms in Spanish
Localized Forms
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate workflows
DocHub
Instapage
Social Media
Call us now toll free:
1-877-389-0141
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232