Get Workers Compensation Texas

Filling out the Workers Compensation Texas form is a crucial step for ensuring that your claim is processed effectively. This guide provides you with clear, step-by-step instructions on how to complete the form online, addressing each section to help you navigate the process smoothly.

Follow the steps to fill out the Workers Compensation Texas form online.

1. Click 'Get Form' button to access the form and open it for editing.
2. Begin with Section I: Employee/Employee’s Attorney Information. Here, enter the employee's full name, Social Security number, and mailing address. Include their telephone numbers and the date of injury.
3. Proceed to Section II: Employer Information. Fill in the employer's name and address as it was at the time of the injury.
4. Move to Section III: Insurance Carrier Information. Provide the name and address of the insurance carrier along with details of the adjuster, including their name, email, and phone number.
5. In Section IV, complete the Examination Information. This includes the RME doctor's name, mailing address, license number, and contact details, alongside the examination location and appointment details.
6. For Section V: Purpose of Examination, indicate the name and date of the designated doctor's examination, and check any relevant issues to be addressed.
7. In Section VI, certify that the request is accurate and authorize the insurance carrier representative to act on the carrier's behalf.
8. If applicable, complete Sections VII and VIII for the Appropriateness of Health Care Received, following similar steps to provide all necessary details.
9. Finally, review the entire form for accuracy. Once completed, users can save changes, download, print, or share the form as needed.

Take the next step and complete the Workers Compensation Texas form online today.