Get Tx Dwc045 2017-2025

The TX DWC045 form is a vital document for requesting either a Benefit Review Conference or a direct move to a Contested Case Hearing within the Texas workers' compensation system. This guide provides clear, step-by-step instructions to help users complete the form accurately and confidently.

Follow the steps to successfully complete the TX DWC045 online.

1. Click ‘Get Form’ button to access the TX DWC045 form and open it in your preferred editor.
2. Begin with the Request Specifications section. Select one option to indicate the purpose of your request: Schedule a BRC, Reschedule a BRC, Cancel a BRC, or Proceed directly to CCH.
3. In the same section, check any applicable boxes for services you are requesting, such as Special Accommodations or Expedited BRC, and provide necessary explanations.
4. Proceed to the Injured Employee Claim Information section. Fill in the employee's name (Last, First, Middle), physical address, insurance carrier's name, date of injury formatted as mm-dd-yyyy, employer's business name, employer's business address, and the employee's Social Security Number.
5. Identify the party requesting the conference by checking the appropriate box: Injured Employee, Insurance Carrier, Employer, Sub-claimant, Beneficiary, or Attorney for.
6. Indicate whether the injured employee is assisted by the Office of the Injured Employee Counsel (OIEC) and provide the requester's typed or printed name, mailing address, business/firm name (if applicable), and phone number.
7. In the Issues for BRC or CCH section, check the applicable boxes to identify the disputed issues and provide a brief description of each disputed issue if necessary.
8. Document your efforts to resolve the issues. Provide the date the opposing party was notified of the disputed issues and attach supporting documentation of your efforts.
9. Certify that you have made reasonable efforts to resolve the disputed issues and provide your signature along with the date.
10. If you are requesting to proceed directly to a CCH, indicate whether the opposing party agrees with this request and provide information justifying the direct CCH request.
11. For rescheduling or canceling a BRC, complete the specified sub-sections and provide necessary justifications and documentation.
12. Review the entire form for accuracy before submission, ensuring all necessary fields are filled out correctly.
13. Finally, save your changes, download the completed form, print it if required, or share it with relevant parties.

Take action today and complete your TX DWC045 form online with ease.