DWC007
Employers that do not have workers’ compensation insurance coverage (non-subscribers) and employ five or more employees who are not exempt from workers’ compensation insurance coverage must file the DWC Form-007, Employer’s report of noncovered employee’s work-related injury or illness. Examples of exempt employees include certain domestic workers and certain farm and ranch workers.
Employers that have workers’ compensation insurance coverage must file the DWC Form-007 to report an on-the-job injury or illness for an employee who has waived workers’ compensation insurance coverage. See Texas Labor Code Section 406.034 for more information.
DWC005
A non-subscriber is a Texas employer who does not have workers’ compensation insurance coverage or has terminated their workers’ compensation coverage and has one or more employees.
DWC001S
Send this form to your workers’ compensation insurance carrier and to the injured employee or the injured employee’s representative. Do not send this form to the Texas Department of Insurance, Division of Workers’ Compensation (DWC), unless DWC specifically requests it.
DWC039
First responders who get LIBs because of a serious bodily injury file this form.
DWC038
Send this form to your insurance carrier. The insurance carrier has up to 60 days to approve or deny your
benefits. If the insurance carrier approves your benefits, you should get your first LIBs payment within 15 days.
If the insurance carrier does not approve your application, it must send you a notice explaining why. If you don’t agree, you can ask for a benefit review conference (BRC) to talk about their decision. A BRC is an informal meeting to talk about disputes. Learn more at www.tdi.texas.gov/wc/idr/brc.html.
DWC032
The injured employee, the injured employee’s representative, or the insurance carrier may request the Texas Department of Insurance, Division of Workers’ Compensation (DWC) to order a designated doctor exam. DWC may also order a designated doctor exam on its own.
PLN07
This notice must be used to report to the injured employee/representative and the beneficiaries/representatives (if applicable) when the insurance carrier is changing the payment of one income benefit type to another or to death benefits.
PLN04
This notice must be used to report to the injured employee/representative the approval of LIBs.
DWC006
The Texas Department of Insurance, Division of Workers’ Compensation (DWC) requires either the employer or the injured employee to report to the insurance carrier all return-to-work activity and post-injury change of earnings. This allows the insurance carrier to adjust the weekly amount of temporary income benefits (TIBs) paid to an injured employee to match the changes in weekly earnings after the injury.
DWC002
Send a copy of this form to the Texas Department of Insurance, Division of Workers’ Compensation (DWC) and the insurance carrier. You can fax or mail the completed form to DWC or drop the form off at a DWC field office.