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(dwc1) Employer's First Report of Injury or Illness - 10/05
(dwc1s) Employer's First Report of Injury or Illness (for state employees) - 10/05
(dwc2) Employer's Report for Reimbursement of Voluntary Payment Interim - 10/05
(dwc3) Employer's Wage Statement - 10/05
(dwc3me) Employer's Multiple Employment Wage Statement - 10/05
(dwc3mes) Declaración de Salario de Múltiples Trabajos del Empleado - 10/05
(dwc3s) Employer's Wage Statement (Spanish) - 10/05
(dwc3sd) Employer's Wage Statement for School Districts - 10/05
(dwc3sds) Declaración de Salario Para Escuelas de Distrito - 10/05
(dwc4) Employer's Contest of Compensability Interim - 11/08
(dwc5) Employer's Notice of No Coverage or Termination of Coverage - 10/05
(dwc5s) Aviso del Empleador por No-Cobertura o Anulación de Cobertura (Formulario DWC-005s) - 6/07
(dwc6) Supplemental Report of Injury - 10/05
(dwc7) Non-Covered Employer's Report of Occupational Injury and Illness - 10/05
(dwc7sup) Supplement DWC 7, Non-Covered Employer\'s Report of Occupational Injury and Illness - 10/05
(dwc8) Application for Reimbursement from the Return-to-Work Account for Small Employers - 2/08
(dwc20) Insurance Carrier's Notice of Coverage/Cancellation/Non-Renewal of Coverage - 10/05
(dwc20a) Correction/Revision/Endorsement to Existing Policy - 10/05
(dwc20si) Self-Insured Government Entity Proof of Coverage -10/06
(dwc21) Payment of Compensation or Notice of Refused or Disputed Claim Interim - N/D
(dwc22) Required Medical Examination Notice or Request for Order / Aviso de Examen Médico Requerido o Solicitud para Ordenar el Examen - 5/04
(dwc23) Request For Screening - 5/04
(dwc24) Benefit Dispute Agreement - 10/05
(dwc024s) Acuerdo Para Disputa De Beneficios - 7/08
(dwc25) Benefit Dispute Settlement - 10/05
(dwc025s) Acuerdo Por Disputa De Beneficios - 7/08
(dwc26) Reimbursement Request Made by Health Care Insurer - 9/07
(dwc27) Carrier Representative Information Submission Form - 9/07
(dwc31) Application for Commission Approval of Change in the Payment Period and/or Purchase of an Annuity - 10/05
(dwc32) Request for Designated Doctor - 11/08
(dwc32-sp) Solicitud Para Obtener Un Médico Designado - 11/08
(dwc33) Carrier's Request for Reduction of Income Benefits Due to Contribution - 10/05
(dwc35) Application for Commission Approval of the Purchase of an Annuity for Lifetime Income Benefits - 10/05
(dwc41) Employee's Notice of Injury or Occupational Disease and Claim for Compensation - 3/07
(dwc41s) Notificación del Trabajador Lesionado o Afectado por Enfermedad de Trabajo y Reclamo de Compensación - 3/07
(dwc41a) Form DWC-41, Supplement A - Beneficiary\'s Claim for Compensation - 10/05
(dwc41as) Formulario DWC-41s, Suplemento A - Recalamo de Compensación Beneficiario - 10/05
(dwc42) Notice of Fatal Injury or Occupational Disease and Claim for Compensation for Death Benefits - 11/08
(dwc42s) Aviso Sobre Fatalidad o Enfermedad Ocupacional y Reclamo para Compensación por Beneficios a Causa de Muerte - 11/08
(dwc44) Election to Engage in Arbitration - 10/05
(dwc45) Request for a Benefit Review Conference Interim - 10/05
(dwc045asmedcch) Solicitud para una Audiencia para Disputar Beneficios Médicos o Audiencia en la Oficina Estatal de Audiencias Administrativas (SOAH, por sus Siglas en Inglés) - 10/07
(dwc45a) Request For Medical Contested Case or SOAH Hearing - 9/07
(dwc46) Employee's Request for Acceleration of Impairment Income Benefits - 10/05
(dwc46s) Solicitud del Trabajador Lesionado para Recibir un Pago Acelerado de Beneficios por Causa del Impedimento Corporal - 10/05
(dwc47) Employee's Request for Payment of Advanced Compensation - 10/05
(dwc47s) Solicitud del Trabajador Lesionado Acerca de Pagos Adelantados de Compensación - 10/05
(dwc48) Request for Travel Reimbursement / Solicitud de Reembolso - 6/06
(dwc49) Request for Prospective Review of Medical Care Not Requiring Preauthorization - 10/05
(dwc51) Employee's Election for Commuted (Lump Sum) Impairment Income Benefits - 11/08
(dwc52) Application for Supplemental Income Benefits - 10/05
(dwc52s) Aplicación del trabajador para beneficios de ingresos suplementales - 10/05
(dwc53) Employee's Request To Change Treating Doctors - 2/08
(dwc53s) Solicitud del Trabajador para Cambiar de Médico Tratante - 2/08
(dwc54) Notice to Employee: Intention to Request Commission Permission to Adjust Benefits - 10/05
(dwc54s) Aviso ala la Empleadoa: Intencion de Solicitar Permisio a la Comision para Ajuste de Beneficios - 10/05
(dwc55) Request to Adjust Average Weekly Wage for Seasonal Employee - 10/05
(dwc55s) Solicitud de Ajuste al Salario Medio Semanal de un(a) Empleado/a de Temporada - 10/05
(dwc56) Carrier's Request for Seasonal Wage Information from Texas Work Force Commission - 10/05
(dwc57) Request for Extension of Maximum Medical Improvement for Spinal Surgery - 10/05
(dwc057s) Request for Extension of Maximum Medical Improvement for Spinal Surgery (Spanish) - 7/08
(dwc58) Request for Interlocutory Order - 9/07
(dwc60) Request for Medical Dispute Resolution - 2/07
(dwc60s) DWC Formulario-060S: Solicitud para Resolución de Disputas por Honorarios Médicos - 2/07
(dwc62) Explanation of Benefits - 7/07
(dwc65) Private Providers of Vocational Rehabilitation Services - 11/06
(dwc66) Statement of Pharmacy Services Services - 10/05
Instructions for Completing the CMS - 1500 - 10/05
Instructions for Completing the UB - 92 - 10/05
(dwc69) Report of Medical Evaluation - 10/05
Instructions For Completing The ADA J515 Dental Claim Form - 10/05
(dwc73) Work Status Report - 10/05
(dwc073s) Work Status Report (Spanish) - 7/08
(dwc74) Description of Injured Employee's Employment - 9/09
(dwc75) Non-ADL Doctor Request for Case by Case Exceptions - 10/05
(dwc81) Agreement Between General Contractor and Sub-Contractor to Provide Worker'sCompensation Insurance - 10/05
(dwc081sagree) Acuerdo Entre el Contratista General y el Sub Contratista - 9/07
(dwc82) Agreement for Motor Carriers and Owner Operators - 10/05
(dwc83) Agreement for Certain Building and Construction Workers - 10/05
(dwc083sagree) Acuerdo para Ciertos Trabajadores de Edificación y Construcción - 9/06
(dwc84) Exception to Application of Joint Agreement for Certain Building and Construction Workers - 10/05
(dwc85) Agreement Between General Contractor and Subcontractor to Establish Independent Relationship - 10/05
(dwc085sagree) Acuerdo Entre el Contratista General y el Sub Contratista Para Establecer una Relación Independiente - 11/06
(dwc101) Program Review Report - 8/06
(dwc102) Accident Prevention Plan Cover Sheet - 8/06
(dwc103) Approved Professional Source Safety Consultant Application - 12/06
(dwc104) Employer Request for DWC Safety Consultation - 8/06
(dwc105) Accident Prevention Services Worksheet - 4/09
(dwc109) Accident Prevention Services Annual Report - 12/05
(dwc150) Notice of Withdrawal of Representation - 10/05
(dwc151) Attorney Application for Web Access - 10/05
(dwc152p1) Application for Attorney's Fees Last form in Master Packet - 10/05
Cover - 10/05
Instructions - 10/05
Page 2 - 10/05
Page 3 - 10/05
Page 4 - 10/05
(dwc153) Request for Copies of Confidential Claimant Information - 10/06
(dwc155) Request for Record Check - 10/05
(dwc156) Prospective Employment Authorization and Certification - 10/05
(dwc156s) Prospective Employment Authorization and Certification - 10/05
(dwc205) Locations of Employers' Business(es) - 10/05
(dwc210) Surety Bond for Certified Self-Insurance Liabilities - 1/06
(dwc215) Surety Bond Amount Rider - 1/06
(dwc216) Surety Bond Name Change Rider - 1/06
(dwc223) Documentary Irrevocable Standby Letter of Credit - 01/07
(dwc224) Documentary Irrevocable Standby Letter of Credit ("Confirmation") - 1/07
(dwc225) Self-Insurers Agreement to Post Documentary Irrevocable Standby Letter of Credit - 01/07
(dwc226) Parental Guaranty - 1/07
(dwc227) Parental Guaranty for Less than Wholly Owned Subsidiary - 1/07
(dwc228) Power of Attorney - 1/07
(newemployeenotice) New Employee Notice - 7/06
(newemployeesp) New Employee Notice (covered and non-covered employers shall notify their employees of coverage status, in writing) - 7/06
(notice5) For Employers who do not have coverage - 10/05
(notice5s) For Employers who do not have coverage Spanish 10/05
(notice5r) Rule - 10/05
(notice6) For Employers who do have coverage - 10/05
(notice6s) For Employers who do have coverage Spanish - 10/05
(notice6r) Rule - 10/05
(notice9) For Work-Related Communicable Diseases - 10/05
(notice9s) For Work-Related Communicable Diseases Spanish - 10/05
(pln01) Notice of Denial of Compensability/Liability and Refusal to Pay - 10/05
(pln02) Notification of First Temporary Income Benefit Payment - 10/05
(pln03) Notification of Maximum Medical Improvement/First Impairment Income Benefit Payment - 10/05
(pln04) Notification of First Lifetime Income Benefit Payment - 10/05
(pln05) Notification of First Death Income Benefit Payment - 10/05
(pln06) Notification of Employer Full Salary Payment - 10/05
(pln07) Notification of Change of Indemnity Benefit Payment - 10/05
(pln08) Notification of Change in Amount of Indemnity Benefit Payment - 10/05
(pln09) Notification of Suspension of Indemnity Benefit Payment - 10/05
(pln10) Notification of Reinstatement of Indemnity Benefit Payment - 10/05
(pln11) Notification of Disputed Issue(s) and Refusal to Pay - 10/05
(rtwposter) Stay at Work or Return To Work Poster - 10/05
(notice7e) Notice to employees concerning Workers' Compensation in Texas English - 8/00
(notice7r) Notice to Certified Self-Insured Employer Rules - 7/94
(notice7s) Notice to employees concerning Workers' Compensation in Texas Spanish - 8/00
(notice8e) Required Workers' Compensation Coverage (building or construction projects for governmental entities) - 10/05
(notice8s) Required Workers' Compensation Coverage (building or construction projects for governmental entities) (Spanish) - 1/06
(dwc008rtw) Return-To-Work Pilot Program for Small Employers - 2/08
(employacke) SAMPLE Workers Compensation Network Acknowledgement - N/D