Texas Workers' Compensation Information



Please Note: for Claims assistance or questions about coverage and exemptions You will need to call one of the numbers listed below.

Also be aware that the Workers' Compensation Assistance Offices in different states may go by different names such as "Industrial Accidents".
These are the only numbers that we are aware of and have available for Texas Workers' Compensation.

Texas Workers' Compensation Telephone Directory


DWC - Austin - Central Office Toll Free: 800-252-7031

DWC - Abilene - Field Office - Toll Free: 800-252-7031

DWC - Amarillo - Field Office - Toll Free: 800-252-7031

DWC - Austin - Field Office - Toll Free: 800-252-7031

DWC - Beaumont - Hearings only Office - Toll Free: 800-252-7031

DWC - Bryan - Field Office - Toll Free: 800-252-7031

DWC - Corpus Christi - Field Office - Toll Free: 800-252-7031

DWC - Dallas - Field Office - Toll Free: 800-252-7031

DWC - Denton - Field Office - Toll Free: 800-252-7031

DWC - El Paso - Field Office - Toll Free: 800-252-7031

DWC - Euless - Field Office - Toll Free : 800-252-7031

DWC - Houston EAST- Field Office - Toll Free: 800-252-7031

DWC - Houston WEST - Field Office - Toll Free: 800-252-7031

DWC - Laredo - Field Office - Toll Free: 800-252-7031

DWC - Lubbock - Field Office - Toll Free: 800-252-7031

DWC - Lufkin - Field Office: 936-639-6406

DWC - San Angelo - Field Office - Toll Free: 800-252-7031

DWC - San Antonio - Field Office - Toll Free: 800-252-7031

DWC - Tyler - Field Office - Toll Free: 800-252-7031

Safety Violations Hotline - Toll Free: 800-452-9595

DWC - Waco - Field Office - Toll Free: 800-252-7031

DWC - Weslaco - Field Office - Toll Free: 800-252-7031

Hearings - Main Line: 512-804-4010

DWC-Midland/Odessa-Field Office - Toll Free: 800-252-7031

Safety Training - Phone & Email Address: 512-804-4610

Claims and Customer Services - Toll Free: 800-252-7031, #1

Workplace Safety - Toll Free & Email: 800-252-7031, #2

Self Insurance Regulation: 512-804-4775

Fraud: 844-FRAUD99

Fraud - Phone Number (hotline) & Email Address: 844-373-8399

DWC Workplace Safety - Toll Free: 800-687-7080

Managed Care Quality Assurance - Toll Free: 866-554-4926

Open Records Request - Fax, Email Address & Mailing Address: 512-490-1021

Vocational Rehabilitation - Phone & Email Address: 512-936-6400

Medical Fee Dispute Resolution: 800-252-7031 opt3

DWC Media Relations: 512-804-4208

Dispute Resolution - Ombudsman: 866-393-6432 x441

Workplace Safety from WC Carrier Information: 800-687-7080

DWC Chief Clerk of Proceedings/Hearings: 512-804-4020

Workers' Compensation Commission: 512-804-4103

Appeals Panel: 512-804-4033

Appeals Panel - Second Number: 512-804-4020

Compliance & Investigations : 512-804-4733

Hearings: 512-804-4015

Hearings Director: 512-804-4085

TXCOMP: 888-489-2667

Report Suspected WC Fraud: 512-804-4710

Accident Prevention Services: 800-252-7031 opt 2

Comp Connection for Health Care Providers: 800-252-7031 opt3

DWC Fraud Mailing Address & Phone Number: 512-804-4720

Health & Safety: 512-804-4870

Commissioner of Workers' Compensation Cassie Brown: 512-804-4400

Legal Services: 512-804-4040

Obtaining an Attorney: 800-252-9690

Office of Injured Employee Counsel: 866-393-6432x44186

Bureau of Labor Statistics (BLS) of Fatal Occupational Injuries: 512-804-4640

OIEC (Office of Injured Employee Counsel): 512-804-4170

OIEC (Office of Injured Employee Counsel) - First Responder Liaison: 512-804-4173

OIEC (Office of Injured Employee Counsel) - Legal & Staff Services Manager: 512-804-4194

OIEC (Office of Injured Employee Counsel) - General Counsel: 512-804-4185

OIEC (Office of Injured Employee Counsel) - Assistant General Counsel: 512-804-4170

OIEC (Office of Injured Employee Counsel) - Field Operations Director: 512-804-4170

Chief Clerk of Proceedings (Appeal): 512-804-4021

Department of Insurance (State): 512-676-6000

Department of Insurance (State) - Mailing Address & Toll Free Number: 800-578-4677

Department of Insurance (State) - Chief Deputy Commissioner Doug Slape: 512-676-6023

Insurance (State) Fraud: 512-676-6925

OSHA - Austin Area Ofc. - Federal OSHA covers private Employers/Employees in TX : 512-374-0271

Forms & Publications


Welcome to the most extensive library of workers' compensation forms available anywhere. Almost 3,600 forms are available for your immediate download and use. Our forms, all of which have been custom programmed by WorkersCompensation.com for Type & Save functionality, are available for individual purchase below.

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Some "Revision Dates" may be displayed as part of the Description.

NOTICE: Beginning December 6, 2018, revised DWC Form-032, Request for Designated Doctor Examination and DWC Form-068, Designated Doctor Examination Data Report must be used to comply with new rules to 28 Texas Administrative Code Chapter 127, regarding Designated Doctor Procedures and Requirements.

On March 1, 2018, Texas workers' compensation insurance carriers must use the new and revised plain language notices. The Texas Department of Insurance, Division of Workers' Compensation (TDI-DWC) recently revised plain language notices PLN-1, PLN-2, and PLN-4 through PLN-12; and created new notices PLN-3a, PLN3b, and PLN-3c.

Insurance carriers may not use older versions of the plain language notices on or after March 1, 2018. TDI-DWC will remove all previous versions from its website.

(dwc1) Employer's First Report of Injury or Illness 10/05
(dwc1s) Employer's First Report of Injury or Illness 10/05
(dwc2) Employer's Report for Reimbursement of Voluntary Payment 2/17
(dwc3) Employer's Wage Statement 10/05
(dwc3s) Employer's Wage Statement (Spanish) 10/05
(dwc3me) Employer's Multiple Employment Wage Statement 4/16
(dwc3mes) Employer's Multiple Employment Wage Statement (Spanish) 4/16
(dwc3sd) Employer's Wage Statement for School Districts 10/05
(dwc3sds) Employer's Wage Statement for School Districts (Spanish) 10/05
(dwc4) Employer's Contest of Compensability Interim 11/08
(dwc5) Employer's Notice of No Coverage or Termination of Coverage 2/18
(dwc5s) Employer's Notice of No Coverage or Termination of Coverage (Spanish) 2/18
(dwc6) Supplemental Report of Injury 10/05
(dwc7) Employer's Report of Non-covered Employee's Occupational Injury or Disease 01/13
(dwc8) Application for Reimbursement from the Return-to-Work Account for Small Employers 4/10
(dwc20a) Correction/Revision/Endorsement to Existing Policy 10/05
(dwc20si) Self-Insured Governmental Entity Coverage Information 08/12
(dwc22) Required Medical Examination Notice or Request for Order 7/11
(dwc22s) Required Medical Examination Notice or Request for Order (Spanish) 7/11
(dwc24) Benefit Dispute Agreement 11/17
(dwc24s) Benefit Dispute Agreement (Spanish) 11/17
(dwc25) Benefit Dispute Settlement 11/17
(dwc25s) Benefit Dispute Settlement (Spanish) 11/17
(dwc26 2015) Request for Reimbursement of Payment Made by Health Care Insurer 01/15
(dwc27) Designation of Insurance Carrier's Austin Representative 12/11
(dwc29) Request for Standard Detailed Data Reports 11/19
(dwc30) Austin Representative's Authorized Designees 12/11
(dwc31) Application for Division Approval of Change in the Payment Period and/or Purchase of an Annuity for Death Benefits 2/17
(dwc31s) Application for Division Approval of Change in the Payment Period and/or Purchase of an Annuity for Death Benefits (Spanish) 2/17
(dwc32) Request for Designated Doctor Examination 10/18
(dwc32s) Request for Designated Doctor Examination (Spanish) 10/18
(dwc33) Carrier's Request for Reduction of Income Benefits Due to Contribution 2/17
(dwc35) Application for Division Approval of the Purchase of an Annuity for Lifetime Income Benefits 2/17
(dwc41) Employee's Notice of Injury or Occupational Disease and Claim for Compensation 3/07
(dwc41s) Employee's Notice of Injury or Occupational Disease and Claim for Compensation (Spanish) 3/07
(dwc42) Claim for Workers'Compensation Death Benefits 3/16
(dwc42s) Claim for Workers' Compensation Death Benefits (Spanish) 3/16
(dwc44) Election to Engage in Arbitration 6/12
(dwc44s) Election to Engage in Arbitration - (Spanish) 6/12
(dwc45) Request to Schedule, Reschedule, or Cancel a Benefit Review Conference (BRC) 7/21
(dwc45s) Request to Schedule, Reschedule, or Cancel a Benefit Review Conference (BRC) (Spanish) 7/21
(dwc45a) Request for Medical Contested Case or SOAH Hearing 9/07
(dwc45as) Request for Medical Contested Case or SOAH Hearing (Spanish) 10/07
(dwc45m) Request to Schedule, Reschedule, or Cancel a Benefit Review Conference to Appeal a Medical Fee Dispute Decision (BRC-MFD) 7/21
(dwc45ms) Request to Schedule, Reschedule, or Cancel a Benefit Review Conference to Appeal a Medical Fee Dispute Decision (BRC-MFD)(For disputes filed on or after June 1, 2012) (Spanish) 7/21
(dwc46) Employee's Request for Acceleration of Impairment Income Benefits 2/17
(dwc46s) Employee's Request for Acceleration of Impairment Income Benefits (Spanish) 2/17
(dwc47) Employee's Request for Advance of Benefits 2/17
(dwc47s) Employee's Request for Advance of Benefits (Spanish) 2/17
(dwc48) Request to Get Reimbursed for Travel Costs 7/21
(dwc48s) Request to Get Reimbursed for Travel Costs(Spanish) 7/21
(dwc49) Request to Schedule a Medical Contested Case Hearing (MCCH) 11/17
(dwc49s) Request to Schedule a Medical Contested Case Hearing (MCCH) (Spanish) 11/17
(dwc51) Employee's Election for Commuted (Lump Sum) Impairment Income Benefits 2/17
(dwc51s) Employee's Election for Commuted (Lump Sum) Impairment Income Benefits (Spanish) 2/17
(dwc52) Application for Supplemental Income Benefits 2/17
(dwc52s) Application for Supplemental Income Benefits (Spanish) 2/17
(dwc53) Employee's Request to Change Treating Doctors 3/12
(dwc53s) Employee's Request to Change Treating Doctors (Spanish) 3/12
(dwc54) Notice to Employee: Intention to Request Division Permission to Adjust Benefits 2/17
(dwc54s) Notice to Employee: Intention to Request Division Permission to Adjust Benefits (Spanish) 2/17
(dwc55) Request to Adjust Average Weekly Wage for Seasonal Employee 2/17
(dwc55s) Request to Adjust Average Weekly Wage for Seasonal Employee (Spanish) 2/17
(dwc56) Carrier's Request for Seasonal Wage Information from Texas Work Force Commission Records 2/17
(dwc57) Request for Extension of Maximum Medical Improvement Date for Spinal Surgery 2/17
(dwc57s) Request for Extension of Maximum Medical Improvement Date for Spinal Surgery (Spanish) 2/17
(dwc58) Request for Interlocutory Order 9/07
(dwc60) Medical Fee Dispute Resolution Request 2/21
(dwc60s) Medical Fee Dispute Resolution Request (For disputes filed on or after June 1, 2012) (Spanish) 2/21
(dwc64) Medical Interlocutory Order Request 8/11
(dwc66) Statement of Pharmacy Services Services 12/11
Designated Doctor Certification Application * For use on or after 9/1/2016 * 8/16
Designated Doctor Examination Data Report- For use on or after 12/6/2018 10/18
(dwc69) DWC069 Report of Medical Evaluation 1/15
Instructions for Completing the ADA J515 Dental Claim Form 10/05
(dwc72) Medical Quality Review Panel Application (for use on or after January 1, 2013) 1/13
(dwc73) Work Status Report 9/19
(dwc73s) Work Status Report- Spanish 9/19
(dwc74) Description of Injured Employee's Employment 9/09
(dwc81) Agreement Between General Contractor and Sub-Contractor to Provide Workers' Compensation Insurance 10/21
(dwc81s) Agreement Between General Contractor and Sub-Contractor to Provide Workers' Compensation Insurance (Spanish) 10/21
(dwc82) Agreement for Motor Carriers and Owner Operators 10/21
(dwc82sp) Agreement between motor carrier and owner operator to provide workers' compensation insurance-Spanish 10/21
(dwc83) Agreement for Certain Building and Construction Workers 10/21
(dwc83s) Agreement for Certain Building and Construction Workers 10/21
(dwc84) Exception to Application of Joint Agreement for Certain Building and Construction Workers 10/21
(dwc84s) Exception to Application of Joint Agreement for Certain Building and Construction Workers (Spanish) 10/21
(dwc85) Agreement between General Contractor and Subcontractor to Establish Independent Relationship 10/21
(dwc85s) Agreement between General Contractor and Subcontractor to Establish Independent Relationship (Spanish) 10/21
(dwc95) SIF Reimbursement Request Form - Overturned Order or Designated Doctor Opinion 1/21
(dwc96) SIF Reimbursement Request Form – Refund of Death Benefits 1/21
(dwc97) SIF Reimbursement Request Form – Multiple Employment 1/21
(dwc98) SIF Reimbursement Request Form – Pharmaceutical 1/21
(dwc101) Program Review Report 11/21
(dwc102) Accident Prevention Plan Cover Sheet 11/21
(dwc104) Employer Request for DWC Safety Consultation 11/21
(dwc105) Accident Prevention Services Worksheet 11/21
(dwc109) Accident Prevention Services Annual Report 11/21
(dwc120) Designation of Administrative Services Company Administrator 8/19
(dwc121) Claim Administration Contact Information 3/20
(dwc150) Notice of Representation 12/16
(dwc150a) Notice of Withdrawal of Representation 11/17
(dwc150as) Notice of Withdrawal of Representation (Spanish) 11/17
(dwc150s) Notice of Representation (Spanish) 12/16
(dwc151) Attorney Application for Web Access 12/16
(dwc152) Application for Attorney's Fees 11/17
(dwc153) Request for Copies of Confidential Claimant Information 2/21
(dwc153s) Request for Copies of Confidential Claimant Information (Spanish) 2/21
(dwc154) Workers' Compensation Complaint Form 3/16
(dwc154s) Workers' Compensation Complaint Form(Spanish) 3/16
(dwc156) Prospective Employment Authorization and Certification 8/21
(dwc156s) Prospective Employment Authorization and Certification (Spanish) 8/21
(dwc205) Locations of Employers' Business 11/10
(dwc205s) Locations of Employers' Business (Spanish) 11/10
(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 1/07
(dwc224) Documentary Irrevocable Standby Letter of Credit ("Confirmation") 1/07
(dwc225) Self-Insurers Agreement to Post Documentary Irrevocable Standby Letter of Credit 1/07
(dwc226) Parental Guaranty 1/07
(dwc227) Parental Guaranty for Less than Wholly Owned Subsidiary 1/07
(dwc228) Power of Attorney 1/07
(dwc230suretybond) Surety Bond for Assumed Certified Self-Insurance Liabilities 3/14
(newempnotice) New Employee Notice (covered and non-covered employers shall notify their employees of coverage status, in writing, 7/12
(newempnotices) New Employee Notice - (Spanish) 7/12
(notice5) For Employers who do not have coverage 1/13
(notice5s) Notice to Employees Concerning Workers' Compensation in Texas - (Spanish) 1/13
(notice6) Notice to Employees Concerning Workers' Compensation in Texas 1/13
(notice6s) Notice to Employees Concerning Workers' Compensation in Texas - (Spanish) 1/13
(notice07) Notice to Employees Concerning Workers' Compensation in Texas - (Spanish) 1/13
(notice07s) Notice to Employees Concerning Workers' Compensation in Texas - (Spanish) 1/13
(notice8) Required Workers' Compensation Coverage (building or construction projects for governmental entities) 12/15
(notice8s) Required Workers' Compensation Coverage (building or construction projects for governmental entities) (Spanish) 12/15
(notice9) For Work-Related Communicable Diseases 12/15
(notice9s) For Work-Related Communicable Diseases (Spanish) 12/15
(notice10) Notice to Employees Concerning Workers' Compensation in Texas (must be posted for employees to read, for use on or after 1/1/13) 1/13
(notice10s) Notice to Employees Concerning Workers' Compensation in Texas (must be posted for employees to read, for use on or after 1/1/13) (Spanish) 1/13
(pln01) Notice of Denial of Compensability/Liability and Refusal to Pay Benefits 7/21
(pln01s) Notice of Denial of Compensability/Liability and Refusal to Pay Benefits (Spanish) 7/21
(pln02) Notification of First Temporary Income Benefit Payment 7/21
(pln02s) Notification of First Temporary Income Benefit Payment (Spanish) 7/21
(pln03a) Notice of Maximum Medical Improvement and No Permanent Impairment 7/21
(pln03as) Notice of Maximum Medical Improvement and No Permanent Impairment (Spanish) 7/21
(pln03b) Notice of Maximum Medical Improvement and Permanent Impairment 7/21
(pln03bs) Notice of Maximum Medical Improvement and Permanent Impairment (Spanish) 7/21
(pln03c) Notice of Maximum Medical Improvement and Estimated Permanent Impairment 7/21
(pln03cs) Notice of Maximum Medical Improvement and Estimated Permanent Impairment (Spanish) 7/21
(pln04) Notice of Eligibility for Lifetime Income Benefits 7/21
(pln04s) Notice of Eligibility for Lifetime Income Benefits (Spanish) 7/21
(pln05) Notice of First Death Benefit Payment 7/21
(pln05s) Notice of First Death Beenefit Payment (Spanish) 7/21
(pln06) Notification of Employer Full Salary Payment 7/21
(pln06s) Notification of Employer Full Salary Payment (Spanish) 7/21
(pln07) Notice of Change of Indemnity Benefit Payment 7/21
(pln07s) Notification of Change of Indemnity Benefit Payment (Spanish) 7/21
(pln08) Notice of Change in Amount of Indemnity Benefit Payment 7/21
(pln08s) Notification of Change in Amount of Indemnity Benefit Payment - (Spanish) 7/21
(pln09) Notice of Suspension of Indemnity Benefits 7/21
(pln09s) Notification of Suspension of Indemnity Benefit Payment (Spanish) 7/21
(pln10) Notification of Reinstatement of Indemnity Benefit Payment 7/21
(pln10s) Notification of Reinstatement of Indemnity Benefit Payment (Spanish) 7/21
(pln11) Notification of Disputed Issue(s) and Refusal to Pay Benefits 7/21
(pln11s) Notification of Disputed Issue(s) and Refusal to Pay - (Spanish) 7/21
(pln12) Notice of Potential Entitlement to Workers' Compensation Death Benefits 7/21
(pln12s) Notice of Potential Entitlement to Workers' Compensation Death Benefits (Spanish) 7/21
(pln14) Notice of Continuing Investigation 7/21
(pln14s) Notice of Continuing Investigation(Spanish) 7/21
(pln15) Notice of Request to Reprocess a SARS-CoV-2 or COVID-19 Claim Subject to Texas Government Code Section 607.0545 7/21
(pln15sp) Notice of Request to Reprocess a SARS-CoV-2 or COVID-19 Claim Subject to Texas Government Code Section 607.0545-Spanish 7/21
(sample notice) Notice of Underpayment of Income Benefits 12/11
(sample notice s) Notice of Underpayment of Income Benefits (Spanish) 12/11
(samcovid) Sample Request to Reprocess a SARS-CoV-2 or COVID-19 Claim for an Injured Employee Covered under Texas Government Code Section 607.0545 7/21
(samcovid sp) Sample Request to Reprocess a SARS-CoV-2 or COVID-19 Claim for an Injured Employee Covered under Texas Government Code Section 607.0545-Spanish 7/21
(dwc-edi-01) Trading Partner Profile 10/16
(edi002) Insurance Carrier or Trading Partner Medical Electronic Data Interchange (EDI) Profile 10/16
(edi003) Medical EDI Compliance Coordinator and Trading Partner Notification 10/16
(lhl009) Req for review by IRO 9/20
(lhl009s) Req for review by IRO (Spanish) 1/18

Current Rules

Old Law Rules (Prior to 1991 Chapter 41 - Chapter 89)

Chapter 401. General Provisions (401.011-401.026)

Chapter 402. Operation and Administration of Workers' Compensation System (402.001-402.251)

Chapter 403. Division Financing (403.001-403.008)

Chapter 404. Office of Injured Employee Counsel (404.001-404.155)

Chapter 405. Workers' Compensation Research (405.001-405.004)

Chapter 406. Coverage Election; Security Procedures (406.001-406.165)

Chapter 407. Self-insurance Regulation (407.001-407.133)

Chapter 407A. Group Self-insurance Coverage (407a.001-407a.465)

Chapter 408. Workers' Compensation Benefits (408.001-408.222)

Chapter 409. Compensation Procedures (409.001-409.024)

Chapter 410. Adjudication Of Disputes (410.001-410.308)

Chapter 411. Workers' Health And Safety (411.001-411.110)

Chapter 412. Division Of Risk Management (412.001-412.054)

Chapter 413. Medical Review (413.001-413.055)

Chapter 414. Division Of Compliance And Practices (414.001-414.007)

Chapter 415. Administrative Violations (415.001-415.036)

Chapter 416. Actions Against Insurance Carrier For Breach Of Duty (416.001-416.002)

Chapter 417. Third-party Liability (417.001-417.004)

Chapter 418. Criminal Penalties (418.001-418.003)

Chapter 419. Misuse of Division Name (419.001-419.007)

Chapter 451. Discrimination Prohibited

Chapter 501. Workers' Compensation Insurance Coverage For State Employees, including Employees Under The Direction Or Control Of The Board Of Regents Of Texas Tech University (501.001-501.051)

Chapter 502. Workers' Compensation Insurance Coverage For Employees Of the Texas A&M University System

Chapter 503. Workers' Compensation Insurance Coverage For Employees Of The University Of Texas System

Chapter 504. Workers' Compensation Insurance Coverage For Employees Of Political Subdivisions

Chapter 505. Workers' Compensation Insurance Coverage For Employees Of Texas Department Of Transportation

Chapter 506. Payment Of Certain Judgments

Government Code Title 6. Public Officers and Employees Subtitle A. Provisions Generally Applicable to Public Officers and Employees Chapter 607. Benefits Relating to Certain Diseases and Illnesses