Claims Kit

Physician Selection

The employee has the right to an initial choice of doctor. TLC 408.022 This does not apply to requirements regarding the selection of a doctor under a workers' compensation health care network. (See Managed Care below)

The employee is able to request a change in doctors. Any request to change doctors must be approved by the local Division office handling theclaim. If the employee or the doctor move or the doctor becomes unavailable to provide medical treatment, the employee will be allowed to choose another doctor from the ADL. This will be considered an exception to the law and will not be viewed as a request to change doctors. The Employee's Request to Change Treating Doctors (DWC-53) will need to be completed and filed with the local Division office. TLC 408.022

If the employee goes to a doctor other than one that is authorized, they may have to pay for their own medical bills. TLC 408.024

Penalties for Late Reporting TLC 409.021(e)

An insurance carrier commits an administrative violation if they do not initiate payments or file a notice of refusal as required statute.

Posting Requirements RULE 110.101

If you buy workers' compensation insurance, you are considered a "subscriber." As a subscriber, you will be required to post a notice at your work place that provides your insurance carrier's name, information regarding the Ombudsman program at the Texas Department of Insurance, Division of Workers' Compensation (Division), and a contact number for reporting unsafe work conditions. This notice must be placed in the employer's personnel office and in a prominent place where employees can see it regularly.

Notice 6 - Notice to Employees Concerning Workers Compensation in Texas

Notice 6 - Spanish

Notice 6 - Rule

You are also required to give written notice of your coverage to new employees upon hire and inform them of their right to reject your workers' compensation coverage and retain their common law right for action in district court. If at any time your coverage lapses and then you obtain coverage again, you are required to give all employees this change of coverage information in writing.

New Employee Notice

If you do not carry workers' compensation insurance coverage, you are considered a "non-subscriber," and you must notify your employees and the Division that you do not have workers' compensation insurance

Notices in English, Spanish and any other language common to the employer's employee population must be posted and prominently displayed in the employer's personnel office, if any; and located about the workplace in such a way that each employee is likely to see the notice on a regular basis;

DWC 5 - Employer Notice of No Coverage or Termination of Coverage

Notice 5 - Notice to Employees Concerning Workers Compensation in Texas

Failure to post or to provide notice as required in the rule is a violation of the Act and Division rules. The violator may be subject to administrative penalties.

Reporting of Claim by Employer Rule 120.2

If the employer has workers' compensation coverage or is a certified self-insurer they must:

File the Employer's First Report of Injury or Illness (DWC-1) with their insurance carrier within eight (8) days from the date the employer received notice or had knowledge of an occupational disease or death or after the employee has missed more than one day due to the work related injury.  
Provide a copy of the DWC-1 and Employee's Rights and Responsibilities to the employee at the time the DWC-1 is filed.
Check with the insurance carrier to see what methods of reporting they have available.

If the employer does not have workers' compensation insurance coverage and has more than 4 employees:

If the employer has a reportable injury, by the seventh day of each month, they are required to complete the Non-covered Employer's Report of Occupational Injury or Illness (DWC-7), to report all fatalities, occupational diseases of which the employer has knowledge, and all on-the-job injuries resulting in more than one day's absence from work for the month prior to the filing date. Mail the DWC-7 to the Division at

           Texas Department of Insurance, Division of Workers' Compensation
           7551 Metro Center Drive, Ste 100, MS-93 

           Austin, Texas 78744