Texas Department of Insurance - Division of Workers' Compensation Forms

This form is used for requesting a medical contested case or SOAH (State Office of Administrative Hearings) hearing in Texas.

This Form is used for reporting pharmacy services in the state of Texas.

Este formulario se utiliza para que un empleado solicite un cambio de médico de tratamiento en Texas.

This form is used for requesting a medical fee dispute resolution in Texas. It is for individuals who have a dispute with their medical provider or insurance company over the amount of a medical fee.

This Form is used for submitting a written request for an interlocutory order in the state of Texas. It is used to request a court order that addresses a specific issue during the course of a legal proceeding before a final judgment is made.

This form is used for requesting a medical interlocutory order in the state of Texas. It allows individuals to request a court order related to medical treatment or services.

This form is used for reporting medical evaluations in the state of Texas. It is used to document and provide information on medical evaluations that have been conducted.

This form is used for creating an agreement between a general contractor and a subcontractor in Texas regarding the provision of workers' compensation insurance.

This form is used for an agreement between the general contractor and the subcontractor in order to provide workers' compensation insurance. This form is specific to Texas and is written in Spanish.

This form is used for providing a description of the injured employee's employment in the state of Texas. It helps gather information about the job duties, work hours, and other details related to the employment of the injured worker.

This form is used for workers in the building and construction industry in Texas who want to affirm their independent relationship and be exempted from a joint agreement.

This form is used for entering into an agreement with certain building and construction workers in Texas.

This type of document is used to establish an independent relationship between a general contractor and a subcontractor in Texas.

This document is a Spanish form (Formulario) called DWC083S used in Texas. It is an agreement for certain workers in the building and construction industry.

This form is used for establishing an agreement between a general contractor and a subcontractor in Texas to establish an independent relationship. It is written in Spanish.

This Form is used for claiming an exception to the application of the Joint Agreement to affirm the independent relationship of certain building and construction workers in Texas.

This Form is used for applying to the Medical Quality Review Panel in Texas.

This form is used for notifying the Texas Division of Workers' Compensation about the withdrawal of legal representation in a workers' compensation case.

This form is used for providing contact information for claim administration purposes in the state of Texas. It is important for individuals to accurately fill out this form to ensure effective communication during the claims process.

This form is used for notifying the Texas Division of Workers' Compensation about legal representation in a worker's compensation case.

This type of document is a Spanish version of the DWC150S Legal Representation Notice form used in Texas. It is used to notify the Workers' Compensation Commission about the legal representation of a party in a workers' compensation case.

This Form is used for reporting the locations of the employer's business in Texas.

This form is used for applying for attorney fees in Texas.

This type of document is a DWC154S Complaint Form for Workers' Compensation in Texas. It is used by Spanish speakers to file a complaint regarding compensation for work-related injuries.