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Form DWC042 Claim for Workers' Compensation Death Benefits - Texas
What Is Form DWC042?
This is a legal form that was released by the Texas Department of Insurance - a government authority operating within Texas. As of today, no separate filing guidelines for the form are provided by the issuing department.
FAQ
Q: What is Form DWC042?
A: Form DWC042 is a claim form used to apply for Workers' Compensation Death Benefits in Texas.
Q: Who can use Form DWC042?
A: The form can be used by dependents or legal beneficiaries of a deceased worker who died as a result of a work-related injury or illness.
Q: What are Workers' Compensation Death Benefits?
A: Workers' Compensation Death Benefits are benefits provided to the dependents or legal beneficiaries of a worker who dies due to a work-related injury or illness.
Q: How do I submit Form DWC042?
A: The completed form should be mailed to the Texas Department of Insurance - Division of Workers' Compensation.
Form Details:
- Released on March 1, 2016;
- The latest edition provided by the Texas Department of Insurance;
- Easy to use and ready to print;
- Available in Spanish;
- Quick to customize;
- Compatible with most PDF-viewing applications;
- Fill out the form in our online filing application.
Download a fillable version of Form DWC042 by clicking the link below or browse more documents and templates provided by the Texas Department of Insurance.
Download Form DWC042 Claim for Workers' Compensation Death Benefits - Texas
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