This version of the form is not currently in use and is provided for reference only. Download this version of Form DWC051 for the current year.
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.
Q: What is Form DWC051?
A: Form DWC051 is the Employee's Election for Commuted (Lump Sum) Impairment Income Benefits in Texas.
Q: What is the purpose of Form DWC051?
A: The purpose of Form DWC051 is for an employee to elect to receive a commuted (lump sum) payment for impairment income benefits.
Q: Who should use Form DWC051?
A: Form DWC051 should be used by employees in Texas who are eligible for impairment income benefits and wish to receive a lump sum payment.
Q: How do I fill out Form DWC051?
A: To fill out Form DWC051, you need to provide your personal information, medical information, and indicate your election for a commuted (lump sum) payment.
Q: Are there any deadlines for submitting Form DWC051?
A: Yes, there are deadlines for submitting Form DWC051. It should be submitted within one year after the date of maximum medical improvement, or within 90 days of receiving notice of eligibility, whichever is later.
Q: What happens after I submit Form DWC051?
A: After you submit Form DWC051, the insurance carrier will review your election and calculate the lump sum payment. If approved, you will receive the payment within a specified timeframe.
Q: Can I change my election after submitting Form DWC051?
A: No, you cannot change your election after submitting Form DWC051. Once your election for a commuted (lump sum) payment is made, it is final.
Q: What if I have questions or need assistance with Form DWC051?
A: If you have questions or need assistance with Form DWC051, you can contact the Texas Department of Insurance or consult with your employer's workers' compensation insurance carrier.
Form Details:
Download a fillable version of Form DWC051 by clicking the link below or browse more documents and templates provided by the Texas Department of Insurance.