Form DWC053 Employee Request to Change Treating Doctor - Texas

What Is Form DWC053?

This is a legal form that was released by the Texas Department of Insurance - Division of Workers' Compensation - 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 DWC053?
A: Form DWC053 is an Employee Request to Change Treating Doctor form in Texas.

Q: What is the purpose of Form DWC053?
A: The purpose of Form DWC053 is to request a change of treating doctor for an employee in Texas.

Q: Who can use Form DWC053?
A: Form DWC053 is used by employees who want to change their treating doctor in Texas.

Q: How do I fill out Form DWC053?
A: You need to provide your personal information, reason for the request, and the name of the new treating doctor.

Q: Is there a deadline to submit Form DWC053?
A: Yes, you must submit Form DWC053 within 90 days of the injury or the date of the last medical treatment.

Q: What happens after I submit Form DWC053?
A: Once you submit Form DWC053, the Texas Department of Insurance will review your request and make a decision.

Q: Can my request to change treating doctor be denied?
A: Yes, the Texas Department of Insurance may deny your request if they determine it is not justified.

Q: Can I appeal the decision if my request is denied?
A: Yes, you can appeal the decision by requesting a benefit review conference with the Texas Department of Insurance.

Q: Is there a fee to submit Form DWC053?
A: No, there is no fee to submit Form DWC053.