TDI Forms
Workers' Compensation Forms
This is one of several pages linking to a central repository of forms used by TDI customers. Use the search or Forms by Type links on the Forms Home Page or scan through our form listings.
As of September 1, 2005, the Division of Workers' Compensation (DWC) forms have been renamed. Forms previously titled in the format TWCC-(Form #) are now titled DWC- (Form #). The form numbers have not changed.
If you have questions concerning DWC forms or processes involving the forms, please refer to the Forms Frequently Asked Questions (FAQ).
DWC has provided a Form Developer Kit for stakeholders who develop their own forms. Before using these items, please read the Readme file included. Alternate forms must use DWC specifications and be approved for use by the Division.
DWC is not currently accepting forms submitted electronically.
To order the forms not published on this website, please call Forms Management Customer Services at (512) 804-4240.
Texas Department of Insurance, Division of Workers' Compensation
Open Records
Executive Communication, MS-3
7551 Metro Center Drive
Austin, Texas 78744-1609
open.records@tdi.state.tx.us
Requests for Workers' Compensation Claim File Information | Employer Forms | Carrier Forms | Employee Forms | Medical Forms
| Agreement Forms | Health & Safety Forms | Other Business Forms | Self-Insurance Regulation Forms
Requests for Workers' Compensation Claim File Information
Information in or derived from a claim file regarding a Workers' compensation claimant is confidential and may not be disclosed except as provided in the Texas Workers' Compensation Act. Because of the confidential nature of claimant information, REQUESTS FOR CLAIM FILE INFORMATION WILL NOT BE ACCEPTED VIA INTERNET E-MAIL OR FAX. The following forms for requesting confidential claimant information can be downloaded from this website. These request forms may be hand-delivered or submitted via mail to:
Texas Department of Insurance, Division of Workers' Compensation 7551 Metro Center Drive, MS-92B Austin, Texas 78744-1609 |
DWC-153 |
Request for Copies of Confidential Claimant Information (Rev. 10/06) - Effective September 1, 2006, requests for a claim file, medical dispute resolution file, and/or an indemnity resolution file must be made on the newly revised DWC-153 form (10/2006). A requestor must be eligible by statute to receive the |
PDF |
DWC-155 |
Request for Record Check (Rev. 10/05) |
PDF |
DWC-156 |
Prospective Employment Authorization and Certification (Rev. 10/05) |
PDF |
DWC-156S |
Certificación Y Autorización De Un Posible Empleo (Rev. 10/06) |
PDF |
Employer Coverage Package
New Employee Notice English |
New Employee Notice (covered and non-covered employers shall notify their employees of coverage status, in writing) |
PDF |
New Employee Notice Spanish |
New Employee Notice (covered and non-covered employers shall notify their employees of coverage status, in writing) |
PDF |
Notice 6 English |
Notice to Employees Concerning Workers' Compensation in Texas (must be posted for employees to read) |
PDF |
Notice 6 Rules |
Notice to Employees Concerning Workers' Compensation in Texas
|
PDF |
Notice 6 Spanish |
Notice to Employees Concerning Workers' Compensation in Texas (must be posted for employees to read) |
PDF |
Notice 8 English |
Required Workers' Compensation Coverage (building or construction projects for governmental entities) |
PDF |
Notice 8 Spanish |
Required Workers' Compensation Coverage (building or construction projects for governmental entities) |
PDF |
Notice 9 English |
Notice Regarding Certain Work-Related Communicable Diseases and Eligibility for Workers' Compensation Benefits (law enforcement officers, fire fighters, emergency medical service employees, paramedics, and correctional officers) |
PDF |
Notice 9 Rules |
Notice Regarding Certain Work-Related Communicable Diseases and Eligibility for Workers' Compensation Benefits (law enforcement officers, fire fighters, emergency medical service employees, paramedics, and correctional officers) |
PDF |
Notice 9 Spanish |
Notice Regarding Certain Work-Related Communicable Diseases and Eligibility for Workers' Compensation Benefits (law enforcement officers, fire fighters, emergency medical service employees, paramedics, and correctional officers) |
PDF |
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For more information contact: Webstaff@tdi.state.tx.us