WebNext, download the correct workers’ compensation employee form. It is likely Form DWC041, titled “Employee’s Claim for Compensation for a Work-Related Injury or Occupational Disease.” Fill out the form in its entirety, … Web252-7031. Information about DWC is available on the Internet at: www.tdi.texas.gov. Your Rights in the Texas Workers’ Compensation System: 1. You have the right to hire an attorney to help you with your workers’ compensation claim. For assistance locating an attorney, contact the State Bar of Texas’ lawyer referral service at 1-877-983 ...
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Web2818 S. Business Hwy 281 • Edinburg, Texas 78539 • (956) 318-2660 RECORD ONLY MEDICAL EMPLOYEE INCIDENT/INJURY REPORT LOSS TIME Employee’s Name: Incident Date: ... For a copy of the DWC041 form you may contact DWC or OIEC. 6. You have the responsibility to provide your current address, telephone number, and employer … WebUpon receipt of your completed DWC Form-041, or other notice of your injury, the Division will create a claim and establish a DWC claim number for you, and the Division will mail information regarding workers’ compensation in Texas to you. The Division will also notify your employer and the employer’s workers’ compensation insurance carrier. can landlords turn off heat
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WebClaim for Compensation for a Work-Related Injury or Occupational Claim Form (DWC041) to DWC. You have one year to send the form after you were injured or first knew that your illness might be work-related. Send the completed DWC041 form even if you already are receiving benefits. WebOIEC。其他資訊,包括辦公室地點可上網站www.oiec.texas.gov 查閱。您可以撥打免費電話1-800-252-7031聯絡 DWC。 ... 您有責任向 DWC 遞交「僱員工傷及職業病補償索賠表」 (DWC041) 。 自受傷或最初暸解您的傷病可能與工作有關之日起,您可以在一年遞交 DWC041表。 ... Webthe completed DWC041 form even if you already are receiving benefits. You may lose your right to benefits if you do not timely send the completed claim form to DWC. For a copy of the DWC041 form you may contact DWC or OIEC. You have the responsibility to provide your current address, telephone number, and employer information to fix a referral was returned from the server