Texas Department of Insurance - Division of Workers' Compensation Forms

The Texas Department of Insurance - Division of Workers' Compensation is responsible for regulating and overseeing the state's workers' compensation system. Their main objective is to ensure that injured workers receive appropriate medical care and necessary benefits, while also promoting workplace safety and reducing the incidence and cost of occupational injuries and illnesses in Texas. They handle complaints, enforce compliance with workers' compensation laws, and provide assistance and resources to employers, workers, healthcare providers, and insurance carriers involved in the workers' compensation system.

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Documents:

123

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This form is used for requesting reimbursement for travel expenses incurred in Texas.

This form is used for employers in Texas to report and request reimbursement for voluntary payments made to injured employees.

This Form is used for employers in Texas to report an employee's injury or illness to the Division of Workers' Compensation.

This form is used for reporting additional information about an injury in Texas workers' compensation cases.

This Form is used for settling benefit disputes in Texas workers' compensation cases.

This form is used for designating authorized representatives for an individual or organization in Austin, Texas.

This form is used for requesting reimbursement from a health care insurer in Texas for a payment made. Fill out the DWC026 form to request reimbursement.

This Form is used for requesting a hearing to dispute medical benefits or to have a hearing at the State Office of Administrative Hearings (SOAH) in Texas.

This form is used for requesting a medical contested case or SOAH (State Office of Administrative Hearings) hearing in Texas.

This form is used to request a reimbursement for travel expenses in Texas. It is written in Spanish.

This Form is used for reporting pharmacy services in the state of Texas.

Este formulario se utiliza para que un empleado solicite un cambio de médico de tratamiento en Texas.

This form is used for requesting a medical fee dispute resolution in Texas. It is for individuals who have a dispute with their medical provider or insurance company over the amount of a medical fee.

This Form is used for submitting a written request for an interlocutory order in the state of Texas. It is used to request a court order that addresses a specific issue during the course of a legal proceeding before a final judgment is made.

This form is used for requesting a medical interlocutory order in the state of Texas. It allows individuals to request a court order related to medical treatment or services.

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