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Form DWC096 Subsequent Injury Fund Reimbursement Request Form - Refund of Death Benefits - Texas
What Is Form DWC096?
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 the Form DWC096?
A: Form DWC096 is the Subsequent Injury Fund Reimbursement Request Form.
Q: What is the purpose of Form DWC096?
A: The purpose of Form DWC096 is to request a refund of death benefits from the Subsequent Injury Fund in Texas.
Q: Who can use Form DWC096?
A: Form DWC096 can be used by individuals or entities who are seeking a refund of death benefits from the Subsequent Injury Fund in Texas.
Q: What does the Subsequent Injury Fund do?
A: The Subsequent Injury Fund in Texas provides refunds of death benefits for certain workers' compensation cases.
Form Details:
- Released on January 1, 2021;
- The latest edition provided by the Texas Department of Insurance - Division of Workers' Compensation;
- Easy to use and ready to print;
- Quick to customize;
- Compatible with most PDF-viewing applications;
- Fill out the form in our online filing application.
Download a fillable version of Form DWC096 by clicking the link below or browse more documents and templates provided by the Texas Department of Insurance - Division of Workers' Compensation.
Download Form DWC096 Subsequent Injury Fund Reimbursement Request Form - Refund of Death Benefits - Texas
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