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*New Employee Notice of Coverage for Political Subdivisions
*Please note that per Sec. 504.018(b), employees of a political subdivision are conclusively considered to have accepted the compensation provisions instead of common law or statutory liability or cause of action, if any, for injuries received in the course of employment or death resulting from injuries received in the course of employment. Therefore, Rule 110.101(s)(5), advising employers to inform new employees of their rights to retain their common law right of action does not apply to political subdivisions. This "New Employee Notice" is written specifically for political subdivisions, with the correct information. |
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Employer Required DWC Postings |
| DWC Notice 6, Notice to Employees Concerning Workers' Compensation in Texas |
PDF |
English |
| DWC Notice 6, Notice to Employees Concerning Workers' Compensation in Texas |
PDF |
Spanish |
| DWC Notice 8, Required Workers' Compensation Coverage (building or construction projects for governmental entities) |
PDF |
English |
| DWC Notice 9, Notice Regarding Certain Work-Related Communicable Disease and Eligibility for Workers' Compensation Benefits |
PDF |
English |
| Office of Injured Employee Counsel (OIEC) Ombudsman Program Notice |
PDF |
English/ Spanish |
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Sample Documents and DWC Forms |
| Medical Release of Information |
DOC |
English |
| Forma Médica del Lanzamiento |
DOC |
Spanish |
| Network Acknowledgement Form |
DOC |
English |
| Notice of Injured Employee Rights and Responsibilities in the Texas WC System |
PDF |
English Spanish Chinese Vietnamese Korean |
| DWC 1, Employer's First Report of Injury |
PDF |
English |
| DWC 2, Employer's Report for Reimbursement of Voluntary Payment |
PDF |
English |
| DWC 3, Employer's Wage Statement |
PDF |
English |
| DWC 3S, Declaracíon de Salario del Empleador |
PDF |
Spanish |
| DWC 3ME, Employee's Multiple Employment Wage Statement |
PDF |
English |
| DWC 3MES, Declaracíon de Salario de Múltiples Trabajos de Empleado |
PDF |
Spanish |
| DWC 3SD, Employer's Wage Statement for School Districts |
PDF |
English |
| DWC 3SDS, Declaracíon de Salario Para Escuelas de Distrito |
PDF |
Spanish |
| DWC 4, Employer's Contest of Compensability |
PDF |
English |
| DWC 6, Supplemental Report of Injury |
PDF |
English |
| DWC 47, Employee's Request for Advance of Benefits |
PDF |
English |
| DWC 48, Request for Travel Reimbursement/Solicitud de Reembolso |
PDF |
English/ Spanish |
| DWC 53, Employee Request to Change Treating Doctor |
PDF |
English |
| DWC 73, Work Status Report |
PDF |
English |
| DWC 74, Description of Injured Employee's Employment |
PDF |
English |