TX DWC Form-73 2005 free printable template
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Employee You are required to report your injury to your employer within 30 days if your employer has workers compensation insurance. You have the right to free assistance from the Texas Department
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How to fill out TX DWC Form-73
How to fill out TX DWC Form-73
01
Obtain the TX DWC Form-73 from the Texas Department of Workers' Compensation website or your employer.
02
Fill in your personal information including your name, address, and contact details at the top of the form.
03
Provide details of your injury, including the date of injury and description of how it occurred.
04
Indicate the specific benefits you are claiming, such as medical benefits or wage loss benefits.
05
Fill in the details of your treating doctor, including their name, address, and phone number.
06
Include any additional information required in the relevant sections of the form.
07
Review the completed form for accuracy and completeness.
08
Sign and date the form at the designated section.
09
Submit the completed form to the appropriate claims office as instructed.
Who needs TX DWC Form-73?
01
Anyone who has sustained a work-related injury in Texas and is seeking benefits under workers' compensation.
02
Employers who need to report an employee's injury to the Texas Department of Workers' Compensation.
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People Also Ask about
Does workers comp pay for time off for doctors appointments in Texas?
If an employee gets sick or injured at work, workers' comp benefits pay for medical expenses related to the resulting injury. Those expenses include doctors' visits, medical tests (e.g. x-rays, blood tests), rehabilitation, emergency room care, hospital stays, and in some cases, even transportation costs.
Who is exempt from workers compensation insurance in Texas?
However, there are exclusions to this rule for some employers listed below: Any public employer including cities, counties, state agencies and state universities. Building and construction contractors for public employers. Motor bus companies and motor carriers.
Does workers comp pay for time off for physical therapy in Texas?
Physical Therapy Under Workers' Comp Under workman's compensation laws in the state of Texas for those who have opted to provide this to their employees, the employer is required to shoulder the costs of physical therapy if the treatment is associated with a work-related injury.
Is it mandatory to have workers compensation in Texas?
Texas Law. Requires all employers, with or without workers' compensation insurance coverage, to comply with reporting and notification requirements under the Texas Workers' Compensation Act. Provides for reimbursement of medical expenses and a portion of lost wages due to a work-related injury, disease, or illness.
What is a DWC 7 form?
DWC-7 Notice to Employees-Injuries Caused by Work (English and Spanish). This form provides your employees with information regarding workers' compensation benefits and the Medical Provider Network (MPN) in California.
Do I have to use PTO for workers comp in Texas?
Can My Employer Make Me Use PTO? If you were hurt in a workplace accident and are entitled to workers' compensation, your employer cannot legally require you to use your PTO instead of utilizing the workers' compensation benefits.
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What is TX DWC Form-73?
TX DWC Form-73 is a document used in Texas for reporting workers' compensation claims. It is specifically utilized to provide information regarding the injured employee's condition and the treatment being provided.
Who is required to file TX DWC Form-73?
The form is typically required to be filed by healthcare providers who are treating injured workers under the Texas workers' compensation system.
How to fill out TX DWC Form-73?
To fill out TX DWC Form-73, healthcare providers need to provide patient information, details of the injury, treatment rendered, and any other relevant information as prescribed on the form.
What is the purpose of TX DWC Form-73?
The purpose of TX DWC Form-73 is to document and report the medical treatment and progress of an injured worker, ensuring compliance with workers' compensation laws in Texas.
What information must be reported on TX DWC Form-73?
The information that must be reported includes the injured worker's name, date of injury, diagnosis, treatment provided, progress notes, and any referrals made as part of the medical care.
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