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This document is a request to adjust the average weekly wage for a seasonal employee, submitted by the employer's insurance carrier to the Division of Workers' Compensation in Texas. It includes instructions

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How to fill out request to adjust average

How to fill out REQUEST TO ADJUST AVERAGE WEEKLY WAGE FOR SEASONAL EMPLOYEE (DWC Form-055)

01

Obtain the DWC Form-055 from the official website or your employer's HR department.

02

Fill in the employee's personal information, including name and contact details.

03

Provide the employee’s seasonal job title and description of duties performed.

04

Indicate the dates of employment for the season and the average number of hours worked weekly.

05

Calculate the average weekly wage based on the hours worked and the pay received during the season.

06

Document any previous average weekly wage determinations if applicable.

07

Sign and date the form to certify the accuracy of the information provided.

08

Submit the completed form to your employer or the appropriate department for processing.

Who needs REQUEST TO ADJUST AVERAGE WEEKLY WAGE FOR SEASONAL EMPLOYEE (DWC Form-055)?

01

Seasonal employees who have had a change in their average weekly wage due to changes in work hours or pay.

02

Employers managing seasonal workers needing to adjust wage information for compensation purposes.

03

Workers' compensation representatives who oversee wage calculations for seasonal employment.

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What is REQUEST TO ADJUST AVERAGE WEEKLY WAGE FOR SEASONAL EMPLOYEE (DWC Form-055)?

The REQUEST TO ADJUST AVERAGE WEEKLY WAGE FOR SEASONAL EMPLOYEE (DWC Form-055) is a form used to adjust the average weekly wage for seasonal employees to ensure that compensation reflects their actual earnings during work periods.

Who is required to file REQUEST TO ADJUST AVERAGE WEEKLY WAGE FOR SEASONAL EMPLOYEE (DWC Form-055)?

Employers of seasonal employees are required to file the REQUEST TO ADJUST AVERAGE WEEKLY WAGE FOR SEASONAL EMPLOYEE (DWC Form-055) to appropriately calculate workers' compensation benefits.

How to fill out REQUEST TO ADJUST AVERAGE WEEKLY WAGE FOR SEASONAL EMPLOYEE (DWC Form-055)?

To fill out the DWC Form-055, provide accurate information regarding the employee's earnings, hours worked, seasonality of the job, and other relevant details as specified in the form's instructions.

What is the purpose of REQUEST TO ADJUST AVERAGE WEEKLY WAGE FOR SEASONAL EMPLOYEE (DWC Form-055)?

The purpose of the form is to recalculate the average weekly wage for seasonal employees so that their compensation during periods of injury or disability reflects their actual earnings.

What information must be reported on REQUEST TO ADJUST AVERAGE WEEKLY WAGE FOR SEASONAL EMPLOYEE (DWC Form-055)?

The information that must be reported includes the employee's wage history, work periods, job duties, and any adjustments necessary to determine the accurate average weekly wage.

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