TX DWC Form-73 2018 free printable template

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

How to fill out TX DWC Form-73

How to fill out TX DWC Form-73

1. Obtain a copy of the TX DWC Form-73 from the Texas Department of Workers' Compensation website or office.
2. Fill in the employee's information, including full name, address, and date of birth in the designated fields.
3. Provide details about the injury, including the date and circumstances of the incident.
4. Include information about the employer, such as the business name and address.
5. Indicate whether the employee has sought medical treatment and, if so, provide the details of the healthcare provider.
6. Review the completed form for accuracy and completeness before submission.
7. Submit the form to the appropriate authority as indicated in the instructions.

Who needs TX DWC Form-73?

1. Employees who have sustained a work-related injury and are seeking benefits.
2. Employers who need to document an employee's claim for workers' compensation.
3. Insurance carriers that require documentation to process the claim.

Instructions and Help about TX DWC Form-73

One the library has a thousand books how many books are there to the weatherman says it will freeze tonight what does he mean three Berries went to a technical school for six months how long did he attend school for he's a new student when did he arrive five the sergeant said smoking is allowed in this room what did he say six the price tag on this shirt is correct seven the doctor told Kim to eat more vegetables eight that person is an expert driver nine sergeants Fischer's condition is good ten Jacks wants to send a money order to his parents 11 have a nice weekend 12 he told me to maintain my speed what should I do 13 the teacher made two points clear what did the teacher make clear 14 Mr Roberts is a strict person what kind of person is he 15 what is the pipe made of 16 can you tell me who that individual is 17 this machine can finish the job in an instant how soon can it do the job 18 John looked in a mirror what did he see 19 I want a variety of colored pencils what do I want 20 what is the highest part of a room 21 the woman kept her diamonds in a safe why 22 the pilot took off in the new jet what did he do 23 Alberta was caught in the rain without her raincoat she got wet all over how wet did she get 24 I'm using this pen 25 the commander says he approves of the plan 26 this book is a reprint of an old book 27 please answer the call for me 28 Jane ended up at the top of her class 29 in the United States which of these meals is usually eaten in the evening 30 I need someone to substitute for me who can I get there 31 the mechanic attached the part to the engine what did he do with the part 32 she wrote very good stories about people how well did she write 33 when the instructor talked about some real problems what kind of problems did he have in mind 34 the design is simple what is simple 35 what is the exact time of departure 36 Dave told us to bring the sports equipment what did Dave tell us to bring 37 the results showed a temperature differential what did the results show 38 everyones surprised by Nancy's opinions what surprises them 39 the student found out about the trip yesterday what happened yesterday 40 Louies cut in on the conversation what did she do 41 John speaks English as well as I do 42 it's important to arrive early 43 this office door is marked private 44 there are no exceptions to the rule 45 Tom always wakes up at 7 am 46 is there any advantage in studying English 47 yesterday the wind came from the south, and it was warm today the wind is from the north, and it is cold why is it cold today 48 when he jumped from the fence Peter tore his trousers 49 here is a level place to have our picnic 50 we captured three of the enemy's fighter planes 51 the foreign student had to get used to the new customs 52 Bob gave the woman a fleeting look 53 this meat is rancid 54 what are you going to use that trailer for 55 Mrs Jackson remained inconsolable for a long time after the accident 56 MS Simpson is impartial 57 do you know Jim...

People Also Ask about

What is a DWC 3 wage statement in Texas?

Initial Amended EMPLOYER'S WAGE STATEMENT (DWC Form-003) The Texas Workers' Compensation Act and Workers' Compensation rules require an employer to provide an Employer's Wage Statement to its workers' compensation insurance carrier (carrier) and the claimant or the claimant's representative, if any.

What is a DWC court?

At the Division of Workers' Compensation's (DWC) 22 district offices plus satellites located around the state, sometimes called WCABs, employers, injured workers and others receive judicial services to assist in the prompt and fair resolution of disputes that sometimes arise from workers' compensation claims.

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.

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.

What is a DWC notice?

Division of Workers' Compensation Notice to Employees--Injuries Caused By Work. You may be entitled to workers' compensation benefits if you are injured or become ill because of your job. Workers' compensation covers most work-related physical or mental injuries and illnesses.

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What is TX DWC Form-73?

TX DWC Form-73 is a form used in the Texas workers' compensation system for reporting injuries that occur in the workplace and filing necessary information for claims.

Who is required to file TX DWC Form-73?

Employers are required to file TX DWC Form-73 when a work-related injury occurs that may lead to a workers' compensation claim.

How to fill out TX DWC Form-73?

To fill out TX DWC Form-73, employers must provide details about the injured employee, the nature of the injury, circumstances surrounding the event, and any previously reported claims related to that employee.

What is the purpose of TX DWC Form-73?

The purpose of TX DWC Form-73 is to provide a standardized method for employers to report workplace injuries to the Texas Department of Insurance and facilitate worker's compensation claims.

What information must be reported on TX DWC Form-73?

The information that must be reported on TX DWC Form-73 includes the employee's details, injury specifics, date and time of the incident, nature of the injury, and any necessary witness information.