TX DWC048 2016 free printable template
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DWC048 Complete if known DWC Claim Carrier Claim Request to Get Reimbursed for Travel Costs Este formulario est disponible en espa ol en el sitio web de la Divisi n en http //www. tdi. texas. gov/forms/dwc/dwc048trvlreims. pdf. Para obtener asistencia en espa ol llame a la Divisi n al 800-252-7031. 11. Sign here 12. Date DWC048 Rev. 02/16 Page 1 of 2 Administrative Code TAC 134. 110 f. You may complete Section D or use your own form and send a copy to the injured employee and the injured...
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How to fill out TX DWC048
How to fill out TX DWC048
01
Obtain the TX DWC048 form from the Texas Department of Workers' Compensation website.
02
Fill in the worker's name, address, and phone number in the appropriate fields.
03
Provide the employer's name, address, and account number as requested.
04
Indicate the date of injury and describe the nature of the injury or illness.
05
List any medical treatments provided to the injured worker.
06
Ensure that all information is accurate and complete before submitting.
07
Sign and date the form, and keep a copy for your records.
08
Submit the completed TX DWC048 form to the appropriate insurance carrier.
Who needs TX DWC048?
01
Employers who have employees that have sustained work-related injuries or illnesses.
02
Injured workers who are filing for workers' compensation benefits.
03
Insurance adjusters and legal professionals involved in workers' compensation claims.
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People Also Ask about
What is the Texas state Comptroller mileage rate for 2023?
The State of Texas Comptroller announced that the state mileage reimbursement rate effective January 1, 2023 to December 31, 2023 is 65.5 cents per mile. This is an increase from the January 2022 calendar year rate of 62.5 cents per mile.
How do I file a workers comp claim in Texas?
Call 800-252-7031, option 1. Workers' compensation is an insurance program managed by the State of Texas. It provides pay and medical benefits to employees who have a work-related injury or illness.
What is fair compensation for mileage?
What is the current federal mileage reimbursement rate? The current, 2023 federal mileage rate: 65.5 cents per mile for business purposes. 22 cents per mile for medical and moving purposes.
How much does workers comp reimburse for mileage in Texas?
Effective July 1 – December 31, 2022, the automobile mileage reimbursement rate is 62.5 cents per mile. Effective January 1 – June 30, 2022, the automobile mileage reimbursement rate is 58.5 cents per mile. Grantees may claim reimbursement retroactively for this rate for the effective dates.
How much does Texas workers Comp pay for mileage?
What is the Mileage Reimbursement Rate for 2021? What Does The Rate Change Mean? The new rate means that, regardless of your date of injury, if you incur mileage during the year of 2022, that is reimbursable, you will receive $. 58.5, per mile.
What does Texas workers Comp pay?
Injured workers in Texas are eligible for temporary income benefits when they have lost money from a job for more than seven days due to a work-related injury. Those days do not have to be in the same week or consecutive. Temporary benefits amount to 70 or 75% of what the worker's average weekly wage before the injury.
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What is TX DWC048?
TX DWC048 is a form used in Texas for reporting various information related to workers' compensation claims, specifically focusing on the private health information of injured employees.
Who is required to file TX DWC048?
Employers and insurance carriers are required to file TX DWC048 when they have workers' compensation claims involving injured employees.
How to fill out TX DWC048?
To fill out TX DWC048, one must provide accurate information regarding the injured employee's details, the nature of the injury, medical treatment provided, and any other relevant information as specified in the form's instructions.
What is the purpose of TX DWC048?
The purpose of TX DWC048 is to ensure that accurate and comprehensive information is collected and reported regarding workers' compensation claims, which assists in the administration and oversight of such claims.
What information must be reported on TX DWC048?
The information that must be reported on TX DWC048 includes the injured employee's personal details, injury description, treatment information, employer details, and relevant claim numbers.
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