Get the free Revised DWC Form-073, Work Status Report. Revised DWC Form-073, Work Status Report

To:Texas Workers Compensation Insurance CarriersFrom: Kara Mace, Deputy Commissioner, Legal Services Date: February 4, 2022, RE:Revised DWC Form073, Work Status Reportage Texas Department of Insurance,

How to fill out revised dwc form-073 work

How to fill out revised dwc form-073 work

1. To fill out the revised DWC Form-073 work, follow these steps:
2. Start by providing the injured worker's personal information, including their full name, address, and contact details.
3. Next, indicate the date of injury and the time it occurred.
4. Specify the body part(s) affected by the injury.
5. Describe in detail how the injury occurred and provide any additional relevant information.
6. Provide information about the injured worker's employment, such as their job title, wages, and employer's details.
7. Indicate if the injured worker has returned to work, and if so, provide details about their current work status.
8. Attach any supporting documents, such as medical reports or witness statements, if necessary.
9. Review the completed form for accuracy and make any necessary corrections.
10. Sign and date the form to certify its authenticity.
11. Keep a copy of the filled-out form for your records.
12. Remember to follow any specific instructions or guidelines provided by the relevant authorities or your employer when filling out the form.

Who needs revised dwc form-073 work?

1. Any injured worker who wishes to report a work-related injury or illness needs to fill out the revised DWC Form-073 work. This form is essential for initiating the workers' compensation claim process and documenting the details of the injury or illness. It helps both the injured worker and the employer to ensure proper and timely medical treatment and to assess any benefits the injured worker may be entitled to.

For pdfFiller’s FAQs

How do I execute revised dwc form-073 work online?

pdfFiller has made it easy to fill out and sign revised dwc form-073 work. You can use the solution to change and move PDF content, add fields that can be filled in, and sign the document electronically. Start a free trial of pdfFiller, the best tool for editing and filling in documents.

Can I create an electronic signature for signing my revised dwc form-073 work in Gmail?

With pdfFiller's add-on, you may upload, type, or draw a signature in Gmail. You can eSign your revised dwc form-073 work and other papers directly in your mailbox with pdfFiller. To preserve signed papers and your personal signatures, create an account.

How do I fill out revised dwc form-073 work using my mobile device?

The pdfFiller mobile app makes it simple to design and fill out legal paperwork. Complete and sign revised dwc form-073 work and other papers using the app. Visit pdfFiller's website to learn more about the PDF editor's features.

What is revised dwc form-073 work?

Revised DWC Form-073 is a form used to report work-related injuries and illnesses to the Division of Workers' Compensation.

Who is required to file revised dwc form-073 work?

Employers are required to file Revised DWC Form-073 for any work-related injury or illness that results in lost time from work or medical treatment beyond first aid.

How to fill out revised dwc form-073 work?

Revised DWC Form-073 must be completed with details of the injury or illness, including the date of the incident, nature of the injury, and medical treatment received.

What is the purpose of revised dwc form-073 work?

The purpose of Revised DWC Form-073 is to track and report work-related injuries and illnesses to ensure proper medical treatment and compensation for affected employees.

What information must be reported on revised dwc form-073 work?

Information such as employee's personal details, employer information, date and time of injury, description of the incident, medical treatment received, and any lost time from work must be reported on Revised DWC Form-073.