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Workers' Compensation Forms and Notices
Below are links to frequently used workers’ compensation forms and required notices for Texas employers published by theTexas Department of Insurance, Division of Workers’ Compensation.

Although it is acceptable to fill out these forms manually and submit them by fax, Texas Council Risk Management Fund members can fill out and submit the forms electronically through the member section of this web site. Access to the Fund’s online services requires a user ID and password (top of this page). For further information, contact the Fund Administrator at 800-580-6467 or use the “Contact Us” form on the web site.
 
Forms
(Note online filing is available through "members section." Enter ID and password at top of page.)
DWC Form-1 Employer’s First Report of Injury
 
DWC Form-3 Employer’s Wage Statement
 
DWC Form-6 Supplemental Report of Injury
 
 
Employer Notices
Notice 6  Employer's Notice of Workers' Compensation Coverage (Spanish)
[Note: Texas Workers' Compensation Rule 110.101(e)(1) requires employers who are covered by workers' compensation through a commercial insurance company to advise their employees that they do have workers' compensation insurance coverage and to advise their employees of the Texas Department of Insurance, Division of Workers' Compensation's toll free number to obtain additional information about their workers' compensation rights.
 
Notices in English, Spanish and any other language common to the employer's employees must be posted and:
1. Prominently displayed in the employer's personnel office, if any;
2. Located about the workplace in such a way that each employee is likely to see the notice on a regular basis;
3. Printed with a title in at least 26 point bold type, subject in at least 18 point bold type, and text in at least 16 point normal type; and
4. Contain the exact words as prescribed in Rule 110.101(e)(1).]
 
New Employee Notice  Reference Rule 110.101 (Spanish)
[Note:  In addition to the Notice 6 requirements above, all employees must receive an additional notice advising them of their right to elect common law remedies in lieu of their employer's workers' compensation coverage.  Although the notice is required of all Texas employers, it conflicts with  §504.018b of the Texas Labor code requiring all public employees to be covered by workers' compensation. Until the Texas Department of Insurance corrects this conflicting notice, Fund members must provide the notice to new employees. Be sure to explain to the employee that they are covered for workers' compensation and they can not reject the coverage.]
 
Employer's Notice of Ombudsman Program (English and Spanish)
*** This is a new notice to be posted effective after September 1, 2013
[Note: This notice should be posted in locations as Notice 6 above. The document provides instructions.]