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 247 State Forms found

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NOTICE TO EMPLOYEES CONCERNING WORKERS' COMPENSATION IN TEXAS (Notice 6) (Spanish)

 Notice 6 (01/13)

NOTICE TO EMPLOYEES CONCERNING WORKERS' COMPENSATION IN TEXAS (Notice 7)

 Notice 7 (01/13)

NOTICE TO EMPLOYEES CONCERNING WORKERS' COMPENSATION IN TEXAS (Notice 7) (Spanish)

 Notice 7 (01/13)

NOTICE TO EMPLOYEES CONCERNING WORKERS' COMPENSATION IN TEXAS (Notice 10)

 Notice 10 (01/13)

NOTICE TO EMPLOYEES CONCERNING WORKERS' COMPENSATION IN TEXAS (Notice 10) (Spanish)

 Notice 10 (01/13)

Governmental Entity Coverage Information

 DWC020SI Rev. 08/24

Request for designated doctor examination

 DWC032 Rev. 11/24

Request for designated doctor examination (Spanish)

 DWC032S Rev. 11/24

Designated doctor certification application

 DWC067 Rev. 04/23

Designated doctor examination data report

 DWC068 Rev. 06/23

Request for a lump sum payment of impairment income benefits (IIBs) (Spanish)

 DWC051S Rev. 06/23

Request to extend the date of maximum medical improvement for an approved spinal surgery

 DWC057 Rev. 06/23

Employee's Claim for Compensation for a Work-Related Injury or Occupational Disease

 DWC041 Rev. 03/07

Claim for Workers' Compensation Death Benefits

 DWC042 Rev. 12/23

Request for a Review by an Independent Review Organization (IRO) (Spanish)

 LHL009 0824
Disclaimer: These forms may not be the most recent version. Texas may have more current or accurate information. We make no warranties or guarantees about the accuracy, completeness, or adequacy of the information contained on this site or the information linked to on this site. Please check official sources.
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