Upon receipt of your completed DWC Form-041, or other notice of your injury, the Division will create a claim and establish a DWC claim number for you, and the Division will mail information regarding workers’ compensation in Texas to you.

Employee's Claim for Compensation for a Work-Related Injury or Occupational Disease (DWC Form-041) Claim for workers’ compensation must be filed by the injured employee or by a person acting on the injured employee’s behalf within one year of the date of injury or within one year from the date the injured employee knew or should have known ...

2023年3月3日 · Full listing of forms and notices by number Draft forms Agreement forms Carrier forms Employee forms Employer forms and notices Health & safety forms Health care provider/medical forms Other business forms Plain language notices Requests for workers' compensation claim file information

2024年12月12日 · Report the injury or illness to your employer. DWC will send you a packet with these documents: Notice of injury letter (CS-41) DWC Form-041, Employee's Claim for Compensation for a Work-Related Injury or Occupational Disease Injured employee rights and responsibilities Return-to-work information Injured employee checklist

2023年1月24日 · You must also submit a completed DWC Form-041, Employee's Claim for Compensation for a Work-Related Injury or Occupational Disease, to the DWC within one year of the date you were hurt.

Employee's Claim for Compensation for a Work-Related Injury or Occupational Disease (DWC Form-041) Claim for workers’ compensation must be filed by the injured employee or by a person acting on the injured employee’s behalf within one year of the date of injury or within one year from the date the injured employee knew or should have known ...

A DWC Form 041 is a legal document in Texas to allow injured workers to file a claim for compensation for a work-related injury. The Division of Workers Compensation Department often requires this form and serves as a claim for wage replacement benefits, medical coverage, and other compensation claims.

Today, we’re going to discuss a form that many of you will and should have filled out, if you are reporting that you have been injured on the job in Texas. This form number is DWC-041. […]

Employee's Claim for Compensation for a Work-Related Injury or Occupational Disease (DWC Form-041) Claim for workers’ compensation must be filed by the injured employee or by a person acting on the injured employee’s behalf within one year of the date of injury or within one year from the date the injured employee knew or should ...