Workers Compensation Forms for all 50 States | State Forms and Information | Claimwire: Workers' Compensation Resource for Forms and Information

Register Login

Texas Forms

247 State Forms found

name	number	revision	print or send online
Subsequent Injury Fund Reimbursement Request Form - Refund of Death Benefits	DWC096	Rev. 01/2021
Subsequent Injury Fund Reimbursement Request Form - Multiple Employment	DWC097	Rev. 01/2021
Subsequent Injury Fund Reimbursement Request Form - Pharmaceutical	DWC098	Rev. 01/2021
Designation of administrative services company administrator	DWC120	Rev. 03/22
Injury and Illness Prevention Plan Guide	HS96-103E	(8-2019)
Notice of Continuing Investigation - EDI	PLN-14	Rev. 07/23
Notice of Continuing Investigation (Spanish) - EDI	PLN-14-Spanish	07/23
Claim Administration Contact Information	DWC121	Rev. 03/20
Notice of First Payment of Income Benefits on an Acquired Claim - EDI	PLN-2B	Rev. 07/23
Notice of First Payment of Income Benefits on an Acquired Claim (Spanish) - EDI	PLN-2B-Spanish	Rev. 07/23
Notice of Lump Sum Payment of Income or Death Benefits - EDI	PLN-10B	Rev. 07/23
Notice of Lump Sum Payment of Income or Death Benefits (Spanish) - EDI	PLN-10B-Spanish	Rev. 07/23
Notice of Reinstatement of Indemnity Benefits - EDI	PLN-10A	Rev. 07/23
Notice of Reinstatement of Indemnity Benefits (Spanish) - EDI	PLN-10A-Spanish	Rev. 07/23
Notice of First Temporary Income Benefit Payment - EDI	PLN-2A	Rev. 07/21

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.

Loading results ...

Origami Risk

1379 N 1075 W, Suite 226,
Farmington, UT 84025
312.546.6515
info@origamirisk.com

© 2025 Origami Risk. All Rights Reserved.