REQUEST FOR RECORD CHECK OR COPIES OF CONFIDENTIAL CLAIM INFORMATION Forms
| Form Name | REQUEST FOR RECORD CHECK OR COPIES OF CONFIDENTIAL CLAIM INFORMATION |
| Form # | DWC153 |
| Form Revision | Rev. 02/21 |
| Category | Forms » Legal/Fraud |
| Downloads | |
| Form State | Texas |
| Language | English |
| State Description | (Rev. 10/06) - Effective September 1, 2006, requests for a claim file, medical dispute resolution file, and/or an indemnity resolution file must be made on the newly revised DWC-153 form (10/2006). A |
| Claimwire Description | n/a |