DWC Form-022, Request for a required medical examination (RME) 2025

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Submit the DWC-1 to your employer Your Supervisor/HR Representative is then required to complete the Employer section of the form and return a signed copy to you within one working day.
A designated doctor (DD) is a doctor or health care provider selected and trained by DWC to resolve questions about an injured employees medical condition; or a dispute about a work-related injury or illness. The injured employee, the employees representative, or insurance carrier, or DWC can request a DD exam.
REQUIRED MEDICAL EXAMINATION: A Required Medical Examination (RME) may be requested by the Texas Department of Insurance Division of Workers Compensation (TDI-DWC) or the insurance carrier. An RME is a medical examination to resolve questions about the workers compensation claim.
The Division of Workers Compensation (DWC) monitors the administration of workers compensation claims, and provides administrative and judicial services to assist in resolving disputes that arise in connection with claims for workers compensation benefits.
What You Shouldnt Tell Your Workers Comp Doctor Never lie about prior injuries, pre-existing conditions, or medical history. Never lie about the extent of your workplace injury or how it happened. Do not exaggerate your symptoms, including pain or functionality.
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The document is a Report of Medical Evaluation (DWC Form-069) used by the Texas Department of Insurance, Division of Workers Compensation. It outlines the process for certifying an injured employees Maximum Medical Improvement (MMI) and any permanent impairment resulting from a work-related injury.
Form DWC 1 is the official form that California businesses and employees use to file a workers compensation claim. The employee fills out a portion of the form, and the employer fills out the remainder. The employer then sends the completed form to their workers comp insurance company in order to file a claim.

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