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Begin with Section I: Insurance Carrier Information. Fill in the Insurance Carrier’s Name, Group Affiliation (if applicable), and Primary Mailing Address. Ensure you include the Federal Employer ID Number (FEIN) and TXCOMP Customer ID Number if known.
Proceed to Section II: Austin Representative Information. Enter the Austin Representative’s full name, mailing address, organization name, email address, telephone number, fax number, FEIN, and TDI-DWC Box Number if applicable.
In Section IV: Insurance Carrier Affirmation, ensure that the authorized person signs to confirm their authority to act on behalf of the insurance carrier. Include the printed name, date of signature, and coordinator's telephone number.

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What happens if your employer doesnt have workers comp in Texas?

Texas law allows injured employees to file a personal injury lawsuit against non-subscribing employers (those who do not carry workers comp). You may be eligible for compensation for medical expenses, lost wages, pain and suffering, and other damages.

What qualifies for workers comp in Texas?

Injured workers in Texas are eligible for temporary income benefits when they have lost money from a job for more than seven days due to a work-related injury. Those days do not have to be in the same week or consecutive. Temporary benefits amount to 70 or 75% of what the workers average weekly wage before the injury.

How to file for workers compensation in Texas?

Send a completed claim form (DWC Form-041) to the Texas Department of Insurance, Division of Workers Compensation (TDI-DWC) within one (1) year of the date of injury or date you learned of an illness related to your occupation The form and instructions are at Workers Compensation Employee Forms, or call TDI-DWC at

How long does it take to get approved for workers comp in Texas?

Processing Time for Workers Compensation Claims Generally, the Texas Department of Insurance Division of Workers Compensation aims to process workers compensation claims within 30 days of receiving all necessary documentation.

How to file a workers comp complaint in Texas?

You can file a written complaint with the TDI-DWC in several ways. Complete and submit the form online at .tdi.texas.gov/consumer/complfrm.html. Electronic correspondence with any TDI-DWC employee. Written correspondence to the TDI-DWC, 7551 Metro Center Drive, Suite 100, MS-8, Austin, Texas 78744-1645.