Dwc form 73 2026

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The document outlines the requirements for employees in Texas to report workplace injuries to their employer within 30 days if the employer has workers' compensation insurance. It details the rights of injured employees to receive free assistance from the Texas Department of Insurance, Division of Workers' Compensation (DWC), and potential medical and income benefits. Additionally, it includes a Work Status Report form (DWC Form-073) that must be completed by healthcare providers regarding the employee's work status and any activity restrictions due to the injury.

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Click ‘Get Form’ to open the DWC Form 73 in the editor.
Begin by filling in the 'General Information' section. Enter the date sent, doctor’s name, and the injured employee's details including their name, date of injury, and last six digits of their Social Security Number.
In the 'Work Status Information' section, indicate whether the employee can return to work without restrictions, with restrictions, or if they are unable to return. Fill in estimated dates and provide a description if applicable.
If there are activity restrictions, complete the relevant fields under 'Activity Restrictions'. Specify posture, motion, lift/carry restrictions as necessary.
Complete the 'Treatment/Follow-Up Appointment Information' section by providing details about follow-up services and expected appointments.
Finally, ensure all required signatures are included before saving or sending your completed form.

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