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Workers' Compensation Requests for Workers' Compensation Claim File Information


Division of Workers Compensation Main Forms page

 

English

Requests for Workers' Compensation Claim File Information
Information in or derived from a claim file regarding a Workers' compensation claimant is confidential and may not be disclosed except as provided in the Texas Workers' Compensation Act. Because of the confidential nature of claimant information, REQUESTS FOR CLAIM FILE INFORMATION WILL NOT BE ACCEPTED VIA INTERNET E-MAIL OR FAX. The following forms for requesting confidential claimant information can be downloaded from this website. These request forms may be hand-delivered or submitted via mail to:

Texas Department of Insurance, Division of Workers' Compensation
7551 Metro Center Drive, MS-92B
Austin, Texas 78744-1609
TDI Form NumberDescriptionFile Format
DWC153 Request for Copies of Confidential Claimant Information
Rev. 10/06
PDF
DWC155 Request for Record Check
Rev. 10/05
PDF
DWC156 Prospective Employment Authorization and Certification
Rev. 10/05
PDF

En Español

Requests for Workers' Compensation Claim File Information
Número del Formulario de TDIDescripciónFormato del Archivo
DWC153s Solicitud para Obtener Copias de la Información Confidencial del Reclamante
Rev. 07/08
PDF
DWC156S Certificación Y Autorización De Un Posible Empleo
Rev. 10/06
PDF

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Translation by WorldLingo


Translation by WorldLingo