• Increase Text Icon
  • Decrease Text Icon
  • Email Icon
  • Print this page
You are here: Home . forms . form20request

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

Division of Workers Compensation Main Forms page

Requests for Workers' Compensation Claim File Information
TDI Form Number Description File FormatLanguage
Request for Copies of Confidential Claimant Information
Rev. 10/06
PDF English
Solicitud para Obtener Copias de la Información Confidencial del Reclamante
Rev. 07/08
PDF English
Request for Record Check
Rev. 10/05
PDF English
Prospective Employment Authorization and Certification
Rev. 10/05
PDF English
Certificación Y Autorización De Un Posible Empleo
Rev. 10/06
PDF Spanish


For more information, contact:

Contact Information and Other Helpful Links