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Advisory 2000-09

Notice of New and Revised Forms

The Executive Director, under the authority granted by the Texas Labor Code, 402.042, has revised the following forms:

TWCC-22, Required Medical Examination Notice or Request for Order;

TWCC-31, Application for Commission Approval of Change in Payment Period and /or Purchase of an Annuity for Death Benefits; and

TWCC-65, Private Providers of Vocational Rehabilitation Services.

The Executive Director also adopts the following new forms:

TWCC-35, Application for Commission Approval of the Purchase of an Annuity for Lifetime Income Benefits, in compliance with Commission Rule 131.4; and

TWCC-57, Request for Extension of Maximum Medical Improvement for Spinal Surgery, in compliance with Section 408.104 of the Texas Labor Code.

Although TWCC encourages the immediate use of these new or revised forms, they will be required effective February 1, 2001.

These forms and instructions are available on our Web page at and may be downloaded and copied.

Signed this 8 th day of November 2000

Leonard W. Riley, Executive Director

TWCC Staff
Public Information List
Commission Representatives
Professional Medical Associations