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Texas Department of Insurance
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Advisory 99-01

Notice of Form Revision and Fee Requirement

The Executive Director, under the authority granted by the Texas Labor Code, Section 402.042 hereby adopts:

Form number TWCC-156, Prospective Employment Authorization and Certification (Revised 1/99) for use before the Commission on or after May 1, 1999. The revised form and instructions for use of the new form are attached. The revisions include the request for the employer's telephone number and notification of a $2.00 fee.

The TWCC Fee Schedule including the $2.00 fee per each Pre Employment check was adopted on November 5, 1998 by TWCC Commissioners.

The Texas Workers' Compensation Commission does not require an employer to use this service. However, if a Texas employer who carries workers' compensation insurance coverage chooses to, the revised form must be submitted with the $2.00 fee when requesting information available to prospective employers on the prior injuries of an applicant for employment.

Form TWCC-156 must be signed and notarized by the applicant and the employer. The instructions for completion are on the back of the form. The current version of the TWCC-156 (Revised 7/95) form will be accepted until April 30, 1999. Questions concerning the submission of the form should be directed to the telephone number in the instructions.

An English and Spanish version of the form is located on our Web Page at under Forms and may be downloaded and copied.

In accordance with the Texas Labor Code, confidential claimant information will not be provided to a person unauthorized to receive the information directly from the Commission. Eligibility will be verified on all employers prior to the release of information.

Adopted this 19th day of March, 1999.

Leonard W. Riley Jr., Executive Director