Texas

What you need to know for Texas…

Texas workers’ compensation claims are administered through the Texas Department of Insurance, Division of Workers’ Compensation (TDI-DWC). If a workplace injury or illness occurs, both the employer and the injured worker have responsibilities to ensure the claim is reported and processed correctly.

For Employers

If an employee reports a workplace injury or illness, Texas law requires employers to take prompt action.

1. Ensure the employee receives medical care.

If the injury requires immediate attention, direct the employee to appropriate medical treatment.

2. File the Employer’s First Report of Injury.
Employers must complete a DWC Form-001 (Employer’s First Report of Injury or Illness) and provide a copy to the injured employee, along with the Notice of Injured Employee Rights and Responsibilities.

3. Report the injury.
Employers must promptly report the injury to the Care West Claims team using the online claims reporting form. Click on the Submit A Claim button in the left menu to initiate the claim.

For Workers

If you are injured at work or develop a work-related illness, you should take the following steps.

1. Report the injury to your employer.
Notify your supervisor or employer as soon as possible after the injury occurs. Prompt reporting helps ensure a smooth claims process.

2. Contact Nurse Triage.
If medical care is needed, contact nurse triage promptly at (844)-326-2918 and inform the provider that the injury occurred at work.

3. File an Employee’s Claim for Compensation.
Workers must file a DWC Form-041 (Employee’s Claim for Compensation for a Work-Related Injury or Occupational Disease) with the Texas Division of Workers’ Compensation to formally initiate a claim.

Texas law generally allows injured workers up to one year from the date of injury to file a claim, but reporting the injury and submitting the necessary forms as soon as possible helps avoid delays.

4. Claim Review
After a claim is filed, the insurance carrier will review the claim and issue a determination regarding benefits and coverage.