Workers’ Compensation Claim Kit – Texas

Who will handle your claims?

The Dallas Regional Claim Office will handle your Texas claims.

Phone: 800-527-5531
Mike Hicks, AVP

Please direct all general correspondence to:

Email:    [email protected]
Fax:        877-622-6911
Mail:      PO Box 14139, Lexington, KY  40512

How to Report Workers’ Compensation Claims?

To report via the Internet: Log on to the Crum & Forster website at https://cfconnect.cfins.com. Use your assigned User ID and Password. If you do not have a current User ID, please contact your local Crum & Forster Claims or Marketing resource.

To report e-mail: [email protected]

To report via fax: 1-877-622-6218

To report claims via telephone: 1-800-690-5520

(7 day/24 hour toll free reporting line for all states)

  • In the event of a serious or fatal injury, notify the local claim office immediately by telephone.

What forms does the employer need to be aware of?

Notice 6 / Texas W/C Posting Notice

Review the instructions and prominently display the notice where each employee is likely to see the notice on a regular basis. Notices should be displayed in English and Spanish. The posting notices are available on the Crum & Forster website at:

http://www.cfins.com/claims/workers-compensation-claims/

Notice to New Employees

In addition to the posted notice, employers shall notify their employees of workers’ compensation insurance coverage status in writing. Click on the following link for further details.

http://www.oiec.texas.gov/

New Employee Notice:

TX-New Employee Notice | TX-New Employee Notice Spanish

 

Employer’s Notice of the Ombudsman Program

Post this along with the Notice 6.

TX-Ombudsman Notice 4-18 | TX-Ombudsman Notice 4-18 Spanish

Notice of Injured Worker Rights and Responsibilities

Give this information to your injured employees. It is available in English and Spanish.

TX-Employee Rights and Responsibilities | TX- Employee Rights and Responsibilities Spanish

DWC-1 / Employer’s First Report of Injury

If you report the claim via the Internet or by telephone, you do not need to fill out this form. If you report the claim via fax, complete this form, and fax it to Crum & Forster at the fax number provided above.

TX- DWC1 Employer’s First Report of Injury or Illness

 

DWC-3 / Employer’s Wage Statement

File this form with the carrier, claimant, and claimant’s representative when the claimant is losing time from work. Read the instructions for more specifics on when to file the form.

TX-DWC3 Employer’s Wage Statement

 

DWC-6 / Supplemental Report of Injury & Instructions

Read the instructions for filing requirements. They are available via the forms link above.

TX-DWC6 Supplemental Report of Injury and Instructions

What is the Waiting Period for Lost Wages in Texas?
The waiting period is 7 days. If the employee is off for more than 14 days, the first 7 days are paid retroactively.

What is the Choice of Physician Rule in Texas?
The employee is entitled to the initial choice of physician unless the employer has implemented a Health Care Network (HCN). TXCOMP is an online system available on the Division website that can assist the employee in finding a doctor (if an HCN has not been implemented).

Where should all medical bills be sent?

Crum & Forster
PO Box 14801
Lexington, KY 40512

Important Websites

Texas Department of Insurance (TDI) / Department of Workers’ Compensation (DWC) – https://www.tdi.texas.gov/wc/index.html

Texas WC Forms https://www.tdi.texas.gov/forms/form20.html

Multi-State Information – http://www.workerscompensation.com/