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Dwc Form 041

Dwc Form 041

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How to file workers comp claim in texas form

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Instructions and help about dwc form 041 texas printable

[Music] hi my name is kim wyatt i'm the managing attorney here at baleen gallen for the workers comp department today we're going to discuss a form that many of you will and should have filled out if you are reporting that you've been injured on the job in texas this form number is dwc form 41. there's quite a bit of boxes and sections that you need to fill out it's always good to fill out as much as possible things like your name social date of birth phone number email address if you have it a bit about your employer you know what your work status is if you're able to work if it's restricted the date you were hired occupation at the time of the injury one thing i would ask that you be careful about when you fill out this form is section two the injury information there's two types of injuries in workers comp one is a specific injury you know exactly when that happened the moment it happened uh and then there's the occupational diseases which happened over a period of time those you ma

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