DWC Has Adopted Revisions to Three Forms
The Texas Department of Insurance, Division of Workers’ Compensation (DWC) has adopted revisions to three forms:
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- DWC Form-027, Designation of Insurance Carrier’s Austin Representative;
- DWC Form-029, Request for Standard Detailed Data Reports; and
- DWC Form-120, Designation of Administrative Services Company Administrator.
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DWC posted the draft forms online from January 31, 2022, to February 14, 2022. A brief explanation of each form follows:
Texas Labor Code Section 406.011 and DWC Rule 156.1 require insurance carriers to designate a person as a representative acting as an agent for receiving notice from DWC. The DWC Form-027 allows insurance carriers to designate their Austin representative.
DWC provides insurance carriers and their authorized agents standard detailed data reports to monitor their compliance with electronic data interchange submission of claims and medical information. The DWC Form-029 allows insurance carriers and their authorized representative to request these reports.
DWC provides designated doctors (DDs) and their administrators access to manage their electronic profiles in TXCOMP, DWC’s electronic claims system. The DWC Form-120 allows administrators to designate up to three TXCOMP administrators to manage their system profile and the profiles for DDs who have authorized the administrative services company to act as their agent. The revisions update the forms to meet new DWC form standards.
Parties may use the adopted forms immediately. The forms are available on the TDI website: https://www.tdi.texas.gov/forms/form20numeric.html.
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