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Employers
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Forms for Employers
Claims: TDI Forms
DWC-1: Employer's First Report of Injury or Illness Form
DWC-3: Employer's Wage Statement
DWC-3S: Employer's Wage Statement (Spanish)
DWC-3ME: Employee's Multiple Wage Statement
DWC-3MES: Employee's Multiple Wage Statement (Spanish)
DWC-6: Supplemental Report of Injury Form
DWC-7: Non-covered Employer's Report of Occupational Injury or Illness
DWC-73: Work Status Report
DWC-81: Agreement Between General Contractor and Subcontractor To Provide Workers' Compensation Insurance
CorCare® Network Forms
Employee Acknowledgement Form
(English & Spanish)
Employer Log / Register
Underwriting Forms
DWC-81: Agreement Between General Contractor and Subcontractor To Provide Workers' Compensation Insurance
DWC 85: Agreement Between General Contractor and Subcontractor to Establish Independent Relationship
Contractor Questionnaire
ACH Authorization Form
Miscellaneous Forms
Sample Modified Work Duty Agreement
Accident Investigation Form
Sample Bona Fide Offer of Employment Letter