(DWC-6) Form
What is the Employer's Supplemental Report of Accident or Occupational Illness Form (DWC-6) designed to accomplish?
The Employer's Supplemental Report of Accident or Occupational Illness Form (DWC-6) is required by The Texas Department of Insurance, Division of Workers' Compensation (TDI/DWC) to account for any period of time lost from work for which the injured worker might be entitled to compensation benefits. The Employer's Supplemental Report Form also serves as written notice to The University of Texas System Workers' Compensation Insurance office (WCI) of an employee's lost time, return-to-work after a period of disability and change in employment status.
When does the Employer's Supplemental Report (DWC-6) Form need to be completed and filed?
For all injuries that require the filing of an Employer's First Report of Accident or Occupational Disease (DWC-1) Form , the employing department must also file a Employer's Supplemental Report (DWC-6) Form with The University of Texas System Workers' Compensation Insurance (WCI) Office and the injured employee no later than three days after the occurrence of any of the following events:
- The injured employee returns to work after having lost time from work.
- The injured employee, after returning to work, experiences an additional day or days of disability as a result of the injury.
The DWC-6 Form must be filed with WCI and the injured employee within ten days of any of the following:
- The injured employee has a change in earnings as a result of the work-related injury.
- The injured employee resigns or terminates employment
- The injured employee has subsequent lost time from work due to the injury.
Penalties
Failure to comply with the following requirements without good cause is a Class D administrative violation. Penalties will be imposed by The Texas Department of Insurance, Division of Workers' Compensation and employers may be assessed an administrative penalty not to exceed $500 per record.
If an employee is missing intermittent periods of time from work, how often must a DWC-6 Form be filed?
A new DWC-6 Form should be filed each time the employee returns to work after having lost time from work and/or each time the employee, after returning from work, experiences an additional day or days of disability as a result of the injury.
Is time taken off for appointments with the doctor or physical therapist considered lost time?
No. Lost time is that period of time during which the injured employee is physically unable to work due to a compensable injury.
