Supplemental Report Of Injury {DWC-6}

DWC006 - SUPPLEMENTAL REPORT OF INJURY. The Texas Department of Insurance, Division of Workers’ Compensation (DWC) requires either the employer or the injured employee to report to the insurance carrier all return-to-work activity and post-injury change of earnings. This allows the insurance carrier to adjust the weekly amount of temporary income benefits (TIBs) paid to an injured employee to match the changes in weekly earnings after the injury. The employer that the injured employee was working for at the time of the on-the-job injury must send this form to the insurance carrier and the injured employee while the injured employee is receiving TIBs and until the injured employee reaches maximum medical improvement or is no longer employed by the employer. If you are no longer working for the employer where the on-the-job injury occurred, and you are receiving benefits, then you must let the workers’ compensation insurance carrier know if your wages changed or if you have received any offers of employment. If you are not receiving benefits, you must tell the insurance carrier if the injury caused you to miss work or lose income. Send this form to the insurance carrier by email, fax, telephone, or personal delivery. The employer must provide a copy of the form to the injured employee by email, fax, mail, or personal delivery. www.FormsWorkflow.com