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Worker's Compensation:
Worker's Compensation:
Accident Investigation FORMs (English) | Employee's Accident Report in Spanish (DOC)
Approved Medical Facility | Injured Workers' Compensation Guidelines
The Office of Environmental Health and Safety will comply with the Texas Workers' Compensation Act as it applies to The University of Texas, while providing quality customer service equally to all UT Dallas employees who have been injured on the job, their departmental representatives, and their medical providers.
If you are injured and need to file a claim, please download and follow some basic guidelines to ensure your claim will be processed in a timely fashion. To ensure full coverage all treatments should be received at an approved medical facility.
If you have any questions, please contact us at x2381.
Your Responsibilities Under Workers' Compensation
- You have the responsibility to tell your employer about your injury or illness.
You must tell your employer within 30 days of the date you were injured, or within 30 days of the date you first knew your illness might be work-related. You, or someone helping you, may either talk with or write your employer or any supervisor where you work.
- You have the responsibility to fill out a claim form and send it to the Commission.
You must send a completed claim form, called a TWCC-41, to the Commission within one year of the date you were injured, or within one year of the date you first knew your illness might be work-related. Send the completed claim form to the Commission even if you are already getting benefits. If you do not send the form within one year, you could lose your right to get benefits. For a copy of the form, call the field office handling your claim, or call 1-800-252-7031.
- You have the responsibility to tell the Commission and the insurance carrier any time your income changes.
If you are not getting benefits and you have changed employers since your injury, tell the Commission if your injury causes you to miss work or lose income. Call 1-800-252-7031. If you are getting benefits and you have changed employers since your injury, tell the Commission and the insurance carrier paying your benefits if your income changes. Tell the Commission and the regardless of whether your income went up or down. If you have stopped working since your injury, tell the Commission and the insurance carrier if you start working again or if you have a job offer.
- You have the responsibility to tell your doctor how you were injured and if you believe it may be work-related.
If possible, tell the doctor before the doctor treats you.
- You have the responsibility to tell the Commission and the insurance carrier how to contact you.
You should contact the Commission and the insurance carrier if your home address, work address, or phone number change, so the Commission and the insurance carrier will be able to contact you when necessary.
If you have any questions, please contact us at x2381.
Your Rights Under Workers' Compensation
- You may have the right to receive benefits.
You may receive benefits regardless of who
caused or helped cause your injury. You may not receive benefits
if your injury occurred while you were intoxicated, you injured
yourself intentionally or while unlawfully attempting to injure
someone else, you were injured by another person for personal
reasons, you were injured while voluntarily participating in
an off-work activity, you were injured by an act of God, or
your injury occurred during horseplay.
You have the right to receive the medical
care reasonable and necessary to treat your work-related injury
or illness for the rest of your life.
- You have the right to the initial choice
of doctor.
You may not change doctors except with the
approval of the Commission. You do not need to get approval
to go to a different doctor for emergency treatment, if you
or your doctor moves or if your doctor is unable to continue
treating you.
You have the right to hire an attorney
to help you get benefits or to help you resolve disputes.
- You have the right to receive assistance
from appropriate, qualified Commission staff and, in the event
of a dispute resolution proceeding, from a Commission ombudsman
free of charge. To request assistance, contact the field office
handling your claim, or call 1-800-252-7031.
You have the right to receive information and
assistance regarding your claim. Commission staff will explain
your rights and responsibilities under the Texas Workers' Compensation
Act. Additionally, you have the right to be assisted by a Commission
ombudsman in informal dispute resolutions and in administrative
proceedings if you are not represented. However, an ombudsman
cannot serve as a legal representative or attorney for you.
- You have the right to confidentiality.
Only people who need to know - such as your
doctor, your employer or your employer's insurance carrier -
may see information in the Commission's files. A prospective
employer may get limited information from the commission from
the commission about your claims. If you wish someone who is
assisting you to have access to your file, you must provide
written approval for them to do so.
If you have any questions, please contact us at x2381.
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