The TDI requires all reports to be submitted on their most current forms.  Please check back regularly to verify that you are using the most current forms available.  These forms require Microsoft Word and can be printed and mailed or e-mailed.

 E-mail all forms to Lisa Folsom at claims@detsif.com . 

 Online Forms

      DWC-1 Employer's First Report of Injury

      DWC-3 Employer's Wage Statement

        DWC-3-SD Employer's Wage Statement for School Districts

        DWC-6  Supplemental Report of Injury

      DWC-48  Request for Travel Reimbursement(PDF only)

       DWC-53  Request to Change Treating Doctor
 

 Instructions:
   1.  Download and save the forms to your computer. 

   2.  Fill out the repetitious information and save the form again.

   3. Filling out a form is a simple "type and tab" process.  After
 completing a form, print and sign a copy for your files.  You may
 also save the form to your computer.

   4.  E-mail the form to claims@detsif.com or FAX the form to
 (409) 384-7953.  To e-mail do a "file, send to, mail recipient
 (as   attachment)".

   5.  We acknowledge receipt of all e-mailed forms by return
 e-mail.  If you do not get a response from us you can assume that
 the form was not received.

HELP!

The prompt reporting of an injury is of extreme importance in the proper handling of a workers' compensation claim.

 Please report all claims and supplemental reports as soon as possible to facilitate the speedy delivery of services to your employees.
 

Remember, the quality of our service can depend on the quality of your reports!