This article outlines the situations in which the Texas Department of Insurance requires providers to file a Workers’ Compensation Work Status Report Form (DWC Form-073) and how to file the report.

Treating or Referral Doctor

Treating or Referral Doctors are required to file a Work Status Report Form in the following circumstances:

1. After the initial examination of the injured employee, regardless of the employee’s work status.
2. When there is a change in the injured employee’s work status or when there is a substantial change in the injured employee’s activity restrictions.
3. On the schedule requested by the insurance carrier as long as it is based on the injured employee’s scheduled appointments with the doctor and does not exceed one report every two weeks.        
4. After receiving a set of functional job descriptions, from the employer or insurance carrier listing modified duty positions, including the physical and time requirements of the positions, that the employer has available for the injured employee to work.
5. After receiving a DWC Form-073 from an RME Doctor that indicates the injured employee is able to return to work with or without restrictions.

Designated Doctor

Designated Doctors are required to file a Work Status Report Form in the following circumstances:

1. After examination of an injured employee to address any question relating to return to work.
2. When there is a change in the injured employee’s work status.

NOTE: In the case of any question relating to return to work, the Designated Doctor must file a narrative report along with the form.

RME Doctor Selected by Insurance Carrier

Doctors conducting Required Medical Examinations (RME) at the request of an Insurance Carrier must file a Work Status Report Form in the following cases:

1. After examination of an injured employee (subsequent to a Designated Doctor's examination), if the RME doctor determines that the injured employee can return to work immediately with or without restrictions
2. Send to Injured Employee/or Representative (fax or email unless no info, then mail), Insurance Carrier (fax or email) and Employer (fax or email unless no info, then mail)

RME Doctor Selected by DWC

Doctors performing Required Medical Examinations (RME) at the request of the Division of Workers’ Compensation do not file a Work Status report. TDI-DWC’s medical examinations are ordered in accordance with § 408.0041, Texas Labor Code, and applicable Division of Workers’ Compensation rules.

Report Form

The Division of Workers’ Compensation requires the Texas Workers’ Compensation Work Status Report Form or DWC-073 to be completed in the above cases.

Filing the Report

In accordance with Rule § 129.5, the doctor or delegated physician assistant shall be considered to have filed a complete Work Status Report if the report is filed in the form and manner prescribed by the division, signed, and contains at minimum:

1. Identification of the injured employee's work status;
2. Effective dates and estimated expiration dates of current work status and restrictions (an expected expiration date is not binding and may be adjusted in future Work Status Reports, as appropriate, based on the condition and progress of the injured employee);
3. Identification of any applicable activity restrictions;
4. An explanation of how the injured employee's workers' compensation injury prevents the injured employee from returning to work (if the doctor believes that the injured employee is prevented from returning to work); and
5. General information that identifies key information about the claim (as prescribed on the report).

To file the completed form, the doctor must hand deliver a copy to the Injured Employee (or by electronic transmission if the injured employee agrees to receive the report by electronic transmission), file a copy with the insurance carrier or its agent, and file a copy with the Employer by electronic transmission if the doctor or delegated physician assistant has been provided the employer's facsimile number or email address; otherwise, the report shall be filed by personal delivery or mail.

DaisyBill Solution

Stay up-to-date on the latest developments in Workers’ Compensation medical billing by subscribing to DaisyBill’s email list.

SIGN UP FOR EMAILS