Notification of Claim of Compensable Injury  Form DWC 29 Revised 4/02

Health care providers are required to submit this notice to the insurer within three days of an initial visit following an injury. The health care provider may charge the insurer a twenty dollar ($20.00) fee for each timely filed form.  A copy should be sent to the employee and his or her attorney.

Physician's Notice of Release to Work    Form DWC 27/28 Revised 4/02

Health care providers are required to submit this notice of release to work to the insurer within three days of the injured employee's release, discharge, return to work, and/or recovery from an injury. The health care provider may charge the insurer a twenty dollar ($20.00) fee for each timely filed form.  A copy should be sent to the employee and his or her attorney.

Request for Additional Palliative Care   Form DWC 40 Revised 04/05

Health care providers are required to submit this request for additional palliative care to the insurer for authorization.