Worker's Compensation

For on the job injuries, please complete these steps:

Steps:

  1. Complete the first report of injury form.
    • Should not be filled out by the employee.
  2. Complete sections 1-29, 40-43 and 51.
    • All remaining sections will be completed by HR.
  3. Email the completed form to Human.Resources@tamucc.edu with the cover page.
    • If the injured employee misses a day of work or requests to see a doctor, place that note on the cover page.
    • If there was a witness to the injury please have them submit a witness statement via email.

Please note: These documents should be completed and sent to HR as soon as possible so that the claim can be processed and reviewed by an adjuster. Once accepted, a case number will be issued via email.

DWC link to their forms, notices and PLNs: http://www.tdi.texas.gov/forms/form20numeric.html

Notice 8 English

Required Workers’ Compensation Coverage
(building or construction projects for governmental entities)

Notice 8 Spanish

Required Workers’ Compensation Coverage
(building or construction projects for governmental entities)

Notice 9 English

Notice Regarding Certain Work-Related Communicable Diseases and Eligibility for Workers' Compensation Benefits
(law enforcement officers, fire fighters, emergency medical service employees, paramedics, and correctional officers)

Notice 9 Spanish

Notice Regarding Certain Work-Related Communicable Diseases and Eligibility for Workers' Compensation Benefits
(law enforcement officers, fire fighters, emergency medical service employees, paramedics, and correctional officers)

Who Do I Contact?

Jennifer Escamilla