| (a) Unless the division-prescribed form, format, or
manner of a written communication specifies otherwise, all written
communications to the division about an injured employee or claim
for benefits must include the following information, if known:
(1) the injured employee's full name, date of injury,
address, and Social Security number. If no Social Security number
has been assigned, insert the numerical digits "999" followed by the
claimant's birth date or if unknown, the claimant's date of injury
listed by the month, day, and year (MMDDYY). Do not use "999" in place
of a valid Social Security number to meet timeliness of reporting
requirements;
(2) the name and address of the claimant, if other
than the injured employee;
(3) the workers' compensation number assigned to the
claim by the division;
(4) the employer's name and address;
(5) the employer's Federal Employer's Identification
Number;
(6) the insurance carrier's name;
(7) the insurance carrier's policy number; and
(8) the insurance carrier's claim number.
(b) Written communications filed by claim EDI under §124.2
of this title (concerning Insurance Carrier Notification Requirements)
must comply with the requirements of Chapter 124, Subchapter B of
this title (concerning Insurance Carrier Claim Electronic Data Interchange
Reporting to the Division).
(c) Subsection (a) is effective on adoption. Subsection
(b) is effective July 26, 2023.
|
| Source Note: The provisions of this §102.8 adopted to be effective October 1, 1992, 17 TexReg 6361; amended to be effective March 15, 1995, 20 TexReg 1418; amended to be effective August 29, 1999, 24 TexReg 6488; amended to be effective December 12, 2013, 38 TexReg 8910; amended to be effective March 9, 2022, 47 TexReg 1093 |
