Skip to Content (custom)
Texas Association of Counties
Toggle Navigation (custom)

    TAC Risk Management Pool

    ​The Texas Association of Counties Risk Management Pool (TAC RMP) has provided counties with a stable, sustainable resource of protection against risks and liabilities for more than 45 years.

    Programs | May 31, 2023

    Workers' Comp Claims & Notices

    Ready to report a claim? Below is information on medical treatment for injured workers, how to report new claims and required forms for existing claims.

    Online and Email Claims Reporting

    For Members who would like online access, or access has expired to report injuries and other claim forms online, please contact Helana Barmore to obtain or reset your security credentials.

    Otherwise, please report injuries using the WC Claims email. Please email all other claim forms and correspondence, including medical bills, to

    Injured Worker Medical Network

    Injured workers of participating counties are required to treat for their on-the-job injuries with providers who are part of the Political Subdivision Workers' Compensation Alliance. This website address is Treating doctors and specialists are searchable on this web site. For more information concerning whether or not your county participates in the Alliance, please contact your county workers' compensation coordinator or your claims examiner at 800 752 6301.

    Claims Forms

    Employer's First Report of Injury or Illness (DWC-1)
    File DWC-1 File Hard Copy

    Use this form to report a work-related injury or occupational illness. You must file this form with the Pool and injured worker within eight calendar days of receiving notice from the injured worker. This form must accompany the Injured Employee Rights and Responsibilities Notice when it is sent to the injured worker.

    Employer's Wage Statement (DWC-3)
    File DWC-3 File Hard Copy

    Use this form to report wages for an injured employee when he or she has reached eight days of disability (inability to earn pre-injury wages due to the compensable injury). You must report 13 weeks of gross wages before the date of injury as well as discontinued fringe benefit amounts, such as health insurance.

    Supplemental Report of Injury (DWC-6)
    File DWC-6 File Hard Copy

    File this form with the Pool if within three days, the injured worker returns to work or loses additional time after initially returning to work, within 10 days if the employee resigns, is terminated, or is earning post-injury wages, such as modified duty or salary continuation. This form must also be sent to the injured worker.

    Employer's Report for Reimbursement of Voluntary Payment (DWC-2)
    File DWC-2 File Hard Copy

    Use this form to seek reimbursement from the Pool for salary continuation paid to law enforcement officers. The Pool will reimburse what it would have paid in Temporary Income Benefits to the injured worker as required by the Texas Labor Code.


    Medication First Fill Authorization
    Download a Hard Copy

    The Pool contracts with myMatrixx for pharmacy benefit management services. Please ensure your injured workers receive this form to get prescriptions filled.

    Notice to Employees Concerning Workers' Compensation in Texas (Notice 6)
    Download a Hard Copy

    This notice must be posted where employees frequent to notify them of your coverage provider (TAC RMP) and the effective dates of your coverage.

    Notice Regarding Certain Work-Related Communicable Diseases (Notice 9)
    Download a Hard Copy

    This notice must be posted where first responders frequent. All first responders as defined on the notice are required to test for communicable diseases within 10 days.

    Employer Rights and Responsibilities
    Download a Hard Copy

    Injured Employee Rights and Responsibilities
    Download a Hard Copy

    This notice must go to the injured worker. It must accompany the Employers' First Report of Injury or Illness and Medication First Fill Authorization.

    Notice Regarding First Responder Liaison to Assist in Workers’ Compensation Claims
    Download a Hard Copy

    This notice must be posted where first responders frequent. It provides information on the Office of Injured Employee Counsel liaison specifically designated to assist, educate and advocate on behalf of all first responders.