Austin, TX – The Texas Department of Insurance, Division of Workers’ Compensation (TDI-DWC) has adopted a revised DWC Form-057, Request for Extension of Maximum Medical Improvement Date for Spinal Surgery.
The form was revised to improve instructions to requestors, insure the certification of the requestor is compliant with the rules, improve the efficiency of processing by collecting all needed information on the form, and improve readability and formatting for use by requestors and by the TDI-DWC.
With adoption of the revised form, the decision of the TDI-DWC to either approve or deny the request will be issued on a separate order rather than on a copy of the request.
The new DWC Form-057, which is effective on February 1, 2013, is available for download from the TDI website
For questions, contact Dixie Evatt at (512) 804-4114 or dixie.evatt@tdi.texas.gov.
Source: TDI-DWC