Texas DWC: Fax Number for Form-041 Claims

What is the Texas DWC fax number for a workers' comp claim?

Texas Division of Workers' Compensation confirms a fax of 512-804-4378 directly on the official Form-041 itself, which states: "Send the completed form to the address above or fax to 512-804-4378." This is the standard first filing for a work-related injury or occupational disease claim, submitted by the injured employee.

Where to fax

• Form-041, Employee's Claim for Compensation (injured employee): fax 512-804-4378. Source: the official Texas DWC Form-041.
• Letter of Clarification requests (provider or employee): fax 512-804-4011. Source: the Texas DWC Injured Employee FAQ.

Fax numbers verified 2026-09-17.

Which route should I use?

1. Use 512-804-4378 specifically for Form-041, the standard claim-starting form.
2. Don't send other DWC forms (Letter of Clarification, Return-to-Work Reimbursement, Medical Interlocutory Order) to this number, they each have their own fax.
3. Confirm you're filling out the current version of Form-041 from the DWC's own site before faxing.

Need a different state's workers' comp fax number? See sending a fax to the Ohio BWC or check Washington L&I's fax number for existing-claim documents.