Workers' Compensation Forms

Manual Forms to Submit via Email

If a member cannot use the online claim submission tool, they can also submit completed claims forms by emailing them to icon-export  to Carla.Meuth@Sedgwick.com with a copy to Martin.Rangel@Sedgwick.com.

Online Workers' Compensation Claim Submission and Administration

Use the link below to complete the Loss Notice. All members of TWCARMF, other than Lower Colorado River Authority (LCRA), should use the TWCARMF button. LCRA users should only use the LCRA button below.

Once the information is entered, be sure to indicate “yes” and enter the email address that the Loss Notice information and DWC-1 should be emailed to.

                                               

At this time, DWC-3 and DWC-6 forms must be manually completed and submitted to the Adjuster.

Access for New Users

New users need to request access to Juris Global Intake to submit claims online by emailing a completed icon-export Juris Global Intake User Access Request Form to Kathy.Hulse@Sedgwick.com.

For Technical Assistance

If you have a username and need help resetting your password, contact the Help Desk at 866-647-7610, option 2 (Monday-Friday 7:00-7:00). You may also email help@sedgwick.com.

More Workers' Compensation Information on WC Notices Page

See Other Workers' Compensation Information on WC Notices Page