Workers' Compensation Claims Forms

Online Workers' Compensation Claim Submission and Administration

button-dwc3 button-dwc6

Workers' Compensation Form General Information

Our online workers’ compensation claims reporting tool icon-export Claims Opening Wizard (iCOW) gives Fund members an easy way to submit workers’ compensation claims (DWC-1’s only). icon-export YCEa is the Fund Administrator’s claim system which can be used to electronically submit Employer’s Wage Statement (DWC Form-3) and  Supplemental Report of Injury (DWC Form-6).

Instructions For Specific Workers' Compensation Form Submission

 button-dwc1q button-dwc3q button-dwc6q

 

Access for New Users

New users need to request access to iCOW and YCEa by emailing a completed icon-export YCEa External User Login Account Request Form to icon-export Kathy.Hulse@yorkrsg.com.

 

 

For Technical Assistance

If you have a user name and need help resetting your password, contact the Help Desk at 800.913.5651 (Monday-Friday 7:00-5:00 CST).

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 OSCTexas@YorkRSG.com.