Supplemental Report of Injury
The Employer's Supplemental Report of Injury form is required by the Texas Department of Insurance, Division of Workers' Compensation (DWC) to account for any period of time lost from work for which the injured worker might be entitled to compensation benefits. It also gives written notice to The University of Texas System of an employee's lost time, return to work after a period of disability, change in employment status, or death.
When to Complete a Supplemental Report of Injury
For all work-related injuries, your department must file a Supplemental Report of Injury (SR6) form no later than three days after the occurrence of any one of the following events:
- The injured employee returns to work after having lost time from work
- The injured employee, after returning to work, experiences an additional day or days of disability as a result of the injury
Your department must also file the SR6 form within ten days of the occurrence of any one of the following events:
- The injured employee has a change in earnings as a result of the work-related injury
- The injured employee resigns, terminates employment, or dies
Note: The Supplemental Report of Injury form should be submitted as often as necessary to report subsequent periods of lost time. Failure to comply with the above requirements without good cause is a Class D administrative violation. Penalties will be imposed by DWC in an amount not to exceed $500 per occurrence.
How to Complete a Supplemental Report of Injury Form
You should complete and submit the Supplemental Report of Injury via *WCMENU, using command SR6.
Wondering what you should do if you don't have access to the *WCMENU application? Have your WCI representative complete the form for now, and learn how to gain authorization for *WCMENU for use in the future.