DWC039 - First Responder's Annual Certification for Lifetime Income Benefits (LIBs)

What this form is

The DWC039, First Responder's Annual Certification for Lifetime Income Benefits, is a short yearly filing required of one group of workers only. Under a provision added to the law in recent sessions, certain first responders receive lifetime income benefits, called LIBs, when a serious bodily injury suffered on the job leaves them permanently unable to work. Lifetime Income Benefits (LIBs) in Texas Workers' Compensation Claims covers that eligibility. This page covers the one duty that comes with it: every year, the responder must certify in writing that they were not employed in any capacity during the past year, and the DWC039 is the form that does it.

This page is only about the certification. The separate laws that presume certain first responder illnesses to be work-related are a different subject, covered at First Responder Presumptions: When the Law Assumes Your Illness Is Work-Related.

What you certify

The form asks you to certify, over your signature, that you were not employed in any capacity during the certification period, the year being certified. The phrase is broad, and the form does not define it. Read it as broadly as it sounds. A part-time job, paid odd jobs, or self-employment income could all contradict the certification, and a responder doing occasional paid work could sign a false certification without realizing it. If any work, payment, or side income during the year gives you doubt, resolve the doubt before you sign, not after. A certification signed carelessly creates a problem far larger than the question it was meant to answer.

When it is due

The certification is due every year, no later than 30 days after the anniversary of your accrual date, the date your LIBs began to accrue. That gives you one 30-day window each year, about a month, tied to a date that is easy to lose track of because it is not a calendar date anyone celebrates.

The carrier, the insurance company paying your benefits, must send you a notice of the anniversary date each year. Do not depend on the notice. Mark the anniversary and the 30 days that follow it in your own calendar, file inside the window, and keep a copy of the form with proof of the date you sent it.

If it is not filed

The form does not say what happens if you file late or not at all, and that silence worries people. The practical answer is that the certification is a condition of continuing the benefit, and missing the window can interrupt payments that are otherwise yours for life. The steady course is simple: file on time, every year, whether or not the carrier's notice arrives. If the window has already passed, file immediately rather than waiting to be asked, and treat any resulting stop in payments as a problem to be corrected at once, not accepted.