DWC053 - Employee Request to Change Treating Doctor
Requesting to Change Your Treating Doctor
The DWC053 is how non-network workers ask the state's permission to switch treating doctors. The boxes that matter, the signature nobody warns you about, and the mistake that makes you the bill's owner.
Open the official PDF ↗
What this form is
The DWC053, Employee Request to Change Treating Doctor, asks the Texas Division of Workers' Compensation (DWC) to approve a change of treating doctor on a non-network claim. If your employer's coverage runs through a health care network, this form isn't yours: network changes follow the network's own procedure instead (Changing Your Treating Doctor covers both routes; ask your adjuster which system you're in before touching this form).
When you need it
Any time you want a different treating doctor on a non-network claim, including the situations that feel like they shouldn't need paperwork: your doctor retired, stopped taking workers' comp, or you moved across the state. Near-automatic approvals still require the form, filed promptly.
The boxes that matter
- Your reason for the change. Be specific and practical: documentation problems, communication breakdown, access, relocation, needed care the doctor can't provide. What the reason cannot be, and the rules say this expressly, is dissatisfaction with your impairment rating or work-status opinion; a request built on that gets denied as doctor-shopping. If a rating or release is your real complaint, use the dispute tools built for it instead.
- The new doctor's signature (box 27). The doctor you want to change to must sign the form before you submit it. This is the step that sinks the most requests: workers mail an unsigned form and get denied weeks later for a missing signature. Call the new office first, confirm they take comp patients and will accept you, and get the signature.
- Your claim identifiers. DWC claim number and carrier claim number, both, so nothing stalls in matching.
Where to send it
To the DWC. Keep a copy and proof of the submission date. Then, and this is the part that protects your wallet, keep treating with your current doctor until the approval comes back. Seeing the new doctor before approval can make the care unauthorized, which can make the bill yours.
Traps
The unsigned box 27. The doctor-shopping reason. The premature first visit. And one more from the fine print: if approval is granted, it covers the doctor named on the form, not a whole clinic; if "your" doctor at the new practice changes later, that can mean another form.
The DWC053 is a simple form with an unforgiving order of operations: signature first, submission second, approval third, treatment fourth. Follow that order and it's routine paperwork; break it and it becomes a bill, a records gap, or a denial. If your request was denied, if the new doctor's office won't sign, or if you're caught between a doctor who's harming your claim and an approval that won't come, don't wait it out. One of our attorneys can tell you quickly, and at no cost, whether your denial is worth disputing and how to keep your treatment on track while you do.
3 pages · Rev. 03/12
