Texas Workers Comp DWC Form-005: Employer Notice of No Coverage or Termination of Coverage (non-subscriber notice)

✓ Verified October 06, 2026

The dwc-005 form is the notice a Texas employer files to tell the state it does not carry workers’ compensation insurance. A Texas employer that does not carry workers’ comp files it with the Texas Department of Insurance, Division of Workers’ Compensation each year. An employer may also use it when its coverage ends.

If you were hurt on the job and your employer says it has “no coverage,” this form is often the paper trail behind that answer. Knowing how it works can help you figure out your next step calmly.

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The short answer: The dwc-005 form is an official notice from a Texas employer that it has no workers’ comp coverage, or that its coverage has ended. The employer files it with the Texas Department of Insurance, Division of Workers’ Compensation. You, the worker, do not file it. However, it can tell you a lot about your rights after an injury.

What the Dwc-005 Form Is For

Texas is unusual. In most cases, private employers in Texas may choose whether to carry workers’ comp. Employers who opt out are often called “non-subscribers.” The state still wants to know who those employers are. As a result, Texas asks non-subscribers to report their status on the dwc-005 form. The form creates a public record that the employer has no coverage, or that its coverage has stopped.

For an injured worker, this matters a great deal. If your employer is a non-subscriber, the regular state benefit system typically does not cover your injury. However, you may still have options. For example, you may be able to file a lawsuit against the employer for negligence. Some non-subscribers also offer their own private injury plans. You can read more about who must carry coverage in our guide to Texas workers comp requirements.

Item Details
Form number DWC Form-005
Form title Employer Notice of No Coverage or Termination of Coverage (non-subscriber notice)
Who files A Texas employer that does not carry workers’ comp, filed with DWC each year
Where filed Texas Department of Insurance, Division of Workers’ Compensation
Fee No fee is listed in our verified data. Confirm with DWC before filing.
Official PDF DWC Form-005 official PDF

Who Files the Dwc-005 Form and When

The employer files the dwc-005 form, not the worker. Typically, this is a Texas business that has chosen not to buy workers’ comp insurance. It may also be a business that had coverage and then let it end. In both cases, the employer reports its status to the Division of Workers’ Compensation.

The timing has two parts. First, a non-subscriber files the notice each year. Second, an employer that drops its coverage must report that change after the coverage ends. Texas sets a specific yearly filing window and a specific number of days for reporting a termination. Those exact dates can change, so check them with the agency directly.

Timing rule: A Texas non-subscriber files the dwc-005 form with DWC each year. An employer whose coverage ends must also file within a short window after the coverage stops. Confirm the exact yearly filing window and day count with the Texas Department of Insurance, Division of Workers’ Compensation and a licensed attorney before relying on any date.

Employers also have duties to their workers. In most cases, a non-subscriber must tell employees that it does not carry coverage. That notice to workers is separate from the filing with the state. If you were never told, write that down. It may matter later.

How to Fill It Out and Where to Send It

The dwc-005 form asks for basic facts about the business. Typically, this includes the employer’s legal name, address, and tax ID. It also asks about the type of business and the number of employees. The employer then marks whether it is reporting no coverage or a termination of coverage. Finally, an authorized person signs and dates it.

Common mistakes can cause problems. For example, an employer may leave out the tax ID or use a name that doesn’t match its records. Others forget to sign or check the wrong box. An outdated version of the form can also be a problem. As a result, employers should always download the current version. The official PDF is posted at the TDI DWC Form-005 PDF. You can also find it on the TDI numeric forms list.

The finished dwc-005 form goes to the Texas Department of Insurance, Division of Workers’ Compensation. TDI may offer more than one way to send it, such as online or by mail. Check the forms page for the current options and mailing details. Our guide to the Texas workers comp board explains how the agency is set up.

What Happens After You File

Once the employer files, DWC records it as a non-subscriber. That record can help an injured worker confirm the employer’s status. If you are unsure whether your employer had coverage, you can contact DWC and ask. However, a missing filing does not always mean the employer had insurance. Some employers simply fail to file. Typically, an employer who skips the dwc-005 form can face penalties from the state.

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If you are hurt and your employer has coverage, the next step is your own claim. Our guide on how to file a Texas workers comp claim walks through it. If your employer is a non-subscriber, your path may be different. In most cases, that path runs through a private plan or a negligence lawsuit. Lawsuits have their own time limits. Confirm those limits with a licensed Texas attorney as soon as you can.

Frequently Asked Questions

Do I need to file the dwc-005 form as an injured worker?

No. The dwc-005 form is filed by the employer, not the worker. As a worker, you may find it useful to check whether your employer filed one. That record can help you understand which path fits your injury.

What does it mean if my employer filed a dwc-005 form?

It typically means your employer told the state it has no workers’ comp coverage. As a result, the regular Texas benefit system may not cover your injury. However, you may be entitled to pursue a private plan or a negligence claim. Confirm your options with a licensed attorney.

Can a non-subscriber employer still be responsible for my injury?

In many cases, yes. Texas non-subscribers can be sued for negligence, and they may lose some legal defenses. Every case is different, so any outcome depends on your facts. Confirm the rules and deadlines with DWC and a licensed Texas attorney.

Bottom line: The dwc-005 form is how a Texas employer tells the state it has no workers’ comp, or that its coverage ended. It is the employer’s job to file it, but it can shape your options after an injury. Check your employer’s status with DWC, then confirm any deadline with the agency and a licensed attorney before you act.

Dwc-005 form: Quick Recap

If you remember one thing about dwc-005 form, make it this: the rule is set by the state (or the federal program), not by the insurer, and the official source is linked above. Every figure on this page about dwc-005 form should be confirmed with the agency before you act on it.

Questions about dwc-005 form that this page does not answer are usually answered for free by the state workers’ comp agency’s information line — and, for a disputed claim, by a licensed attorney in a first consultation.

See your state’s exact numbers

What you are owed depends on your state’s benefit caps and deadlines. Start with your state’s settlement and claim guides for the exact figures.

Find Your State’s Workers Comp Guide →

Sources & How to Verify

The figures on this page come from official government and industry sources. Workers’ comp benefit caps, deadlines, and rules change, so always confirm the exact figure with your state’s workers’ comp board or a licensed attorney before acting. Settlement estimates are illustrative, and every case is different.

  • Your state workers’ comp board, division, or commission: the official source for your state’s exact caps, deadlines, and forms — search “[your state] workers compensation board”
  • U.S. Department of Labor (OWCP): dol.gov — federal workers’ compensation overview
  • NCCI: ncci.com — workers’ comp rating and benefit data
  • Social Security Administration: ssa.gov — benefit-cap and SSDI offset data
  • Insurance Information Institute: iii.org — neutral workers’ comp background

Content last reviewed October 2026. If you notice an outdated figure, please contact us.

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