(a) Except as provided in subsection (b) of this section, an injured employee, or a person acting on that employee’s behalf, shall notify an employer of an injury not later than the 30th day after the date on which the injury occurs. The notice of injury should include the following information:
(1) the name, address, and telephone number (if any) of the injured employee;
(2) the date, time, and place the injury occurred;
(3) a description of the circumstances and the nature of the injury;
(4) the names of any witnesses (if known);
(5) the name and location of the health provider that has treated the employee for the injury; and
(6) the name of the person (if any) acting on behalf of the injured employee.
(b) An employee whose injury results from an occupational disease, or a person acting on that employee’s behalf, must give notice as required in subsection (a) of this section not later than the 30th day after the date on which the employee knew or should have known that the disease may be related to the employment. This notice must be given to the employer for whom the employee worked on the date of the last injurious exposure to the hazards of the disease.
(c) Any notice to the employer may be given to any employee of the employer who holds a supervisory or management position.
(d) Failure to notify the employer shall relieve the employer and the employer’s insurance carrier from liability under the Texas Workers’ Compensation Act unless:
(1) the employer, or person eligible to receive notice under subsection (c) of this section, or the insurance carrier, had actual knowledge of the injury;
(2) good cause exists for failure to give notice in a timely manner; or
(3) the employer or insurance carrier does not contest the claim.
The provisions of this § 122.1 adopted to be effective January 28, 1991, 16 TexReg 228.