Workers' Compensation Claim Form (DWC-1)

Workplace injuries can happen at any time to anyone. Therefore, it's important to know what to do if you are hurt at work.

In California, injured workers are entitled to benefits, such as temporary disability, permanent disability and medical treatment. However, there is a protocol in place that must be followed in order to set things in motion.

Following the Workers' Comp Claim Process

• Report the injury
• File a claim with your employer
• File an application for adjudication of claim with the Workers' Compensation Appeals Board

If you are hurt at work, it is imperative that you report your work-related injury or illness, regardless of the nature or severity, to your supervisor immediately. Request an "Employee's Claim for Workers' Compensation Benefits" form from your supervisor (it's also known as a DWC 1 form). Your employer must give or mail you a claim form within one working day after learning about your injury or illness. 

Fill out the employee section of the DWC 1 claim form accurately, and return the form to your supervisor as soon as possible, making sure to include all the parts of your body you feel may be hurt or effected by your workplace injury or illness. 

Keep a copy of the completed form as your receipt and ask your employer to return the form to you with the employer section completed. By law, your employer has 24 hours to return the completed form to you. 
The application for adjudication of claim is a form that is filled out if there is a dispute between an injured worker and the employer's insurance company.

Not All Injuries Are the Same

A workplace injury is one that arises out of employment/course of employment (AOE/COE). Your employer's insurance carrier has 90 days from receipt of the claim to accept or deny the case. If there is no denial within 90 days, the claim is considered accepted. 
Injuries are classified as one of two types:

• Specific
• Cumulative trauma

An example of a specific injury is falling off a ladder at work and breaking your leg. In other words, it occurred at a definitive time. A cumulative trauma injury is one that is caused by the repetitive stress of the job, such as the following:

• Carpal tunnel syndrome
• Back, neck, leg, feet, knees, or shoulder issues
• Hypertension
• Respiratory illness
• Diabetes
• Gastrointestinal illnesses
• Psychiatric injuries

Injury Awareness Can Be Tricky

Deadlines regarding a Workers' Compensation claim begin with the date of injury, which is clear when the injury is specific, but becomes more challenging with cumulative trauma injuries. When it comes to workplace injuries or illnesses that occur over time, the period for filing a claim begins when:

• You first missed work or consulted with a physician about the injury or illness, and
• You knew or should have known the injury/illness was caused by work

It is important to keep in mind that by filling a DWC claim form, you are merely filing a claim for benefits; you are not suing your employer. Workers' compensation is a no-fault system in which benefits are paid for injuries on the job regardless of fault.

You can obtain a copy of the California DWC 1 claim form here.