Form DWC1 Workers' Compensation Claim Form - California (English / Spanish)

What Is Form DWC1?

This is a legal form that was released by the California Department of Industrial Relations - Division of Workers' Compensation - a government authority operating within California. As of today, no separate filing guidelines for the form are provided by the issuing department.

FAQ

Q: What is Form DWC1?
A: Form DWC1 is the Workers' Compensation Claim Form used in California.

Q: Is the form available in English and Spanish?
A: Yes, the form is available in both English and Spanish.

Q: What is the purpose of Form DWC1?
A: Form DWC1 is used to report a work-related injury or illness and file a workers' compensation claim in California.

Q: Do I need to fill out Form DWC1 if I get injured at work?
A: Yes, if you get injured or ill due to your job, you should fill out Form DWC1 to report the incident and initiate the workers' compensation process.

Q: Are both employees and employers required to complete sections of Form DWC1?
A: Yes, both employees and employers have specific sections to complete on Form DWC1.

Q: What information is required on Form DWC1?
A: Form DWC1 requires information about the injured employee, the employer, details of the injury or illness, and the medical treatment received.

Q: What should I do with Form DWC1 once it is completed?
A: Once Form DWC1 is completed, you should give a copy to your employer and keep a copy for your own records.

Q: What happens after I submit Form DWC1?
A: Once you submit Form DWC1, your employer's insurance company will review the claim and determine if you are eligible for workers' compensation benefits.

Q: Is there a deadline to submit Form DWC1?
A: Yes, you should submit Form DWC1 as soon as possible after the injury or illness occurs, but no later than one year from the date of the incident.