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What is a DWC 1 Form?


After a workplace injury, it can be difficult to know what steps to take to file a workers’ compensation claim. While this information should be clear and easy to find for all employees, not all employers make this information accessible.

Either through negligence or as an attempt to discourage people from filing a claim, many employees are left wondering how to get the benefits they deserve. This blog will break down the first and crucial step in filing a workers’ compensation claim; filling out and submitting a DWC 1 form.

What is a DWC 1 Form?

A DWC 1 is the form that is filled out to report an injury to your employer, and officially initiate a workers’ compensation claim. DWC stands for Division of Workers' Compensation, this is the government agency that monitors workers’ compensation claims and law. Employees who suffer from the following are eligible to file for workers’ comp:

  • Injury directly related to your job
  • Physical illness directly related to your job
  • Mental illness directly related to your job
  • Injuries resulting from a workplace crime

Where Can I Get a DWC 1 Form?

According to California law, your employer is required to give or mail you a DWC 1 form within one business day after you report your injury. The form can also be found by clicking here. Once filled out, you return your form to your employer, either by hand or through certified mail. In return, your employee should give you a copy of the form with the phrase, “Employee’s Temporary Receipt” added to it.

It is important to sign and date your records and equally as important to keep a copy of your records for yourself. If a problem arises with your claim later, you will want to have a copy of the date your form was completed and the date it was returned to your employer

How Do I Fill Out a DWC 1 Form?DWC 1 Form

A DWC 1 form is a four-page form with only a small section that needs to be filled out. Those filing for workers’ compensation only need to fill out the “employee” section at the bottom of the form. The form requires basic information such as name, address, and social security number, as well as a brief description of the injury or illness you are facing.

After receiving your completed form, a claim administrator should get back to you concerning the status of your benefits within 14 days. It is possible for your claim to be denied or for more information about your injury to be requested. If you are facing any issues with the status of your claim, contact our team of attorneys for assistance. We are backed by years of experience and have recovered over $300 million for our clients.

Contact our firm today to get started with a free consultation.


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