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

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

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 the DWC1 Workers' Compensation Claim Form?A: The DWC1 Workers' Compensation Claim Form is a form used in California to file a workers' compensation claim.

Q: Who needs to fill out the DWC1 Form?A: Employees who have suffered a work-related injury or illness in California need to fill out the DWC1 Form.

Q: Is the DWC1 Form only available in English and Chinese?A: Yes, the DWC1 Form is available in both English and Chinese.

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

Q: How long do I have to submit the DWC1 Form?A: You should submit the DWC1 Form as soon as possible after the injury or illness occurs, but you generally have up to one year from the date of injury to file the form.

Q: What happens after submitting the DWC1 Form?A: Once you submit the DWC1 Form, your claim will be reviewed by your employer's insurance company and the appropriate benefits will be determined.

Q: Are there any fees associated with filing the DWC1 Form?A: No, there are no fees associated with filing the DWC1 Form.

Q: Can I get legal representation for my workers' compensation claim?A: Yes, you have the right to seek legal representation for your workers' compensation claim if needed.

Q: What should I do if my claim is denied?A: If your claim is denied, you have the right to appeal the decision and seek legal advice for assistance.

ADVERTISEMENT

Form Details:

  • Released on January 1, 2016;
  • The latest edition provided by the California Department of Industrial Relations - Division of Workers' Compensation;
  • Easy to use and ready to print;
  • Available in Spanish;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a printable version of Form DWC1 by clicking the link below or browse more documents and templates provided by the California Department of Industrial Relations - Division of Workers' Compensation.

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

4.5 of 5 (6 votes)
  • Form DWC1 Workers' Compensation Claim Form - California (English/Chinese)

    1

  • Form DWC1 Workers' Compensation Claim Form - California (English/Chinese), Page 2

    2

  • Form DWC1 Workers' Compensation Claim Form - California (English/Chinese), Page 3

    3

  • Form DWC1 Workers' Compensation Claim Form - California (English/Chinese), Page 4

    4

  • Form DWC1 Workers Compensation Claim Form - California (English / Chinese), Page 1
  • Form DWC1 Workers Compensation Claim Form - California (English / Chinese), Page 2
  • Form DWC1 Workers Compensation Claim Form - California (English / Chinese), Page 3
  • Form DWC1 Workers Compensation Claim Form - California (English / Chinese), Page 4
Prev 1 2 3 4 Next
ADVERTISEMENT

Related Documents