Workers' Compensation blog


Understanding the DWC-1 Form in a Los Angeles Work Comp Claim

On behalf of Mitchell Law Corporation
March 4, 2024

Understanding the DWC 1 Form in a Los Angeles work comp claim can be difficult at times. It can be challenging to know where to find the form and which sections to fill out. The DWC 1 Form is an essential part of every workers’ comp claim. It is the official form used to initiate a claim. An experienced Los Angeles workers’ comp attorney can help guide you through the process of completing the DWC 1 Form and initiating your claim.

Where Do I Get the DWC 1 Form?

In workers’ comp cases in California, the employer will be responsible for issuing the employee the DWC 1 Form. California state law requires employers to provide employees with the form either in person or through the mail.

The form must be provided within one work day of discovering the workplace injury. For example, if your injury occurs on a Wednesday, then your employer should provide you with the form in person or send it in the mail by the end of the day on Thursday. If the injury occurs on a Friday, then the employer has until Monday to provide the form, assuming a traditional Monday through Friday work schedule.

Understanding the DWC-1 Form in a Los Angeles work comp claim

Who Has to Complete the Form?

The form must be completed by the employee, and it will then be sent back to the employer. The employer should then send the form to the insurance company. It is important to ask your employer for a completed copy of the form once it has been sent to the insurance company. It is a good idea to keep the form for your records. The form must be completed by both the employee and the employer and sent to the insurance company for the claim process to be initiated.

What Does the Employee Fill Out?

There are typically nine sections of the form that the employee is responsible for filing out:

  • Name and date. This should be your full legal name and the current date when you are completing the form.
  • Home address. You should fill out your full home address, including the city, state, and zip code of your home.
  • Social Security number. Include your Social Security number if you have one. It is possible to continue with your workers’ comp claim without your Social Security number, but it is generally recommended that you include it if you have one.
  • Date and time of the injury. This section should be filled out as accurately as you can.
  • Description of how the injury happened.
  • Address of where the injury happened. It is important to be as specific as possible in this section, as it can help your claim.
  • Injury description. In this section, you will describe the specific injury.
  • Email consent. This will allow you to receive communication about your claim through email.
  • Signature. The form is not complete unless it includes the employee's signature.


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

A: To fill out a DWC 1 Form, you can download the form from the forms page of the Division of Workers’ Compensation. It is important to note that the employer is required to provide you with a claim form within one working day after discovering the injury or illness. This form can either be provided in person or through the mail. Once you have the DWC 1 Form, you should only fill out the “employee” sections and then give it back to the employer.

Q: What Is a DWC 1 Claim?

A: A DWC 1 claim is a workers’ compensation claim that must be started with the DWC 1 Form. This form must be filled out by the employee to start a workers’ comp claim in California. This officially initiates the compensation claim with the employer, the employee, and the insurance company. Some DWC claims can be resolved between the employee and the employer. There are some cases in which a workers’ comp attorney is needed to step in and review the case.

Q: What Does DWC Mean in Workers’ Comp?

A: DWC stands for Division of Workers’ Compensation. The Division of Workers’ Compensation is the administration responsible for monitoring workers’ compensation claims. They can provide administrative and judicial services that help employees and employers resolve their claims.

Any issues or disputes that may arise during a workers’ comp claim can typically be resolved with the help of the DWC. It is still important, however, to engage the help of an experienced workers’ comp attorney who can put your interest first and fight for you to get a fair deal.

Q: How Do You Calculate a Workers' Comp Settlement in California?

A: Calculating a workers’ comp settlement in California often depends on the type of injury that occurred. The calculation also depends on the amount of disability or medical attention that results from the injury. For example, if the injury causes you to be 100% disabled, then the settlement will be roughly two-thirds of your average income. Other general factors that will influence the workers’ comp settlement amount are the gross wages, number of hours worked each week, and amount of time working for the employer.

A Law Firm Ready to Serve You

Navigating through the struggles of filing a workers’ comp claim can become an overwhelming and stressful process. There can be strict forms and deadlines that have to be met to accurately get your claim processed. It is critical that you work with an experienced and qualified attorney who can provide you with advice, direct you to the correct path, and help ensure that you have the right forms in place for your workers’ comp claim.

At Mitchell Law Corporation, our legal team works diligently to provide individuals with the direction and guidance that they need to get their workers’ comp claims successfully processed. We understand that an injury in the workplace can be a stressful process. Our firm can handle each individual case with the care and compassion that it needs. Speak with one of our attorneys today to see how we can assist you through the workers’ comp process.

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Understanding the DWC-1 Form in a Los Angeles Work Comp Claim
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