Which form is used to file an employee workers' compensation claim?

Which form is used to file an employee workers' compensation claim?

• A. DIA-510
• B. DWC-1
• C. 9900
• D. DWC-1 500E

Answer: (B)

The DWC-1 form is the official document employees use to report a work‑related injury and begin a workers’ compensation claim in California. It serves as both Notice of Injury and Claim for Workers’ Compensation, triggering the claim process whether the employer is insured or self‑insured under a SIP. By submitting this form, the employee starts medical treatment provisions and benefit calculations, and the employer or claims administrator forwards it to the appropriate system for processing. The other forms listed are not the standard employee claim form used to initiate a workers’ compensation claim.

The DWC-1 form is the official document employees use to report a work‑related injury and begin a workers’ compensation claim in California. It serves as both Notice of Injury and Claim for Workers’ Compensation, triggering the claim process whether the employer is insured or self‑insured under a SIP. By submitting this form, the employee starts medical treatment provisions and benefit calculations, and the employer or claims administrator forwards it to the appropriate system for processing. The other forms listed are not the standard employee claim form used to initiate a workers’ compensation claim.