If you’ve been injured on the job in California, your first step toward getting workers’ compensation benefits is completing and submitting the DWC-1 Claim Form. This form is essential — without it, your employer and their insurance company have no legal obligation to provide benefits.
At Employees First Labor Law, we help injured workers file claims correctly and on time to avoid costly delays or denials. Here’s your guide to the DWC-1 Form and why it matters.
1. What Is the DWC-1 Form?
The DWC-1 (Division of Workers’ Compensation) Claim Form is the official document that notifies your employer of a work-related injury and starts the process for receiving:
- Medical treatment
- Temporary disability payments (TD)
- Permanent disability benefits (PD)
- Vocational rehabilitation (SJDB Voucher)
- Mileage reimbursement
- Future medical care
Filing this form puts your injury “on record” and establishes your legal right to workers’ compensation benefits under California Labor Code § 5401.
2. When Do You Need to File a DWC-1 Form?
As soon as possible — ideally within 30 days of your injury.
Failing to file on time can result in the loss of your right to benefits. Even if you verbally report your injury, you should still complete the DWC-1 in writing to protect yourself.
📌 Cumulative trauma or stress injuries? The clock starts when you knew or should have known your injury was work-related — often when diagnosed by a doctor.
3. How to Get the DWC-1 Form
Your employer is required to give you a DWC-1 form within one working day of learning about your injury.
If they fail to provide it, you can download it directly from the California Department of Industrial Relations here:
👉 Download the DWC-1 Form (PDF)
4. How to Fill Out the DWC-1 Form (Employee Section)
The top portion of the form is for you (the injured worker). Fill it out carefully:
| Field | What to Include |
|---|---|
| Employee Name | Your full legal name |
| Home Address | Include city, state, and zip |
| Date of Injury | When the injury occurred |
| Time of Injury | If applicable |
| Address Where Injury Occurred | Job site or specific location |
| Describe Injury/Illness | Be clear and concise (e.g., “low back strain from lifting boxes”) |
| Social Security Number | Optional, but may be used for verification |
| Signature and Date | Sign to affirm the accuracy |
✅ Tip: Be consistent with how you describe your injury on this form, with your doctor, and in all communications.
5. What Happens After You Submit the DWC-1
Once you complete the employee section:
- Give it to your employer.
- They must fill out the employer section and return a copy to you.
- They notify their insurance company, who must authorize up to $10,000 in medical treatment while they investigate the claim (Labor Code § 5402(c)).
- You will receive a claims administrator contact and workers’ comp benefits brochure.
💡 Note: Filing a DWC-1 does not guarantee approval — but it’s the legal first step to securing your rights.
6. Common Mistakes to Avoid
- ❌ Delaying the filing — waiting too long can jeopardize your claim
- ❌ Incomplete or vague injury descriptions
- ❌ Not getting a signed and dated copy from your employer
- ❌ Failing to seek medical attention promptly
- ❌ Not consulting an attorney when your claim is denied or delayed
7. When Should You Talk to a Workers’ Comp Lawyer?
If any of the following apply, speak with an experienced attorney immediately:
- Your claim was denied or delayed
- You have a serious injury or surgery is recommended
- Your employer is not cooperating or retaliating
- You were injured due to stress, harassment, or unsafe conditions
- You’re not receiving full TD or PD benefits
At EFLL, we file and follow up on DWC-1 forms for you, ensure prompt medical treatment, and fight for your maximum settlement or award.
8. Need Help with Your DWC-1 Form? Contact EFLL Today
If you’ve been hurt at work and aren’t sure what to do next, Employees First Labor Law is here to help. We’ll explain your rights, complete your paperwork, and deal directly with the insurance company — so you can focus on healing.
📩 Schedule a consultation
📞 Call us now to speak with a workers’ comp attorney
