Get Instructions For Wc-1 Form - Department Of Labor And Industrial ...

Completing the WC-1 Employer's Report of Industrial Injury is an essential task for employers in Hawaii. This guide provides clear, step-by-step instructions on how to fill out the form online, ensuring basic compliance with the reporting requirements while assisting those with limited legal experience.

Follow the steps to successfully fill out the WC-1 form online.

1. Press the ‘Get Form’ button to obtain the WC-1 form and open it in your preferred digital editor.
2. In the document identification section, begin filling out the employee's name exactly as it appears on their social security card, without using any nicknames.
3. Enter the nine-digit social security number for the employee. If this information is missing, the form will be returned unprocessed.
4. Provide the employee's date of birth in the format mm/dd/yy.
5. Indicate the employee's sex and marital status by placing a mark in the corresponding box.
6. Enter the employee's home address, additional address if applicable, city, state, and zip code.
7. Fill in the employee's local phone number, ensuring you provide either a 7-digit number or a full 10-digit number for those outside Hawaii.
8. Document the employee's occupation at the time of injury.
9. Record the date the employee was hired using the format mm/dd/yy.
10. Identify the department in which the employee was assigned at the time of injury, or provide a brief description if there is no formal title.
11. If applicable, enter the employee's rating manual occupation class code.
12. Complete the employer’s information section, including the name of the employer as it appears on the workers' compensation insurance policy. Include address and contact information.
13. Specify the nature of the business engaged by the employer.
14. Indicate the date the injury or illness was reported using the format mm/dd/yy.
15. Provide the date of injury or illness in the same format if known, or use 'on or about' if not.
16. Enter the 10-digit Department of Labor account number.
17. Document the time of the injury or illness in AM/PM format.
18. Describe how the accident occurred, focusing on the chain of events that led to the situation.
19. Note what the employee was doing at the time of the injury, including any tools or equipment in use.
20. Identify the object or substance that directly injured the employee.
21. Provide a detailed description of the nature of the injury or illness, specifying the body part affected.
22. Indicate the date disability began using the mm/dd/yy format.
23. If applicable, indicate whether the employee was furnished meals or lodging by marking the appropriate box.
24. Complete the average weekly wage section, ensuring numerical entries are provided according to the guidelines.
25. If the employee has returned to work, include the date they resumed duties.
26. Provide further relevant details as necessary, including insurance information and emergency treatment specifics.
27. Ensure all sections requiring signatures or authorizations are completed appropriately.
28. Review all entries for accuracy, save your changes, and prepare to submit the original and copy of the WC-1 form to the appropriate office as outlined in the instructions.

Complete the WC-1 form online to ensure compliance with reporting requirements and support timely processing.