Get Dwc 1 Fillable Form

Filling out the Dwc 1 Fillable Form is a vital step in applying for workers' compensation benefits after an injury or illness related to your job. This guide will provide clear instructions to help users complete the form efficiently and accurately.

Follow the steps to complete the Dwc 1 Fillable Form online

1. Press the ‘Get Form’ button to obtain the Dwc 1 fillable form and open it in your preferred editor.
2. Begin with the ‘Employee’ section. Fill in your full name, today’s date, home address, city, state, and zip code.
3. Next, indicate the date and time of your injury. Provide an address and description of where the injury occurred.
4. Describe the injury and specify the part of the body that was affected.
5. Enter your Social Security number and sign the form as the employee.
6. After completing your section, give the form to your employer. Retain a copy for your records, labeled 'Employee's Temporary Receipt.'
7. Your employer will fill out the ‘Employer’ section, including their name, address, and details regarding their knowledge of the injury.
8. Ensure that your employer provides you with a signed and dated copy before they submit the form to the claims administrator.
9. Review everything entered for accuracy and completeness before finishing.
10. Finally, once the form is submitted, you may save changes or download, print, or share the document as needed.

Get started on completing your Dwc 1 Fillable Form online today to ensure you receive the benefits you may be entitled to.