Get Form Wc-1

Filling out the Form WC-1, also known as the Employer’s First Report of Injury or Occupational Disease, is a crucial step in reporting workplace injuries. This guide provides clear and structured guidance for completing the Form WC-1 online, ensuring that you meet all necessary requirements.

Follow the steps to accurately complete the Form WC-1 online.

1. Click ‘Get Form’ button to obtain the form and open it in the editor.
2. Begin by filling out the identifying information section. Input necessary details such as the employee's last name, first name, middle initial, social security number, date of injury, and gender. Ensure that all entries are accurate.
3. Complete the employee's information, including their birthdate, phone number, and address. It is crucial to provide up-to-date contact information.
4. In the employer section, input the employer's name, address, phone number, and NAICS code. Describe the nature of business accurately to reflect operations.
5. Fill in the claims office information along with the appropriate FEIN and contact details. This ensures that the report reaches the correct department.
6. Provide employment and wage details, including the date hired, job classification code number, wage rate at the time of injury, and the number of days worked per week.
7. In the injury/illness section, indicate if the employee received full pay on the date of injury and provide details about the injury, including type, body part affected, and how the injury occurred.
8. Input information about the treating physician, hospital or facility, and initial treatment given. Document any absence from work and any specifics related to when the employee returned.
9. Complete the income benefits section by entering the average weekly wage, weekly benefit, and any compensation paid. If applicable, fill in the details regarding temporary or permanent disability.
10. Once all fields are completed, review the form for accuracy. After verification, you can save changes, download, print, or share the form as necessary.

Begin completing Form WC-1 online today to ensure timely and accurate reporting of workplace injuries.