Get Wc015 Workers' Claim For Compensation - Colorado.gov - Colorado

The WC015 Workers' Claim For Compensation form is crucial for employees seeking compensation for work-related injuries in Colorado. This guide provides clear, step-by-step instructions on how to accurately complete the form online to ensure a smooth filing process.

Follow the steps to fill out the form correctly and efficiently.

1. Click ‘Get Form’ button to obtain the form and open it for completion.
2. Enter your name in the designated field, including your first, middle, and last names.
3. Provide your Social Security number in the appropriate box to ensure proper identification.
4. Fill in your street address, including city, state, and zip code, to provide accurate personal details.
5. Indicate your gender by checking the appropriate box and fill in your birth date.
6. Select your marital status from the given options to provide additional context for your claim.
7. Enter your employer's name and contact information, including the company's mailing address.
8. Document your employment details by stating your occupation and the date you were hired.
9. Indicate your employment status (full-time, part-time, or other) by checking the relevant box.
10. Calculate your average weekly wage by following the instructions provided, detailing your earnings from various sources.
11. Input the date and details of your injury, including how it occurred and the part of your body affected.
12. List any witnesses to the incident and provide their contact details.
13. Specify any prior treatment received and the name of the healthcare provider.
14. Once all fields are completed, save your changes and download or print the form for submission.

Complete your WC015 Workers' Claim for Compensation online to ensure your claim is filed correctly.