Guam Injury Report Form
Description
How to fill out Injury Report Form?
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FAQ
Division of Workers' Compensation Notice to Employees--Injuries Caused By Work. You may be entitled to workers' compensation benefits if you are injured or become ill because of your job. Workers' compensation covers most work-related physical or mental injuries and illnesses.
CA-7 - Claim for Compensation on Account of Traumatic Injury or Occupational Disease. Used for the following purposes: To claim lost wages when continuation of pay expires on a traumatic injury, and to claim wage loss on occupational disease claims.
Form DWC-7 is a notice to provide injured workers with rights, benefits and contact information.
Every physician who treats an injured employee must file a complete Form 5021 Doctor's First Report of Occupational Illness or Injury (DFR) with the employer's claims administrator within five days of the initial examination.
Worker's Compensation Policy protects businesses against the costs of compensating employees who are injured or ill because of their work. Under Guam Law, all businesses are required to carry a minimum limit of $100,000 and in the CNMI, the minimum limit is $40,000.
A DWC 1 is the form that is filled out to report an injury to your employer, and officially initiate a workers' compensation claim. DWC stands for Division of Workers' Compensation, this is the government agency that monitors workers' compensation claims and law.
Division of Workers' Compensation (DWC): A division within the state Department of Industrial Relations (DIR).