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My employer and the insurance company have denied my claim for workers' compensation benefits. Do I need legal representation to get my benefits?The following forms need to be completed and submitted to EMPLOYERS when a work-related injury occurs: DWC1 First Report of Injury (FROI). Items 14 - 33 — Providers sending professional and supplier claims to Medicare on paper must use Form. CMS-1500 in a valid version. Providers can use this Quick Reference Guide to find additional steps and resources for reviewing and rectifying EOB bill denials. The injured worker must complete the first section of the form entitled "Worker's Report" and sign and date this section of the form. If the employer is self-insured, complete the Provider's Initial Report and submit it to the self-insured employers claim contact. If the employer is self-insured, complete the Provider's Initial Report and submit it to the self-insured employers claim contact. Provider signatures are not required on paper claim forms.