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Form DWC-1 Employer's First Report of Injury or Occupational Disease. The employer is required to file an Employer's First Report of Injury or Illness.Employer's First Report of Injury. Office of Workers' Compensation Programs. Instructions: Complete this form as soon as possible after an incident that results in serious injury or illness. CLAIMS ADMINISTRATOR: Enter the name of the carrier, third party administrator, state fund, or self-insured responsible for administering the claim. Employer's First Report of. (Please read the instructions on page 2 for completing this form). IA-1 WORKERS COMPENSATION – FIRST REPORT OF INJURY OR ILLNESS. ​Tell your employer about your work-related injury or illness right away.