When Should An Employer Fill-Out Its Portion Of A Claim Form (DWC-1)?

Q: Should a California employer complete the Employer’s portion of a workers’ compensation claim form (DWC-1 form) before providing it to the employee or should the employer provide a blank form to the employee, completing it upon return by the employee?

A: The language on the claim form itself which mandates the following to an employer:

You are required to date this form and provide copies to
your insurer or claims administrator and to the employee, dependent
or representative who filed the claim within one working day of
receipt of the form from the employee.

The employer should date the form, provide copies to the insurer or claims administrator and the employee, dependent or representative of either who filed the form within one working day of receipt of the form from the employee, dependent or representative. Thus an employer must keep good and accurate records as it may have to complete its portion of the form days, weeks or months after it was first reported and a claim form provided. Completion in accordance with law depends on when the employee returns the form.

It should be noted that LC 5400 requires applicant to serve notice in writing of an injury thirty days after the occurrence of an injury with limited and enumerated statutory exceptions.

Refusal of Medical Care Forms

Q: When Should An Employer Fill-Out Its Portion Of A Claim Form (DWC-1)?

A: There is no legal obligation to complete such a form in the California Workers’ Compensation system thus provision and completion of such a form is completely voluntary. Although these forms are not required by workers’ compensation, there is no reason not to use such a form if available. I recommend having the form completed assuming that the employee is not coerced to do so and does so of his or her own free will.

Completion and/or receipt of the refusal of care form does not preclude liability. LC 5000 is clear that no contract, rule or regulation absolves an employer of liability provided under the selected portions of the Labor Code providing for workers’ compensation benefits. The form may be persuasive at trial or hearing but will in no way be preventative of any California workers’ compensation legal right, remedy or obligation of a California employee or employer.