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Commonly Asked Questions about Mississippi Workers Compensation Forms

Mississippis Basic Process to File a Workers Compensation Claim Obtaining Medical Treatment Reporting the Injury to the Employer. Reporting the Injury to the Insurance Carrier. Accepting or Denying the Workers Comp Claim.
A: A DWC 1 claim is a workers compensation claim that must be started with the DWC 1 Form. This form must be filled out by the employee to start a workers comp claim in California. This officially initiates the compensation claim with the employer, the employee, and the insurance company.
DWC-7 Notice to Employees-Injuries Caused by Work (English and Spanish). This form provides your employees with information regarding workers compensation benefits and the Medical Provider Network (MPN) in California.
Form CA-7 is used to claim compensation for wage loss while in a leave without pay (LWOP) status due to disability or absence to obtain medical treatment (after continuation of pay (COP) period for traumatic injury cases).
The Employers Report of Occupational Injury or Illness (Form 5020). Every employer is required to file a complete report of every occupational injury or illness to each employee which results in lost time beyond the date of injury or illness or which requires medical treatment beyond first aid*.
All employers with five (5) employees regularly employed are required to provide workers compensation insurance coverage. If the employer has less than five (5) employees, workers compensation coverage is not mandatory but may be provided voluntarily by the employer.
This form is used by an employee to claim compensation in an established case for traumatic injury or occupational disease. As the supervisor, you will receive an email from ECOMP notifying you that a form requires your review.