Workers compensation claim form 2025

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The document is a Workers' Compensation Claim Form (DWC 1) and Notice of Potential Eligibility, which outlines the process for employees to file a claim for workers' compensation benefits due to job-related injuries or illnesses. It details the steps for completing the form, medical care coverage, temporary and permanent disability payments, return-to-work procedures, and rights regarding privacy and employer retaliation. The document also provides information on additional benefits such as supplemental job displacement and death benefits.

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What is the purpose of the Workers’ Compensation Claim Form (DWC 1)?

The DWC 1 form is used to file a workers' compensation claim if you are injured or become ill due to your job, allowing you to seek benefits.

How do I complete the DWC 1 form?

You need to fill out the 'Employee' section of the form, keep a copy for yourself, and give the rest to your employer for completion.

What should I do after submitting my claim form?

After submitting your claim, ensure that your employer completes their section and provides you with a dated copy. Benefits cannot start until the claims administrator is notified.

What medical benefits can I expect from workers' compensation?

Your claims administrator will cover all reasonable and necessary medical care related to your work injury or illness, including doctor visits, hospital services, and medications.

Can I choose my own doctor for treatment?

Generally, your employer selects your Primary Treating Physician (PTP) for the first 30 days. After that period, you may be able to switch doctors under certain conditions.

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What is the most common workers comp claim?

What You Shouldnt Tell Your Workers Comp Doctor Never lie about prior injuries, pre-existing conditions, or medical history. Never lie about the extent of your workplace injury or how it happened. Do not exaggerate your symptoms, including pain or functionality.

How much does SC workers compensation pay?

C-11: Employers Report of Injured Employees Change in Status. Report any change in a claimants work status as soon as it occurs to NYSIF by submitting Form C-11, including return to work, discontinuance of work, decrease in regular working hours or reduction of wages.

What is a fair settlement for workers comp?

Overuse. This is the most common claim for workers compensation. Overuse or overexertion happens when a person strains or pulls a muscle or joint or slips a disk from overextending to lift, pull, push, or turn an item.

What not to say to a workers comp doctor?

In South Carolina, injured workers typically receive ⅔ of their pre-tax weekly salary in workers comp benefits. This usually works out to workers receiving 66 and ⅔ % of their average weekly wage. So if you typically make $600 a week, you may receive up to $400 in weekly compensation.

Workers compensation claim form 2025

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Got questions?

What is the purpose of the Workers’ Compensation Claim Form (DWC 1)?

How do I complete the DWC 1 form?

What should I do after submitting my claim form?

What medical benefits can I expect from workers' compensation?

Can I choose my own doctor for treatment?

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What is the most common workers comp claim?

How much does SC workers compensation pay?

What is a fair settlement for workers comp?

What not to say to a workers comp doctor?

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