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First Report of Injury/Notice of Contests When a worker is injured or has an occupational disease that results in more than three days/shifts of lost time, permanent impairment, or death, the insurance carrier must file a First Report of Injury (FROI) with the Division of Workers Compensation (DOWC) within 10 days.
A DWC 1 is the form that is filled out to report an injury to your employer, and officially initiate a workers compensation claim. DWC stands for Division of Workers Compensation, this is the government agency that monitors workers compensation claims and law.
Every physician who treats an injured employee must file a complete Form 5021 Doctors First Report of Occupational Illness or Injury (DFR) with the employers claims administrator within five days of the initial examination.
Within 5 days of your initial examination, for every occupational injury or illness, send two copies of this report to the employers workers compensation insurance carrier or the insured employer.
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