Annual Report Of Adjusting Locations {DWC-851}

Form DWC-851 - 2024 ANNUAL REPORT OF CLAIMS INVENTORY. This form is issued by the Department of Industrial Relations, Division of Workers' Compensation in California. Title 8, California Code of Regulations, Section 10104 requires claims administrators of California workers' compensation claims to file with the Administrative Director, by April 1 of each year, an Annual Report of Inventory indicating the number of claims reported at each adjusting location for the preceding calendar year. The report for CY 2024 must be filed by April 1, 2025. Enclosed is an Annual Report of Inventory. Even if you had no claims reported in the prior year, you must complete and submit the report. Each adjusting location is required to submit an Annual Report of Inventory, whether or not they receive a form for reporting claims from this office. Penalties of up to $500 per location for failure to timely file this Report of Inventory may be assessed under Title 8, California Code of Regulations, Section 10111.1(b) (11) or 10111.2(b) (26). This report must be filed no later than April 1, 2025. Any report received on April 02, 2025, or beyond is considered late and subject to a penalty. www.FormsWorkflow.com