Annual Report Of Adjusting Locations {DWC-851}

Form DWC-851 - 2023 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 2023 must be filed by April 1, 2024. 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. Failure to timely submit reports may be subject to penalty assessments of up to $500 per location. www.FormsWorkflow.com