Employers First Report Of Injury Or Illness {DWC-1}

DWC001 - EMPLOYER’S FIRST REPORT OF INJURY OR ILLNESS. This form is used by Texas employers to report workplace injuries, illnesses, or deaths involving employees. It provides detailed information about the injured employee, the incident, and its circumstances. Send this form to your workers’ compensation insurance carrier and to the injured employee or the injured employee’s representative. Do not send this form to the Texas Department of Insurance, Division of Workers’ Compensation (DWC), unless DWC specifically requests it. You must send the DWC Form-001 within eight days after the employee’s first day of absence from work due to the injury; you receive notice of occupational disease; or an employee dies. Employers must file this form so the insurance carrier has the information they need to begin the claims process. You may be fined if you fail to send this report without having a good reason (good cause.) You can file the form with the insurance carrier and send it to the injured employee or the injured employee’s representative by email, fax, U.S. Postal Service, or personal delivery. Keep a copy of this form to serve as the Employer’s Record of Injury required by Texas Labor Code Section 409.006. For more requirements refer to DWC rule 120.2, Employer’s first report of injury and notice of injured employee rights and responsibilities. www.FormsWorkflow.com