State-Specific Work Comp Claim Form Guides (USA)
California Work Comp Claim Form (DWC-1)
What Is the California Work Comp Claim Form?
California uses the DWC-1 Claim Form, which is mandatory for all work-related injuries and illnesses.
How to File a Work Comp Claim in California
- Report the injury to your employer within 30 days
- Employer must give you the DWC-1 form within 1 working day
- Complete the employee section only
- Return the form to your employer
- Employer submits it to their insurer
Key Deadlines (California)
| Action | Deadline |
|---|---|
| Injury report | 30 days |
| Claim filing | ASAP after injury |
| Medical treatment | Immediately upon filing |
Special California Rules
- Up to $10,000 in medical care must be provided while the claim is pending
- You may pre-designate a personal physician
- Employer retaliation is strictly prohibited
Official Form Name: DWC-1
Agency: California Division of Workers’ Compensation (DWC)
Texas Work Comp Claim Form (DWC-041)
Is Workers’ Comp Mandatory in Texas?
Texas is unique — workers’ compensation is optional for employers. However, if covered, injured workers must file a claim.
Texas Work Comp Claim Process
- Report injury to employer within 30 days
- File DWC-041 (Employee’s Claim for Compensation)
- Submit directly to the Texas Department of Insurance
- Employer files separate report with insurer
Texas Filing Deadlines
| Action | Deadline |
|---|---|
| Report injury | 30 days |
| File DWC-041 | 1 year from injury |
Important Texas Notes
- Claims are filed by the employee, not just the employer
- Non-subscriber employers can be sued in civil court
- Late filing often leads to denial
Official Form Name: DWC-041
Agency: Texas Department of Insurance – Division of Workers’ Compensation
New York Work Comp Claim Form (C-3)
New York Workers’ Compensation Claim Overview
New York requires injured workers to file Form C-3 to receive benefits.
How to File a Claim in New York
- Notify employer within 30 days
- Complete Form C-3
- File with the New York Workers’ Compensation Board
- Employer files Form C-2 separately
New York Deadlines
| Action | Deadline |
|---|---|
| Injury notices | 30 days |
| C-3 filing | 2 years |
New York-Specific Highlights
- Online filing available
- Coverage includes occupational diseases
- Independent medical exams (IMEs) are common
Official Form Name: C-3
Agency: New York Workers’ Compensation Board