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At Workers Compensation Shop.com, we provide free access to most of the forms relating to District of Columbia Workers' Compensation Insurance. We strive to keep these forms up to date and accurate.
As with all information we provide, please verify the accuracy of this information with the DC Office of Workers' Compensation.
If you have any questions about any of these forms, feel free to contact a Workers Comp Specialist at 888-611-7467. If you are ready you can start a quote online today. We want to be your go to for forms, rates, and quotes about your Workers Comp Coverage.
DC Acord 130 Workers' Compensation Application.
The standard Acord 130 application form for workers comp coverage in D.C.
D.C. First Report of Injury Form - DCWC Form 8
D.C. First Report of Injury Form. Employers should complete this form and send to their insurance company each time an injury occurs.
DC Employee Notice of Injury or Disease
DC First Report of Injury Form. Employers should complete this form and send to their insurance company each time an injury occurs.
DC Employee Claim Application- DCWC Form 7A
DC work comp laws require that any claim for benefits be filed within 1 year after the injury occurred. Applications should be sent to the DC Office of Workers' Compensation.
DC Guide to Employee Rights and Obligations Under Workers' Compensation
An employee guide to their rights and responsibilities under DC workers compensation laws.
DC Application for Informal Work Comp Dispute Hearing
DC application for an informal hearing to dispute a workers compensation claim with the DC Department of Employment Services and the DC Office of Workers' Compensation
DC Work Comp Quarterly Surcharge Payment Form
All insurance companies writing workers compensation insurance in Washington DC are required by law to collect a DC surcharge on each DC policy and remit payment of surcharges on a quarterly basis.
Each state has its own laws and requirements regarding when and how employers are allowed to opt-out of coverage under their workers compensation policy. Some states make it easier than others because they don't require anything to be filed. Other states require special inclusion or exclusion affidavit documentation. Failure to comply often causes employers to have to pay premium on themselves even when they wanted to be excluded form coverage.
A waiver of subrogation means that a business and their insurance company is foregoing all rights to file suit, or seek damages, from another business. This is common in the construction industry as builders attempt to protect their company from negligence. A workers' comp waiver of subrogation does not prevent an injured employee from filing a lawsuit for damages. This coverage typically add about $100 to the cost of a work comp policy.
A Certificate of Insurance is a document that serves as evidence of insurance or proof of coverage. Certificates indicate your current coverages and policy limits. Insurance Agencies issue on an insured's behalf and they often list a third party as a certificate holder. This means they should be notified if a policy cancels prior to expiration. Requests for any special wording should be carefully checked against the policy language before being added to a certificate as they can create legal issues with coverage.
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State Resources for DC
DC Office of Workers' Compensation
64 New York Avenue, NE, 2nd FloorWashington, DC 20002202-671-1000 http://does.dc.gov/
National Council on Compensation Insurance (NCCI)
901 Peninsula Corporate CircleBoca Raton, FL 33487-1362800-622-4123 NCCI
Workers compensation insurance is required by law for Washington DC employers.
Washington DC forms and applications such as owners inclusion or exclusion forms are sometimes updated by the state. Contact us if you need help or can't find the workers compensation form your need for Washington DC.
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