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Workers’ Compensation Claim Form (DWC 1) & Notice of ...

Workers' Compensation Claim form (DWC 1) & Notice of potential Eligibility Formulario de Reclamo de Compensaci n de Trabajadores (DWC 1) y Notificaci n de Posible Elegibilidad If you are injured or become ill, either physically or mentally, because of your job, Si Ud. se lesiona o se enferma, ya sea f sicamente o mentalmente, debido a su including injuries resulting from a workplace crime, you may be entitled to trabajo, incluyendo lesiones que resulten de un crimen en el lugar de trabajo, es workers' Compensation benefits. Use the attached form to file a workers' posible que Ud. tenga derecho a beneficios de compensaci n de trabajadores. Compensation Claim with your employer.

Workers’ Compensation Claim Form (DWC 1) & Notice of Potential Eligibility Formulario de Reclamo de Compensación de Trabajadores (DWC 1) y Notificación de Posible Elegibilidad If you are injured or become ill, either physically or mentally, because of your job, including injuries resulting from a workplace crime, you may be entitled to

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