CONVERTED ELECTRONIC FORMS – DCD eCMS Modernization Project

DCD is currently working to update and convert all WC, TDI, and PHC forms electronically. During the interim, DCD is converting the WC-1, WC-2, WC-3, WC-5, WC-5A to a fillable PDF.

Effective January 1, 2020, the WC-3A Carrier’s Benefit Adjustment Report is the only fillable form that can be used. You can still use all of the other forms until they get converted.

A sample of the draft WC-1 is available for review. Do not complete or submit the draft form.

ELECTRONIC SUBMITTALS

Insurance Carriers can submit an electronic version of the WC-1 Employer’s Report of Industrial Injury.  There are currently 4 carriers doing this process.  Within the next year, we will be updating this file to include additional fields (i.e. email address, more space to enter information, etc.).

For information on how to file electronically, please email [email protected]

PLEASE NOTE:  The State will statutorily mandate electronic filing by project end.

FREQUENTLY ASKED QUESTION
Please review the frequently asked questions. To download a free pdf viewer, visit Adobe.

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