What Is the Colorado WC 1 Form?
The Colorado WC 1 form is the official First Report of Injury (FROI) used in Colorado workers' compensation proceedings. When an employee suffers a work-related injury or develops an occupational illness, the employer is required to document the incident on this form. It starts the workers' compensation claim and gives the insurance carrier the information needed to begin processing benefits for the injured worker.
Who Must File the Colorado WC 1 Form?
Colorado employers are responsible for completing and filing the WC 1 form. Any employer with one or more employees who is required to carry workers' compensation insurance in Colorado must file this form when a covered employee is injured on the job. The employer's representative fills out the form using information provided by the injured employee and any witnesses to the incident.
When Must the WC 1 Form Be Filed?
Colorado law requires employers to file the WC 1 form within 10 days of receiving notice of a work-related injury or occupational illness. Timely filing is essential to avoid penalties and to make sure the injured worker receives benefits without unnecessary delay. The completed form must be submitted to the employer's workers' compensation insurance carrier. Keep a copy on file at your business.
How to Complete the Colorado WC 1 Form
The form is divided into several sections. Completing each section accurately helps the insurance carrier process the claim without delays.
Employee information. Enter the injured worker's full legal name, home address, date of birth, Social Security number, and date of hire. Verify that this information matches your official employment records.
Employer information. Provide the employer's legal name, business address, federal tax identification number, and the name of the workers' compensation insurance carrier along with the policy number. Include the employer's contact person and telephone number.
Injury details. Describe the nature and cause of the injury in plain language. Record the date and time of the injury, the specific location where it occurred, the body part or parts affected, and the type of injury. Examples include fracture, laceration, or strain. Include the names of any witnesses.
Medical treatment. Note whether the injured worker received medical treatment and provide the name and address of the treating physician or medical facility. If your workplace has a designated medical provider, indicate whether the employee was directed to that provider.
Wages. Record the employee's wage rate and pay frequency. Accurate wage information is used to calculate the temporary disability benefit payments the injured worker may receive while unable to work.
Frequently Asked Questions About the Colorado WC 1 Form
Does the injured employee need to sign the WC 1 form? The employee is given an opportunity to review and sign the form to confirm the accuracy of the information. However, the employer is responsible for submitting the completed form whether or not the employee signs.
What happens after the WC 1 form is submitted? The workers' compensation insurance carrier reviews the form and investigates the claim. The carrier will contact both the employer and the injured worker to gather additional information if needed and to determine whether the claim qualifies for benefits.
Can a worker file the WC 1 form on their own? The WC 1 form is an employer obligation. If an employer fails to file, the injured worker may contact the Colorado Division of Workers' Compensation directly. Workers may also file a claim with the Division if the employer does not respond.
How long should records be kept? Employers should retain a complete copy of the WC 1 form and any supporting documentation, including witness statements and medical reports, for at least seven years.
What information is needed for the wage chart section? The wage chart requires payroll data for the 52 weeks preceding the injury. You will need to record the employee's gross earnings for each week worked during that period. This information determines the average weekly wage used to calculate benefit amounts.
Related Workers' Compensation Forms
Depending on the circumstances of the injury, you may also need to complete additional forms. A workers' compensation injury report documents the immediate details of the incident and can supplement the WC 1 filing. A workers' compensation intake form is often used by medical providers to collect clinical and employment information at the first visit. For first reports of injury used in other states, see the first injury report form.