1. DWC

OCR form filers

OCR forms are paper forms that replaced the old "legacy" paper forms found at DWC district offices. OCR forms can be downloaded from this Web site, filled out on your computer and mailed or hand-delivered to DWC. Beginners should read the OCR handbook and study the examples below before filing OCR forms for the first time.

For OCR form filers

• Forms tutorial - June 15, 2010
  • Video
  • Transcript of video
• Document titles list Feb. 22, 2011
• EAMS OCR forms
• Fillable form instructions
• I&A guides for unrepresented injured workers
• OCR paper forms filing handbook
• Technical information for OCR forms developers
  • Approved OCR forms vendor list

Examples of how to set up files for submission using OCR forms, cover sheets and document separator sheets:

• Application for adjudication of claim - Sept. 14, 2010
• Amended application for adjudication of claim - Aug. 11, 2010
• Answer to application for adjudication of claim - Oct. 8, 2008
• Compromise and release - Aug. 11, 2010
• Declaration of readiness to proceed - Sept. 14, 2010
• Declaration of readiness to proceed expedited trial - Aug. 11, 2010
• Notice and request for allowance of lien - Sept. 14, 2010
• Petition to terminate liability for temporary disability indemnity - Oct. 8, 2008
• Proof of service - Oct. 8, 2008
• Request for dispute resolution before the administrative director DWC-AD-10133.55 (SJDB) - Oct. 22, 2008
• Request for consultative rating - Oct. 8, 2008
• Request for summary rating determination - PTP report - Oct. 8, 2008
• Request for summary rating determination - QME report - Oct. 8, 2008
• Stipulations with request for award - Aug. 11, 2010
• Substitution of attorneys - Oct. 8, 2008

Frequently asked questions about:

• Filing OCR forms

Back to EAMS home

August 2023