What to do
24/7 Nurse Triage Hotline: Injured employees or the employee’s supervisor can call 1-866-932-5321 for First Responders or 1-855-850-2249 for other employees.
1. Report the work injury or illness to a supervisor or manager
- The supervisor or manager provides the employee with a Claim Form (Form DWC-1) within 24 hours of knowledge.
- Or download the form and read the instructions at the top.
2. Fill out a claim form
- Fill out the "Employee" section.
- Sign and date it.
- Keep a copy for your records.
- Return the form to your supervisor.
3. Next steps
- Supervisor completes the DWC-1 form
- They send the completed form to the assigned workers' compensation coordinator of the department.
- The compensation coordinator records the loss, finishes the department paperwork, and sends all necessary worker's compensation documents via email to ccsf.workcomp@sfgov.org, copying the Claims Supervisor responsible for the department.
- The claim is set up and assigned to an adjuster.
- Be sure to obtain a copy of the completed claim form from your supervisor.
4. Wait to hear back
- You will be contacted by a claims adjuster within 2 business days of assignment of the claim to learn more about your injury and illness and gather additional information to help process your claim.
- The claims administrator has 14 days to send you a status letter about your claim.
- If you do not receive a letter, you should contact a workers' compensation representative.
5. Faster alternative
- The Nurse Triage line is available 24 hours/day, 7 days per week.
- A live nurse takes the report and provides advice on self-care.
- The Triage Nurse provides the employee with a blank Claim Form (Form DWC-1) to complete.
- The nurse sends an incident report to the Workers Compensation Division.
- Finally, the claim is set up.
Last updated March 27, 2024