Workers Compensation Forms & Audit Worksheet


California Workers Compensation Forms

There are many forms that need to be completed when filing for workers’ compensation. The main form that needs to be completed is the DWC-1 (Workers’ Compensation Claim Form and Notice of Potential Eligibility). Employers are required to provide the claim form within one working day of hearing about any workplace injury. Contact Reverent Employer Consultants to assist you in all of your required notices to your employees. We will work with you and your carrier to implement all of the requirements so that you can become and remain in compliance for your specific business. Protect yourself in a proactive way. Don’t wait for a problem to arise and then scramble to deal with it. As a business owner, you should also consider working with your insurer to put together a triage program to address injuries in a timely manner, and to prevent them from becoming worse. You may also want to consider a corporate wellness program to encourage your employees to become and remain as healthy as possible and to resolve their aches and pains before they develop into injuries requiring treatment through the workers’ compensation system.

Workers Comp Audit Worksheet

As the employer, you must comply with the various laws in order to provide benefits to the employee which the employee may be entitled to. Many notices fully outlining the company’s policies need to be provided to the employees upon hire. The DWC-1 form is used to report workers’ compensation accidents or work-related illnesses to your insurance carrier or designated claims office. It is essential that there are no delays or errors on the form. Reverent Employer Consultants will help to make sure that all of your paperwork is in line.

California Workers Compensation Officer Exclusion Form

As corporate officers, you may elect to exclude yourself from the policy. Discuss the pros and cons of this decision with Reverent Employer Consultants before committing to such a decision. Accidents are bound to happen in the workplace. Companies that are fully prepared ahead of time are more likely to handle the situation in a calm manner. Employers should always be checking the ins and outs of the company and ensuring that everything is in order and nothing dangerous lurks around the corner.

If an injury does occur, employers should be prepared to fill out the proper paperwork to cover all of the bases. A workers’ comp claim must be filed with the company’s insurance provider.

The business owner should remain in constant contact with the employee, the doctor, the claims adjustor, and the insurance agent to make sure everything is being handled properly. Following the recommendations from OSHA will ensure that the standards employers are expected to follow are in place for workplace safety.

Management Consultant Los Angeles

Reverent Employer Consultants want to ensure that you are prepared before, during, and after the audit process. Here are some ways we can help management prepare for an audit.


  • Decide on who the primary contact person will be.
  • Review the original policy.
  • Review the website to see what is readily available to the auditor.
  • Address any potential issues early rather than later.
  • Ensure there is no incorrect or misleading information.
  • Review prior years’ audit billing.
  • If your company uses subcontractors or independent contractors, we will make sure that the 1099 certificates of insurance are on hand. This proves that they have their own Workers’ Compensation insurance.


  • Have a comfortable area provided for their workspace.
  • Try to keep the insurance auditor reviewing your records on-premises.
  • Be prepared to hand over any documents they request.
  • Do not show negative emotions when asked for any kind of documentation. This is a sign to the auditor that you could be hiding something.


  • Request a print out of the auditor’s worksheets. (This will usually not be provided unless asked for.)
  • Compare the statement to the original.
  • Ensure that Classification Codes do not include more expensive classifications than were on the original policy.
  • The Schedule Credit or Debit should not have changed from the original policy.

This can also seem very overwhelming and confusing. Allow Reverent Employer Consultants to be there every step of the way.

Compliance Obligations

There are ongoing compliance obligations that companies must take care of to operate legally and remain in good standing with the state. These can include license and permit renewals, along with entity-related filings required by the state. These obligations can also include:

  • California LLC Business Compliance Filings
    • Statement of information
    • Statement of no change
    • Certificate of Amendment
  • California Corporation Business Compliance Filings
    • Statement of information
    • Statement of no change
    • Certificate of Amendment

Reverent Employer Consultants is always happy to work with your accountant so that together we can boost your compliance. 

NOTICE: Making a false or fraudulent workers’ compensation claim is a felony subject to up to 5 years in prison or a fine of up to $50,000 or double the value of the fraud, whichever is greater, or by both imprisonment and fine.


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