Last updated: 6/25/2025
Employees Claim Application {7A DCWC}
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Description
7A DCWC - EMPLOYEE'S CLAIM APPLICATION. This form is issued by the District of Columbia Government Office of Workers' Compensation and is used by employees to file a formal claim for workers' compensation benefits. It gathers key information including the employee’s personal details, Social Security number, employer and insurer information, and specifics about the injury or occupational disease sustained on the job. The form notifies the employer that a claim has been submitted and outlines their obligation to either begin voluntary payment of benefits within 14 days or file a formal denial (Notice of Controversion). It includes a warning about the legal consequences of providing false or misleading information, and it requires the employee's signature to confirm that the claim has been filed. www.FormsWorkflow.com
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