Workers' Compensation Forms
For your convenience, the workers' compensation attorneys at The Hoffman Firm have compiled a list of official forms from the Florida Department of Financial Services, Division of Workers' Compensation, that are commonly used in workers' compensation cases, as provided for in the Florida Statutes, Chapter 440. The most important forms are listed first, with a link near the bottom to all forms available under Chapter 69L of the Florida Administrative Code.
First Report of Injury or Illness (DFS-F2-DWC-1): The First Report of Injury or Illness form needs to be filled out within the first seven (7) days of your accident and given to your employer.
Wage Statement (DFS-F2-DWC-1a): The Wage Statement form is to track wages prior to the incident for the purpose of proper compensation benefits.
Wage Loss/Temporary Partial Benefit Request (DFS-F2-DWC-3): This form is to request for lost wages and temporary/partial benefits.
Notice of Action/Change (DFS-F2-DWC-4): A form used to record progress since a claim was filed or to document changes in work status.
Employee Earnings Report (DFS-F2-DWC-19): A form that must be completed after an official request is made.
More than a dozen other forms for Florida Workers' Compensation claims related to Division 69L (Workers' Compensation) of the Florida Administrative Code (Chapter 69L-3) can be found at the state's Division of Workers' Compensation forms site.
If you need assistance in completing or submitting a Florida workers' compensation form, or if you have other questions about workers' compensation, contact an experienced workers' compensation attorney in Miami, Florida. The knowledgeable workers' comp lawyers at The Hoffman Firm are ready to assist you in all aspects of your case. Call us at (305) 940-2307 today.
Evan A. Hoffman
Mr. Hoffman’s philosophy is "our knowledge and experience is your best defense." He has been a featured author on criminal law issues such as driving under the influence, domestic violence and illegal searches.Read More