Claims Kit

Reporting of claim by Employer:

Within 7 days of knowledge of injury. FS 440.185(2),

For death, must report to Division of Workers' Compensation within 24 hours. FS 440.185(3),

First-aid cases which are treated on site do not have to be reported as long as no medical charges were incurred and the employee is not disabled for more than seven days.

First Report of Injury or Illness form (DWC-1)

The employer must send the Wage Statement (DWC-1a) to the Carrier/Servicing Agent within 14 days of the employer's knowledge of a "lost time" or a "medical only to lost time case". The Carrier is to forward to the Division only upon request.

Posting Requirements FS 440.40, FAC 69L-6.007.

The law requires every employer who has secured workers' compensation coverage to post, in a conspicuous location, the poster developed by the Division of Workers' Compensation (Broken Arm poster).

The following information must be included on the compensation notice if the employer is insured through a commercial insurer;

(a) The name and address of the employer; and

(b) The name and address of the insurer, the employer's current workers' compensation insurance policy number, the effective date of coverage of that policy and the expiration date of the policy.

The following information must be included on the compensation notice if the employer is self-insured through a self-insurance fund:

(a) The name and address of the employer;

(b) The name of self-insurers fund to which the employer belongs;

(c) The employer's membership number;

(d) The effective date of coverage; and

(e) The service agent employer's account number.

The compensation notice may also include such other information, in addition to information required above, as the insurer or self-insurance fund may desire concerning accident reports, the names of physicians, or other pertinent information.

The compensation notice must be printed on paper or cardboard stock 11 inches by 17 inches

Broken Arm Poster [PDF 11x17]

Broken Arm Poster (Spanish) [PDF 11x17]

Per the Division of Workers' Compensation, there is no penalty for failing to post the Broken Arm poster.

If an employer outside the construction industry with fewer than four employees chooses not to secure the workers' compensation coverage, he must post clear written notice in a conspicuous location at each work site telling the employees and others of their lack of entitlement to workers' compensation. FS 440.055

There is no Division mandated form for this notice. It must simply state that the employer is not required to secure workers' compensation coverage and that the employer does not have coverage.

The employer must also post the Anti-Fraud poster

Penalties for Late Reporting

Any employer or carrier who fails or refuses to timely send any form, report, or notice is subject to an administrative fine by the department not to exceed $500 for each failure or refusal. FS 440.185(9)

However, any employer who fails to notify the carrier of the injury on the prescribed form or by letter within the 7 days required is liable for the administrative fine, which will be paid by the employer and not the carrier. FS 440.185(9)

Failure by the employer to timely file the notice does not relieve the carrier from liability for the administrative fine if it fails to comply with its duties to send the informational brochure or file required documents. FS 440.185(9)

Fines for untimely filing:

$100 for 1-7 days late


$200 for 8-14 days late


$300 for 15-21 days late


$400 for 22-28 days late


$500 for over 28 days late.

This applies to employer filing late with carrier and carrier filing late with Division.

Rule 69L-24.006

Physician Selection

The employer/carrier/servicing agent has choice of physician. FS 440.13(2)(c) If medical care is provided through a managed care arrangement, the employee can choose a doctor from the list of physicians provided by the employer's managed care arrangement or insurance carrier. FS 440.134

The physician must be a "certified health care provider" certified by the Agency for Health Care Administration" (AHCA) FS 440.13(1)(q), FS 440.13(3)(a)

Upon the written request of the employee, the carrier shall give the employee the opportunity for one change of physician during the course of treatment for any one accident. The carrier must authorize a change of physician within five days after receiving the request.If the carrier fails to respond within five days, the employee may select the physician who is then deemed authorized. FS 440.13(2)(f)

If the employee goes to a doctor other than one that is authorized, they may have to pay for their own medical bills except that that an employee may seek unauthorized care at the carriers expense if the carrier fails to provide care within a reasonable time after the care is requested. This applies only to initial treatment. FS 440.13(2)(c)