Form No.

Title of Form and Explanation

Responsibility

WC GUIDE (PDF)

A Guide to Filing a Workers Compensation Claim

ORM-0 (PDF)

Common Questions about Workers' Compensation

ORM-1 (PDF)

Responsibilities for Filing a Workers Compensation Claim
(Instruction sheet to be used by the supervisor and employee)

Supervisor & Employee

ORM-2 (PDF)

The George Washington University Office of Risk Management Accident Reporting Form
(To be completed by the supervisor and submitted by the end of the work day following the day of injury)

Supervisor

ORM-3 (PDF)

The George Washington University: Authorization for Medical Treatment
(Authorizes the injured employee to be treated at the GW Emergency Room or Student Health Services WHEN signed by the supervisor)

Supervisor

DCWC Form 7 (PDF)

Employee's Notice of Accidental Injury or Occupational Disease
(To be completed within 30 days from the date of injury or onset of illness. This form may be forwarded to the Office of Risk Management for mailing, if desired)

Employee

DCWC Form 7A (PDF)

Employee's Claim Application
(This form may be forwarded to the Office of Risk Management for mailing, if desired)

Employee