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Yes! You can use AI to fill out DWC001S, Employer’s first report of injury or illness

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DWC001S, Employer’s first report of injury or illness, page 1
Moderate · 58/100Form Complexity Index

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What this form asks for

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The DWC001S, Employer's First Report of Injury or Illness, is a mandatory form for Texas employers to report a work-related injury, illness, or death to the State Office of Risk Management (SORM). Filing this report is the first step in initiating the workers' compensation claims process for the affected employee. Today, this form can be filled out quickly and accurately using AI-powered services like Instafill.ai, which can also convert non-fillable PDF versions into interactive fillable forms.
Fillable fields78
Pages2
Sections43
Form Complexity IndexModerate, 58/100

The AI checks your answers before you download

14 checks built for this form, so a wrong date or a missing answer is caught before anyone else sees it.

Validate Social Security Number Format

This check ensures that the Social Security Number in field 5 is entered in the specific XXX-XX-XXXX format. Correct formatting is crucial for unique employee identification and integration with other systems. If the format is incorrect, the submission should be rejected with an error message prompting the user to correct the entry.

Ensure Date of Injury is After Date of Birth

This validation compares the 'Date of injury or illness' (field 15) with the 'Date of birth' (field 6). The date of injury must be chronologically after the employee's date of birth. This check prevents logically impossible data entry errors that would invalidate the entire report.

Verify Date of Injury is On or After Date of Hire

This check ensures the 'Date of injury or illness' (field 15) is on or after the 'Date of hire' (field 30). An employee cannot have a work-related injury before their official start date. This logical validation is essential for confirming the injury occurred during the course of employment.

Confirm Injury Report Date is On or After Injury Date

This validation compares the 'Date injury reported' (field 19) to the 'Date of injury or illness' (field 15). The report date must be the same day as or after the injury date. This check maintains the logical timeline of events and is important for assessing reporting timeliness.

Conditional Requirement for Employee's Language

This check verifies that if 'No' is selected for 'Does the employee speak English?' (field 11), the subsequent field to specify the language is not empty. Capturing the employee's primary language is critical for ensuring effective communication during the claims process. A failure would prompt the user to provide the required language.

Conditional Requirement for Date of Death

This validation ensures that if 'Yes' is selected for 'Did the employee die?' (field 29), the corresponding 'Date of death' field is populated with a valid date. This is a critical piece of information for fatality claims and must be captured accurately. The form should not be submittable without this date if the 'Yes' box is checked.

And 8 more checks
  • Validate NAICS Code Length
  • Exclusive Selection for Rate of Pay
  • Validate Return-to-Work Date Chronology
  • Completeness Check for Core Incident Fields
  • Validate Dependent Children as Non-Negative Integer
  • Conditional Response for Accident Prevention Services
  • Validate Agency Location Code Format
  • Ensure Date of Death is After Date of Injury

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How to Fill Out DWC001S Online for Free in 2026

What the AI walks you through.

  1. Navigate to Instafill.ai and upload or select the DWC001S form.
  2. Provide the injured employee's personal details, contact information, and Social Security number in Part 1.
  3. Enter detailed information about the injury in Part 2, including the date, time, nature of the injury, and how it occurred.
  4. Complete Part 3 with the employee's employment information, such as date of hire, occupation, and rate of pay.
  5. Fill in the employer's information in Part 4, including agency name, address, and relevant identification numbers.
  6. Review all the information auto-filled by the AI for accuracy and completeness across all sections.
  7. Certify the form with a signature and date in Part 5 before submitting it to the State Office of Risk Management (SORM) and providing a copy to the employee.

Common Mistakes in Completing DWC001S

The ones the AI is built to catch.

Providing a Vague or Incomplete Injury Description
In field 22, employers often write brief, unhelpful descriptions like 'hurt back' or 'employee fell.' This happens because the person filling out the form may be rushing or may not have all the details. A vague description can significantly delay the claim investigation and determination, as the insurer will need to request more information. To avoid this, provide a full narrative including the events leading up to the injury, the specific movements the employee was making, and the resulting injury, as the form instructs.
Using Incorrect Date Formats
Many fields (e.g., 6, 15, 19, 30) require the 'mm/dd/yyyy' format, but users frequently enter dates in other formats like 'dd/mm/yyyy' or 'Jan 1, 2025'. This simple data entry error can cause automated systems to reject the form or lead to processing delays while the information is manually corrected. Always double-check that all dates are entered in the specified format. AI-powered tools like Instafill.ai can help prevent this by automatically formatting dates correctly as you fill out the form.
Confusing 'Nature of Injury' with 'Cause of Injury'
Users often mix up field 20 ('Nature of injury') and field 23 ('Reported cause'). For example, they might write 'fall' in the nature field and 'fractured wrist' in the cause field, which is the reverse of what is required. This confusion can lead to incorrect data classification and slow down the claim. The 'nature' is the medical diagnosis (e.g., sprain, cut, fracture), while the 'cause' is the event that led to it (e.g., slip, overexertion, fall).
Submitting an Unsigned or Undated Form
Forgetting to sign and date the certification in field 53 is a critical error that completely invalidates the report. This often happens when a form is filled out digitally but printed for a physical signature that is then overlooked. An unsigned form is not considered officially filed, which can result in non-compliance and potential fines for failing to report the injury within the required eight-day timeframe. Always perform a final review to ensure the signature and date are present before submission.
Entering an Incomplete Social Security Number
The Social Security number in field 5 is a primary identifier for the injured employee, but it is often entered with typos or in the wrong format. A missing digit or transposed numbers will cause a data mismatch, making it difficult for the insurer to locate the employee's records and process the claim. This leads to significant delays and requires follow-up to correct the information. It is crucial to verify the SSN with the employee's records and enter it exactly as 'XXX-XX-XXXX'.
Omitting Specific Injury Location Details
In field 25, employers sometimes list a general location like 'the warehouse' or just the main company address, even if the injury occurred at a different site or specific area. The form requires the full address and name of the location where the injury happened for investigation and risk assessment purposes. Failing to provide a precise location can impede the investigation and analysis of workplace hazards. Be sure to list the exact business name and street address of the incident location.
Incomplete Pay Rate Information
When filling out field 36, a user might enter the numerical pay rate but forget to check the corresponding box for 'Hourly,' 'Weekly,' or 'Monthly.' This ambiguity forces the claims adjuster to contact the employer for clarification, delaying the calculation of wage replacement benefits for the injured employee. To prevent this, ensure you enter the pay rate and check the box that indicates the correct pay period. AI form-filling tools can often flag such incomplete field groups.
Leaving Technical Codes Blank
Fields for the 'State Payroll Classification Code' (34), 'Primary NAICS code' (47), and 'Specific NAICS code' (48) are frequently left blank. Employers may not have this information readily available and skip it to save time. However, these codes are essential for the insurer and state agencies for statistical tracking, risk analysis, and premium calculations. Leaving them blank can result in follow-up requests and processing delays. This information should be sourced from your company's payroll or accounting department before starting the form.
Forgetting to Specify the Employee's Language
In field 11, if an employee does not speak English, the person completing the form may check 'No' but then forget to write in the employee's primary language. This oversight hinders the ability of the insurance carrier and medical providers to communicate effectively with the injured worker, potentially delaying their care and the claims process. If 'No' is selected, it is critical to also specify the language to ensure proper translation services can be arranged.
Failing to List Known Witnesses
Field 26 asks for the names of all witnesses, but it is often left blank even when witnesses were present. This may happen because the person filling out the form is unaware of witnesses or doesn't think to ask the supervisor or injured employee. Witness statements are crucial for verifying the details of the incident, and omitting them can weaken the claim and complicate the investigation. Always ask the supervisor and employee if anyone saw the incident and list their full names.

Frequently Asked Questions About DWC001S

 

Is it really free for 7 days?
Yes. You pay $0 today. Cancel before Nov 5 and you are never charged. Keep it, and it is $19.99 a month for 5 fills of your DWC001S.
Can I fill other forms too?
This plan is for your DWC001S: your own AI agent fills it as often as 5 times a month. To fill other forms and upload your own, choose a Professional plan from your account.
How do I cancel?
From your account, in two clicks, any time. No email, no call.
How does the AI fill out DWC001S?
You answer a few questions in plain words, or upload your W-2 or last year's return. The AI reads what you give it and puts each answer into the right field of DWC001S, on every page, in seconds. It checks the answers against the form's own rules, and you review and change anything before you download, print or sign.
What happens to my information?
It is encrypted in transit and at rest, and it is never used to train AI.
How complex is DWC001S to fill out?
DWC001S has a Form Complexity Index of 58 out of 100, in the moderate tier: 78 fillable fields across 2 pages. Instafill.ai's AI fills it in under a minute, with every field there for you to review before you download.
What is the purpose of the DWC001S form and who needs to fill it out?
The DWC001S, 'Employer’s first report of injury or illness,' is used by employers to report a work-related injury or illness. It provides the State Office of Risk Management (SORM) with the necessary information to begin the workers' compensation claims process.
When is the deadline to submit this form?
You must submit this form within eight days after the employee’s first day of absence from work due to the injury, you receive notice of an occupational disease, or an employee dies from a work-related incident.
Where do I send the completed DWC001S form?
Send the completed form to the State Office of Risk Management (SORM) and a copy to the injured employee or their representative. Do not send it to the Texas Department of Insurance, Division of Workers’ Compensation (DWC), unless they specifically request it.
What happens if I don't file this report on time?
Failing to file this report in a timely manner without a good reason may result in a fine. It is crucial to submit the form to ensure the claims process can begin promptly for the injured employee.
Do I need to keep a copy of this form for my records?
Yes, you should keep a copy of the completed form for your records. This copy serves as the Employer’s Record of Injury as required by Texas Labor Code Section 409.006.
How much detail is needed for the injury description in Part 2?
You should provide a detailed and factual account of how the injury occurred. Include the events leading up to the incident, a clear description of the injury itself, and the factors you believe contributed to the accident.
What if I don't know all the information requested, like the employee's doctor?
Fill out the form as completely and accurately as possible with the information you have. If some details are unknown, you can indicate that, but be sure to complete all mandatory fields to the best of your ability to avoid delays.
What do I do if the injury resulted in the employee's death?
You must check 'Yes' in Part 2, question 29, and provide the date of death. It is critical to submit the form within eight days of the employee's death.
Where can I find my company's NAICS code required in Part 4?
The North American Industry Classification System (NAICS) code can typically be found on your business tax returns or by searching the official U.S. Census Bureau website. You will need to provide both the primary and specific six-digit codes.
Can I use an AI tool to help me fill out this form?
Yes, services like Instafill.ai use AI to help you accurately auto-fill form fields, which can save time and reduce errors. This is especially helpful for recurring information like your agency details.
How can I fill out the DWC001S form online?
You can use a service like Instafill.ai to complete the form digitally. Simply upload the DWC001S form, and the AI will identify the fields, allowing you to type in your information, save your progress, and download the completed document.
The PDF version of the form I have isn't fillable. What can I do?
If you have a non-fillable or 'flat' PDF, you can upload it to a platform like Instafill.ai. The service will automatically convert it into an interactive, fillable form that you can complete on your computer.
What is the difference between the DWC claim number and the SORM claim number?
The DWC (Division of Workers' Compensation) and SORM (State Office of Risk Management) may assign separate numbers to track the claim. You should enter these numbers in the designated fields at the top of the form if they have been provided to you.
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employer injury forms: DWC Form-001, Employer’s first report of injury or illness

employer injury report forms: DWC Form-001, Employer’s first report of injury or illness

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