D.C. Workers' Compensation Forms 7 and 7A Preparation Worksheet - District of Columbia
D.C. WORKERS' COMPENSATION FORMS 7 AND 7A PREPARATION WORKSHEET
Before you use this: The D.C. Office of Workers' Compensation (OWC) provides Form 7, Employee's Notice of Accidental Injury or Occupational Disease, and Form 7A, Employee's Claim Application. Complete and submit the official forms through the OWC filing page. This worksheet prepares facts for them; it is not a notice or claim. The OWC page describes this process for private-sector employees. Public-sector employees should confirm their filing route with their employer.
Form 7 and Form 7A serve different purposes. The OWC instructs workers to give written injury notice to both OWC and the employer within 30 days of the injury or awareness that it is work related. Under D.C. Code § 32-1513, the awareness trigger can include when the relationship should have been known through reasonable diligence; subsection (d) describes circumstances in which late notice does not bar a claim. A separate claim on Form 7A is generally due within one year, with awareness, last-payment, minor or incapacity, and certain prior-suit rules in § 32-1514. Do not assume that submitting Form 7 files the Form 7A claim.
1. PEOPLE AND EMPLOYMENT
Employee's full name and contact details: [________________________________]
Employer's legal name, work address, and supervisor: [________________________________]
Employer's insurer or claim administrator, if known: [________________________________]
Job title and usual work location: [________________________________]
Person completing the official form, if different from the injured employee: [________________________________]
2. EVENT AND AWARENESS DATES
Date and time of injury, or period of occupational exposure: [________________________________]
Place of injury or exposure: [________________________________]
What occurred and what work was being done? Use a factual account in your own words.
[____________________________________________________________]
[____________________________________________________________]
Nature of the injury, disease, or symptoms: [________________________________]
Date you first became aware of the condition: [__/__/____]
Date you knew or should have known it was related to work, and why: [________________________________]
Treating physician or facility, if any: [________________________________]
Witnesses or records that may help locate the event: [________________________________]
3. NOTICE AND CLAIM TRACKING
Date you informed the employer, and method: [________________________________]
Date you sent or submitted official Form 7 to OWC: [__/__/____]
Date and method of delivering a Form 7 copy to the employer: [________________________________]
OWC's page instructs employees to keep a completed copy. Save delivery or submission confirmation for both recipients.
Date you sent or submitted official Form 7A to OWC: [__/__/____]
Claim number and confirmation, if issued: [________________________________]
If compensation was paid without an award, date of last payment and payment record: [________________________________]
If the claimant is a minor or mentally incompetent, or a prior damages suit ended because workers' compensation was the proper route, record that fact and obtain advice on the timing rules in § 32-1514: [________________________________]
4. COMPLETE THE OFFICIAL FORMS
☐ Open the current OWC filing page. Complete Form 7 with the notice facts and submit it to OWC and the employer as instructed.
☐ Complete and submit the distinct Form 7A claim application. Review the official form's current fields and signature instructions.
☐ Keep copies of both forms, attachments, and delivery records. If the current online route is unavailable, the OWC page says the forms may be obtained from the employer, carrier, or OWC and mailed to the address printed on the current form.
Separate benefit disputes may require an informal conference or formal hearing. This worksheet does not request either proceeding.
Sources
About this template
- Last updated
- October 27, 2026
- Citations checked
- October 27, 2026
- Jurisdiction
- District of Columbia
- Category
- Employment & HR
Legal authority
- D.C. Code § 32-1513(a)-(d)
- D.C. Code § 32-1514(a)-(d)
- D.C. Department of Employment Services, Workers' Compensation — filing instructions
Employment documents govern the relationship between a company and its workers, from offer letters and employment agreements through handbooks, performance reviews, and separations. Done right, they set clear expectations, protect against wrongful termination and discrimination claims, and give both sides a record to rely on. Done poorly, they invite lawsuits, agency complaints, and costly disputes.
Not legal advice
This template is provided for informational purposes. We recommend having an attorney review any legal document before signing, especially for high-value or complex matters.
Checked against the law it cites
A reviewer verified this template's legal citations against the official source on October 27, 2026.
D.C. Code § 32-1513(a)-(d) (checked October 27, 2026): "Such notice shall be given to the Mayor and to the employer."
D.C. Code § 32-1514(a)-(d) (checked October 27, 2026): "Except as otherwise provided in this section, the right to compensation for disability or death under this chapter shall be barred unless a claim therefor is filed within 1 year after the injury or death."
D.C. Department of Employment Services, Workers' Compensation — filing instructions (checked October 27, 2026): "The DC Office of Workers’ Compensation has established a convenient process to submit the necessary forms when a private-sector employee has experienced a work-related injury or illness."
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