Florida Workers' Compensation Information



Please Note: for Claims assistance or questions about coverage and exemptions You will need to call one of the numbers listed below.

Also be aware that the Workers' Compensation Assistance Offices in different states may go by different names such as "Industrial Accidents".
These are the only numbers that we are aware of and have available for Florida Workers' Compensation.

Florida Workers' Compensation Telephone Directory


DWC - Tallahasse - Employee Assistance: 850-413-1610

DWC - Pensacola - Employee Assistance: 850-453-7805

DWC - Jacksonville - Employee Assistance: 904-798-5807

DWC - Orlando - Employee Assistance: 407-835-4407

DWC - Tampa - Employee Assistance: 813-221-6507

DWC - West Palm Beach - Employee Assistance: 561-837-5716

DWC - Miami - Employee Assistance: 305-536-0307

DWC - Jacksonville - Bureau of Compliance: 904-798-5806

DWC - Tallahassee - Bureau of Compliance: 850-413-1609

DWC - Pensacola - Bureau of Compliance: 850-453-7804

DWC - West Palm Beach - Bureau of Compliance: 561-837-5716

DWC - Tampa - Bureau of Compliance: 813-221-6506

DWC - Orlando - Bureau of Compliance: 407-835-4479

DWC - Miami - Bureau of Compliance: 305-536-0306

DWC - Fort Myers - Bureau of Compliance: 239-461-4006

Division of Workers' Compensation (Main): 800-342-1741

24 Hour Fatality Reporting: 904-798-5895

Injured Worker Toll Free Helpline and Email : 800-342-1741

Reemployment Services: 800-342-1741

Central Office (Bureau of Employee Assistance): 850-413-1610

Records Request - Phone & Email Address: 850-488-9675

Ombudsman: 866-515-3692

Division of Vocational Rehabilitation : 800-451-4327

WC Bureau of Monitoring & Audit - Drug Free Workplace Info: 850-487-4899

DFS Fraud Hotline: 800-378-0445

Fraud: 800-742-2214

Central Clerks Office: 850-487-1911

Drug Free Workplace Info: 850-413-1601

Drug Free Workplace Info: 850-413-1601

Office of the Judge of Compensation Claims - Sarasota District: 941-753-0900

Office of the Judge of Compensation Claims - Daytona Beach District: 386-254-3734

Office of the Judge of Compensation Claims - St. Petersburg District: 727-893-2321

Office of the Judge of Compensation Claims - Tallahasee District: 850-488-2110

Office of the Judge of Compensation Claims - Tampa District: 813-664-4000

Office of the Judge of Compensation Claims - West Palm Beach District: 561-650-1040

Office of the Judge of Compensation Claims - Orlando District: 407-961-5805

Office of the Judge of Compensation Claims - Panama City District: 850-708-6250

Office of the Judge of Compensation Claims - Pensacola District: 850-595-6310

Office of the Judge of Compensation Claims - Port St. Lucie District: 772-742-9455

Office of the Judge of Compensation Claims - Sebastian-Melbourne District: 772-581-6800

Office of the Judge of Compensation Claims - Ft. Myers District: 239-938-1159

Office of the Judge of Compensation Claims - Gainesville District: 352-955-2244

Office of the Judge of Compensation Claims - Jacksonville District: 904-431-4930

Office of the Judge of Compensation Claims - Lakeland District: 863-648-3150

Office of the Judge of Compensation Claims - Miami District: 305-377-5413

Office of the Judge of Compensation Claims - Ft. Lauderdale District: 954-714-3400

Division of Administrative Hearings: 850-488-9675

Office of Insurance Regulation Commissioner David Altmaier: 850-413-3140

Public Records Request - Office of Insurance Regulation: 850-413-4223

OSHA - Ft. Lauderdale Area Ofc - Federal OSHA covers private employers/employees FL: 954-424-0242

Forms & Publications


Welcome to the most extensive library of workers' compensation forms available anywhere. Almost 3,600 forms are available for your immediate download and use. Our forms, all of which have been custom programmed by WorkersCompensation.com for Type & Save functionality, are available for individual purchase below.

Try a Forms Membership! If you have an ongoing need for multiple forms, and want complete and unrestricted access to our entire 3,000 "Type & Save" Forms Library, you may register for immediate access here. Annual subscribers to this service get the benefit of our forms updating system, making sure the forms they use are the most current available.

= Indicates this Type & Save form is available for individual purchase.

= FlashFormSSL Enabled.
Click here to learn more about auto-populating forms with FlashForm SSL.

Some "Revision Dates" may be displayed as part of the Description.

(dwc1) First Report of Injury or Illness 10/16
(dwc1a) Wage Statement 3/09
(dwc3) Request for Wage Loss/Temporary Partial Benefits 3/09
(dwc4) Notice of Action/Change 3/09
(dwc12) Notice of Denial 3/09
(dwc13) Claim Cost Report 3/09
(dwc14) Request for Social Security Disability Benefit Information 3/09
(dwc19) Employee Earnings Report 3/09
(dwc26) Department and Injured Employee Agreement for the Provision of Contracted Placement Services 12/15
(dwc27) Reemployment Services Questionnaire 12/15
(dwc30) Authorization and Request for Unemployment 3/09
(dwc33) Permanent Total Off-Set Worksheet 3/09
(dwc35) Permanent Total Supplemental Worksheet 3/09
(dwc40) Statement of Quarterly Earnings for Supplemental Income Benefits 3/09
(dwc49) Aggregate Claims Administration Change Report 3/09
(DFWPman) BROCHURE - An Employer's Guide to a Drug-Free Workplace 9/20
(si-1) Application for Self-Insurance 8/09
(si-1G) Application for Governmental Self-Insurance 8/09
(si-4F) Self-Insurer's Surety 8/09
(si-5) Self-Insurers Payroll Report 8/09
(si-6) Self-Insurers Irrevocable Letter of Credit 8/09
(si-8) Self-Insurers Application for Drug-Free Workplace Premium Credit Program 8/09
(si-9) Self-Insurance Certification of Workplace Safety Program Premium 8/09
(si-10) Parental Guaranty and Corporate Resolution 8/09
(si-11) Indemnity Agreement 8/09
(si-17) Unit Statistical Report 11/12
(si-19) Certification of Servicing for Self-Insurers 8/09
(si-20) Report of Outstanding Workers' Compensation Liabilities 8/09
(si-22) Qualified Servicing Entity Application 8/09
(si-23) Qualified Servicing Entity Annual Report 8/09
(si-27) Biographical Statement and Affidavit 8/09
(si-GEP) Application for Governmental Self-Insurance Estimated Payroll 8/09
(dwc250) DWC-250 Notice of Election to be Exempt is no longer available. You must apply online - https://apps.fldfs.com/bocexempt/ ND
(dwc250r) Revocation of Election to be Exempt 8/13
(dwc251) Notice of Election of Coverage 8/13
(dwc251r) Revocation of Election of Coverage 8/13
(dwc25) Florida Workers' Compensation Uniform Medical Treatment/Status Report Form 1/08
Instructions for completion of the DWC-25 1/15
Instructions for Completion of the Health Insurance Claim Form / HCFA-1500 (12-90) not available for download 1/15
Instructions for Completion of the LES Form DWC-9 when Submitted by Licensed Health Care Providers 1/15
Instructions for Completion of the LES Form DWC-9 When Submitted by Work Hardening and Pain Management Programs 1/15
(dwc10) Statement of Charges for Drugs and Medical Supplies 1/15
Instructions for Dental Claim Form (J512) 1/15
(ncci-9) Application for Drug-Free Workplace Premium Credit Program N/D
(SDF-1) Proof of Claim 3./09
(SDF-2) Reimbursement Request 3./09
(SDF-6) Explanation of Benefits 1/08
(PW-2) Preferred Worker Reimbursement Request 1/08
(dwc23) Request for Screening 12/15
(dwc24) Department and Student Agreement for Sponsorship of Training and Education 12/15
(EAO-1) Request for Assistance 6/94
(dfs3160-0023) Petition for Resolution of Reimbursement Dispute 7/21
(dfs3160-0024) Carrier Response to Petition for Resolution of Reimbursement Dispute 7/21
(dwc-2000) Health Care Provider Violation Referral Form 4/10
(EDI-1) Edi Trading Partner Profile 01/08
(EDI-2) Edi Trading Partner Insurer/Claim Administrator Id List 10/06
(EDI-3) Edi Transmission Profile - - Sender's Specifications 10/06
Secure Socket Layer (SSL)/File Transfer Protocol (FTP) Instructions 01/08
(jccRACN) JCC - Request for Assignment of Case Number 1/08
(UPPSampleFormB) JCC - Doctor`s Estimate of Future Medical Expenses N/D
(jccPFB) JCC - Petition for Benefits 4/11
(jccResponsetoPFB) JCC - Response to Petition for Benefit 3/07
(UPPSampleFormC) JCC - Addendum to Stipulation in Support of Petition for Order Approving a Lump-Sum Settlement N/D
(UPPSampleFormE) JCC - Affidavit in Support of Attorney's Fees in Excess of Statutory Guideline N/D
(UPPSampleFormF) JCC - Motion for Approval of Attorney Fee and Allocation of Child Support Arrearage for Settlements N/D
(VP PayFilingFees) JCC - Verified Petition - Relief from Paying Filing Fees N/D
(VP PayPrepCosts) JCC - Verified Petition - Relief from Paying Cost of Record Preparation N/D
(CC-PayFilingFees) JCC - Certified Counsel - Relief from Paying Filing Fees N/D
(CC-PayPrepCosts) JCC - Certified Counsel - Relief from Paying Cost of Record Preparation N/D
(FinancialAffidavit) JCC - Financial Affidavit N/D
(VerifiedMotionSubstituteID) JCC - Verified Motion for Assignment of Substitute Identification Number N/D
(jccAFDS) JCC - Attorney Fee Data Sheet 1/08
(AFDS-INT) JCC - Attorney Fee Data Sheet - Attorney Fee Not in Connection with Settlement 7/05
(AFDS-WOA) JCC - Attorney Fee Data Sheet - Additional Attorney Fee in Connection with Settlement 7/05
(AFDS-WO) JCC - Attorney Fee Data Sheet - Washout Settlement 7/05
(UniformStatewidePretrial) JCC - Uniform Statewide Pretrial Stipulation N/D
(MediationRequest) JCC - Joint Request for Voluntary Mediation OJCC Voluntary Mediation Program N/D
(EJCCAccessRequest) JCC - Party's Request for Complete eJCC Access to Case N/D
(SuspendDefer) JCC - Suspend and Defer Order N/D
(UnpaidSupportOwedRequest) JCC - Request for Amount of Unpaid Support Owed N/D
(Ch119PublicRecordExemption) JCC - CH 119 Public Record Exemption N/D
(ContactRegistration) JCC - Contact Registration Form 11/14
(WC-Reemployment-brochure) BROCHURE - We Are Here 4 You � Reemployment Services Program N/D
(mileage2) Mileage Reimbursement Form 7/14
(ucc-1) Uniform Commercial Code Financing Statement 5/13

59A-23 Florida Workers' Compensation Managed Care Arrangements
(Currently under Agency for Health Care Administration)

59A-24 Drug-free Workplace Standards
(Currently under Agency for Health Care Administration)

69L-3 Workers' Compensation Claims

69L-4 Assessments

69L-5 Rules For Self-insurers Under The Workers' Compensation Act

69L-6 Workers' Compensation Compliance

69L-7 Workers' Compensation Medical Reimbursement and Utilization Review

69L-8 Selected Materials Incorporated By Reference

69L-9 Drug Testing Rule

69L-10 Claim For Reimbursement Against The Special disability Trust Fund

69L-11 Preferred Worker Program

69L-22 Reemployment Services - Workers\' Compensation

69L-24 Workers' Compensation Insurers' Standards and Practices

69L-26 Employee Assistance And Ombudsman office

69L-29 Health Care Provider Certification [Repealed]

69L-30 Expert Medical Advisors

69L-31 Utilization and Reimbursement Dispute Rules

69L-34 Carrier Report of Health Care Provider Violations

69L-56 Electronic Data Interchange (EDI) Technical Requirements


  • 440.01 Short title.

  • 440.015 Legislative intent.

  • 440.02 Definitions.

  • 440.021 Exemption of workers' compensation from chapter 120.

  • 440.03 Application.

  • 440.04 Waiver of exemption.

  • 440.05 Election of exemption; revocation of election; notice; certification.

  • 440.055 Notice requirements.

  • 440.06 Failure to secure compensation; effect.

  • 440.075 When corporate officer rejects chapter; effect.

  • 440.077 When a corporate officer rejects chapter, effect.

  • 440.09 Coverage.

  • 440.091 Law enforcement officer, firefighter, emergency medical technician, or paramedic; when acting within the course of employment.

  • 440.092 Special requirements for compensability; deviation from employment; subsequent intervening accidents.

  • 440.093 Mental and nervous injuries.

  • 440.094 Extraterritorial reciprocity.

  • 440.10 Liability for compensation.

  • 440.101 Legislative intent; drug-free workplaces.

  • 440.102 Drug-free workplace program requirements.

  • 440.1025 Employer workplace safety program in ratesetting; program requirements; rulemaking.

  • 440.103 Building permits; identification of minimum premium policy.

  • 440.104 Competitive bidder; civil actions.

  • 440.105 Prohibited activities; reports; penalties; limitations.

  • 440.1051 Fraud reports; civil immunity; criminal penalties.

  • 440.106 Civil remedies; administrative penalties.

  • 440.107 Department powers to enforce employer compliance with coverage requirements.

  • 440.108 Investigatory records relating to workers' compensation employer compliance; confidentiality.

  • 440.11 Exclusiveness of liability.

  • 440.12 Time for commencement and limits on weekly rate of compensation.

  • 440.125 Medical records and reports; identifying information in employee medical bills; confidentiality.

  • 440.13 Medical services and supplies; penalty for violations; limitations.

  • 440.132 Investigatory records relating to workers' compensation managed care arrangements; confidentiality.

  • 440.134 Workers' compensation managed care arrangement.

  • 440.14 Determination of pay.

  • 440.15 Compensation for disability.

  • 440.151 Occupational diseases.

  • 440.16 Compensation for death.

  • 440.17 Guardian for minor or incompetent.

  • 440.185 Notice of injury or death; reports; penalties for violations.

  • 440.1851 Personal identifying information of an injured or deceased employee; public records exemption.

  • 440.19 Time bars to filing petitions for benefits.

  • 440.191 Employee Assistance and Ombudsman Office.

  • 440.192 Procedure for resolving benefit disputes.

  • 440.1926 Alternate dispute resolution; claim arbitration.

  • 440.20 Time for payment of compensation and medical bills; penalties for late payment.

  • 440.205 Coercion of employees.

  • 440.207 Workers' compensation system guide.

  • 440.21 Invalid agreements.

  • 440.211 Authorization of collective bargaining agreement.

  • 440.22 Assignment and exemption from claims of creditors.

  • 440.23 Compensation a lien against assets.

  • 440.24 Enforcement of compensation orders; penalties.

  • 440.25 Procedures for mediation and hearings.

  • 440.271 Appeal of order of judge of compensation claims.

  • 440.2715 Access to courts through state video teleconferencing network.

  • 440.28 Modification of orders.

  • 440.29 Procedure before the judge of compensation claims.

  • 440.30 Depositions.

  • 440.31 Witness fees.

  • 440.32 Cost in proceedings brought without reasonable ground.

  • 440.33 Powers of judges of compensation claims.

  • 440.34 Attorney's fees; costs.

  • 440.345 Reporting of attorney's fees.

  • 440.35 Record of injury or death.

  • 440.38 Security for compensation; insurance carriers and self-insurers.

  • 440.381 Application for coverage; reporting payroll; payroll audit procedures; penalties.

  • 440.385 Florida Self-Insurers Guaranty Association, Incorporated.

  • 440.386 Individual self-insurers' insolvency; conservation; liquidation.

  • 440.39 Compensation for injuries when third persons are liable.

  • 440.40 Compensation notice.

  • 440.41 Substitution of carrier for employer.

  • 440.42 Insurance policies; liability.

  • 440.44 Workers' compensation; staff organization.

  • 440.442 Code of Judicial Conduct.

  • 440.45 Office of the Judges of Compensation Claims.

  • 440.47 Travel expenses.

  • 440.49 Limitation of liability for subsequent injury through Special Disability Trust Fund.

  • 440.491 Reemployment of injured workers; rehabilitation.

  • 440.50 Workers' Compensation Administration Trust Fund.

  • 440.51 Expenses of administration.

  • 440.515 Reports from self-insurers; confidentiality.

  • 440.52 Registration of insurance carriers; notice of cancellation or expiration of policy; suspension or revocation of authority.

  • 440.525 Examination and investigation of carriers and claims-handling entities.

  • 440.53 Effect of unconstitutionality.

  • 440.54 Violation of child labor law.

  • 440.55 Proceedings against state.

  • 440.572 Authorization for individual self-insurer to provide coverage.

  • 440.585 Workers' compensation group self-insurance fund application disclosure.

  • 440.59 Reporting requirements. REPEALED Eff. 7/1/2012

  • 440.591 Administrative procedure; rulemaking authority.

  • 440.593 Electronic reporting.

  • 440.60 Application of laws.