Understanding the DWC-19 Form in Florida Workers’ Compensation
If you’re dealing with a Florida workers’ compensation claim, you might be asked to fill out a DWC-19 form. Here’s what you need to know:
When Do You Have to Complete the DWC-19?
- Only if you’re seeking or receiving indemnity benefits (like lost wage payments) does the insurance company (Carrier) have the right to ask you to complete the DWC-19.
- The Carrier must first send you the form and an informational letter explaining your obligations. If you don’t return the signed form within 21 days, your benefits can be suspended.
What’s the Purpose?
- The DWC-19 helps the Carrier find out if you have any income, earnings, unemployment, or other payments that could affect your benefits.
- If you’re not getting or claiming indemnity benefits, you don’t have to complete the form—even if it’s sent to you. Sometimes, defense attorneys send it out as a routine part of discovery, but you can ignore it if you’re not seeking benefits.
What Happens If You Don’t Return It?
- If you don’t return the DWC-19 within 21 days and you’re supposed to, your benefits can be suspended. Penalties and interest only start running again once you return the form (this is the general consensus). While Temporary Partial Disability is payable biweekly, the DWC-19 only needs to be returned within 21 days. Additionally, the claims handling entity may require the employee to send Form [DWC-19] Not more than once a month. F.A.C. 69L-3.021(4).
What Should You Report?
- You’re required to report “all earnings of any nature.” If you have any doubt about what counts as income, it’s best to over-report rather than risk a fraud allegation.
- If you’re self-employed, report your net profit (not gross revenue). You should be able to back up any numbers with appropriate records, although attaching cumbersome documentation should not be required.
- Attach documentation like paycheck stubs if possible, and note “see attached” on the form.
Key Takeaways
- Don’t ignore the DWC-19 if you’re getting benefits.
- If you’re not receiving or claiming benefits, you don’t have to complete it.
- Make sure the form is properly filled out by the Carrier before you sign.
- Report all income, and attach supporting documents when you can.
If you have questions or concerns about the DWC-19, talk to your attorney—they can help make sure you’re protected and your benefits aren’t unfairly suspended.
If you have questions regarding the DWC-19 forms in Florida, or questions about the interplay between completion of this form and benefits, reach out to our office for a Free consultation.