The DWC-19 form, also known as the Employee Earnings Report, is used to determine if an injured worker has supplemental income to offset any indemnity benefits due and owing from the employer/carrier. This includes any income from other employment and even social security or disability benefits. It is the employer/carrier’s responsibility to send this form to the injured worker and the injured worker’s responsibility to return the completed form. If not completed and returned within 21 days, the Employer is not required to pay indemnity benefits to the injured worker until the form is properly submitted.
DWC-19s are vital in a workers’ compensation case for a variety of reasons:
- there is a fraud statement, which assists in deterring any person from knowingly providing false information;
- it decreases issues of overpayment and as a result, for the injured worker later having to worry about reimbursing their employer/carrier for any overpayments; and
- adjusters are able to handle claims more efficiently as they will have more time to investigate benefits owed and reduce risk of errors in payment.
While it is important for an injured worker to return a DWC-19, it is just as important if not more so, for the employer/carrier to provide evidence that they sent the DWC-19 forms. The First District Court of Appeal in Perdue v. Sebring Marine Ind. Inc., 82 So.3d 816 (Fla. 1st DCA 2011) reversed the Judge of Compensation Claim’s ruling denying temporary partial disability benefits to an injured worker for failure to return the DWC-19 Employee Earnings Report since the employer/carrier failed to meet the burden of proving they sent the forms to the injured worker.
It should be the normal course of action for employer/carriers to regularly send DWC-19 forms for the injured worker to complete, so that the claim can be initiated. Defense counsel should remind the employer/carrier of the importance of sending and documenting the DWC-19 form when an injured worker has been released to light duty work and has not yet achieved Maximum Medical Improvement.