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How to Complete Maryland's Workers' Compensation C‑1 Form

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The Maryland Workers' Compensation C‑1 form is the employer's official notice of a work‑related injury or illness, required to be filed within three days of learning of the claim. Unlike some states that use separate incident reports, Maryland consolidates employer notification, employee medical information, and wage details into this single document, making accuracy crucial for timely benefits.

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When and Why the C‑1 Must Be Filed

Employers must submit the C‑1 within three calendar days after receiving notice of a claim from an employee, their representative, or a medical provider. Failure to meet this deadline can result in penalties, delayed benefits, and potential civil liability. The form initiates the state's investigation and ensures the employee's claim is entered into the Maryland Workers' Compensation Commission (MWCC) system.

Key Sections of the C‑1 Form

Understanding each part helps avoid errors that cause re‑filings:

  • Employer Information: Legal name, address, FEIN, and contact person.
  • Employee Details: Full name, Social Security number, job title, and hire date.
  • Injury/Illness Description: Date and time of incident, location, brief narrative, and body part(s) affected.
  • Medical Provider: Name, address, and treating physician's contact.
  • Wage Information: Hourly rate, weekly hours, and average weekly wage used to calculate benefits.

Filing Process

Follow these steps to submit a compliant C‑1:

StepActionDeadline
1Gather employee and incident dataImmediately after injury
2Complete the C‑1 form (paper or e‑file)Within 3 days of claim notice
3Submit to MWCC via mail, fax, or online portalSame as Step 2
4Retain a copy for recordsOngoing

Common Mistakes to Avoid

Even seasoned HR teams slip up on details that trigger rejections:

  • Leaving the employee's Social Security number blank or entering it incorrectly.
  • Omitting the exact time of the incident, which is required for benefit calculations.
  • Submitting the form after the three‑day window; extensions are rarely granted.
  • Failing to include the employer's workers' compensation policy number.

After Submission: What Happens Next?

Once the MWCC receives the C‑1, the commission assigns a case number and notifies the employee. The employee's medical provider will then submit treatment reports, and the employer's insurance carrier will begin the benefits review. If the form is incomplete, the MWCC will issue a notice of deficiency, giving the employer a short period to correct the errors.

Resources and Support

Maryland's Department of Labor, Licensing and Regulation offers an online guide and sample C‑1 PDF. Employers can also contact the MWCC Help Desk at 1‑800‑444‑2925 for clarification on specific fields. For larger organizations, integrating the C‑1 into an automated HR incident‑tracking system can reduce manual errors and ensure compliance with the three‑day filing rule.

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