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IRON: OMB: Page 1. DWC 250 NOTICE OF ELECTION TO BE EXEMPT (FLORIDA FORM). FLORIDA: WORKERS COMP: FORMS. PDF, FILLABLE, SAVABLE.
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The DWC 250 notice is a form used to inform the Division of Workers' Compensation about any work-related injury or illness that results in lost time or medical treatment beyond first aid.
All employers in California are required to file the DWC 250 notice if they have any employees who experience work-related injuries or illnesses that meet the reporting criteria.
To fill out the DWC 250 notice, employers need to provide information about the injured employee, the incident that caused the injury or illness, and any medical treatment or lost time from work.
The purpose of the DWC 250 notice is to ensure that the Division of Workers' Compensation is notified of work-related injuries and illnesses, allowing them to track and monitor workplace health and safety issues.
The DWC 250 notice requires reporting of information such as the employee's name, contact information, occupation, date of injury or illness, the nature of the injury or illness, and whether the employee has lost time from work or received medical treatment.
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