July 11, 2026

Workers Compensation Intake Forms: A Field Guide for Claimant Attorneys

Workers compensation cases move fast. Deadlines are short, medical records pile up, and the insurance carrier's adjuster is already building their file before your client even walks through your door. If your intake process does not capture the right information on that first visit, you are going to spend the next several weeks chasing details that should have been nailed down on day one.

I run into this constantly with firms that handle workers compensation alongside personal injury work. They pull out the same intake form for both. On the surface, it seems reasonable — there is an injured person, there are medical bills, there is lost time from work. But the similarity ends there. Workers compensation is a statutory, administrative system. There is no negligence analysis, no comparative fault, no jury. The employer's insurance carrier — not the employer — is the real opposing party. The remedies are fixed by statute: medical treatment, temporary disability benefits, permanent disability awards, and vocational rehabilitation. And the procedural rules, deadlines, and burden-of-proof standards are nothing like what you deal with in a tort case.

A proper workers compensation intake form is built specifically for this system. Here is what it needs to capture and why each piece matters.

The injury: what happened, when, and to what body parts

This is the center of every workers compensation claim, and you need far more detail than "hurt my back at work." The intake form should capture the exact date of injury, the time of day, where on the employer's premises (or job site) the injury occurred, and a detailed description of how it happened. Was it a single traumatic event — a fall, a struck-by, a lifting injury — or was it a repetitive stress injury that developed over weeks or months? That distinction matters because traumatic injuries and occupational diseases often have different filing deadlines and different evidentiary requirements.

Body parts affected need to be listed specifically, not vaguely. "Lower back" is not the same as "lumbar spine at L4-L5 with radiculopathy into the left leg." Your client may not have the medical vocabulary to describe it precisely at intake, and that is fine — you will refine it as medical records come in. But you need to capture what the client is experiencing in their own words: what hurts, when it hurts, what makes it worse, what they cannot do that they used to be able to do. That narrative becomes the foundation of your claim petition.

Ask whether the injury was witnessed. If co-workers, supervisors, or security cameras captured what happened, that evidence matters enormously, and you want to identify it before it disappears. Workers compensation cases are routinely defended on the theory that the injury did not happen at work or did not happen the way the claimant describes it. Witness names collected at intake can make or break that defense.

Employer information and the employment relationship

You need more than the employer's name and address. Your intake should capture the client's job title, a description of their actual job duties (not just the title — what do they physically do all day?), their date of hire, their hourly wage or salary, their average weekly hours, and whether they are full-time, part-time, seasonal, or temporary. The average weekly wage calculation drives the benefit amount, and getting it wrong means the client gets underpaid on every check.

Capture whether the employer is self-insured or carries workers compensation insurance through a carrier, and if the client knows the carrier's name, get it. In many states, the carrier is the party that accepts or denies the claim, and knowing who you are dealing with from the start lets you anticipate how they handle claims. Some carriers are reasonable. Some deny everything and force you to litigate every issue.

Ask about the size of the employer — number of employees, whether they have an HR department, whether they have a return-to-work program. Large employers with dedicated risk management departments handle claims very differently from small businesses where the owner doubles as the HR department. That context helps you calibrate your approach.

And ask whether the client is still employed. A claimant who is still working for the same employer (perhaps on light duty) has a very different set of concerns than one who was terminated after the injury. Termination following a work injury raises retaliation issues that may give rise to a separate employment law claim alongside the workers compensation case.

Medical treatment: past, present, and anticipated

Workers compensation is fundamentally a medical benefits case. The injured worker is entitled to reasonable and necessary medical treatment for the work injury, paid for by the employer's carrier. Your intake must capture the full treatment picture.

Start with the initial treatment: did the client go to the emergency room? An urgent care clinic? Their own doctor? The employer's designated medical provider? In many states, the employer has the right to direct medical treatment for a period of time (90 days in Pennsylvania, for example), and whether the client treated with an authorized provider affects their right to paymen