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Forms are grouped by relevant subject, then in alphabetical order. Use the arrows to change to reverse alphabetical order or search by form number. The ten most-downloaded forms also appear in the “ Frequently used forms ” section.
- Mileage Prior to 1/1/23
Mileage Prior to 1/1/23 - DWC Forms - California Department...
- Fillable Form Instructions
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- Reports, Publications & Schedules
Reports, Publications & Schedules - DWC Forms - California...
- Electronic Reporting System for Doctor's First Report of Injury
Division of Workers' Compensation - Injured worker...
- File a Complaint
DWC; Filing a complaint The California Division of Workers’...
- Physician Education
Physicians treating in the California workers' compensation...
- Frequently Asked Questions
Frequently Asked Questions - DWC Forms - California...
- Mileage Prior to 1/1/23
If you are injured or become ill, either physically or mentally, because of your job, including injuries resulting from a workplace crime, you may be entitled to workers’ compensation benefits. Use the attached form to file a workers’ compensation claim with your employer. You should read all of the information below.
Employers insured for workers' compensation through a private insurance carrier. Filed with any entity requesting to be a certificate holder including a government agency issuing a permit, license or contract. The C-105.2 must be completed by the insurance carrier or its licensed insurance agent.
How to view a form on DWC's Web site. How to complete a fillable form. How to print a filled-in form. How to download and save a fillable form to your computer or network to use again. How to erase your data from a filled-in form. How to prepare EAMS OCR forms. How to print EAMS OCR forms.
14 wrz 2022 · Learn how to get workers’ comp benefits for an injury at work in California. Learn how to file a claim, what forms you must submit, & deadlines you must meet.
Accidents happen and when they do, Employers has your business covered. Find all of the California workers compensation forms & resources you need to file a claim.
Provided to an injured worker immediately after a work-related accident or exposure. When an employee is injured due to a work-related accident or becomes ill due to exposure, the employer or its designee must provide the injured worker with the Claimant Information Packet as soon as possible.