Use the attached form to file a workers’ compensation claim with your employer. You should read all of the information below. Keep this sheet and all other papers for your records. You may be eligible for some or all of the benefits listed depending on the nature of your claim.

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Filing of this application begins formal proceedings against the defendant(s) named in your application. You may request the assistance of an information and assistance officer of the …

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2024年2月21日 · Form DWC 1 is the official form that California businesses and employees use to file a workers’ compensation claim. The employee fills out a portion of the form, and the employer fills out the remainder. The employer then sends the completed form to their workers’ comp insurance company in order to file a claim. Where do I get Form DWC 1?

Actions to take when an injury occurs. Instructions for completing the Workers’ Compensation Claim Form (DWC 1) & Notice of Potential Eligibility (e3301) and the Employer’s Report of Occupational Injury or Illness (e3067).

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2023年3月3日 · Full listing of forms and notices by number Draft forms Agreement forms Carrier forms Employee forms Employer forms and notices Health & safety forms Health care provider/medical forms Other business forms Plain language notices Requests for workers' compensation claim file information

DWC's mission is to minimize the adverse impact of work-related injuries on California employees and employers. Effective March 3, 2025 all status conferences, mandatory settlement conferences (MSCs), priority conferences, and lien conferences, will move to the CourtCall Video Platform. Resources for DWC’s Virtual Courtrooms may be found online.

DWC-1 Workers Compensation Claim Form. This is the form you will complete and send to EMPLOYERS to initiate the claim process for your employee. This form must be completed and provided to EMPLOYERS within one working day from you becoming aware of a work-related injury or occupational disease.