DWC 1 Workers’ Compensation Claim Form

Last UpdatedOctober 26, 2016
Total Files2
VersionRev. 1/1/2016

Provide this form to California employees in the event of a workplace injury or illness.  For more information on employee rights and reporting, download the form or visit the CA DIR's Division of Workers' Compensation website linked below.

Download & Links
Link to CA Dept. of Industrial Relations - Division of Workers' Compensation (DWC) Forms directory
Note: These are forms and links made available to the public by federal, state, or local authorities. The links and copies of the forms are provided here for your convenience and ease of reference. Although ManagEase makes an effort to post the most current links and forms, be sure you are using the latest link and the most up-to-date form when processing current information. You may go directly to the federal, state, or local authorities’ websites for this information. You may also request copies of the forms from the federal, state, or local authorities by contacting them directly or by visiting their websites.
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