DWC 1 Workers’ Compensation Claim Form

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  • Version Rev. 1/1/2016
  • Download
  • File Size 101.23 KB
  • File Count 2
  • Create Date August 16, 2016
  • Last Updated October 26, 2016

DWC 1 Workers' Compensation Claim Form

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.

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