• 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.

Attached Files