DWC 1 Workers’ Compensation Claim Form

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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.


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DWC 1
Link to CA Dept. of Industrial Relations - Division of Workers' Compensation (DWC) Forms directory
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