Form 5020 Employer’s Initial Report of Injury
Last Updated | October 26, 2016 |
Total Files | 2 |
Version | Rev 7 June 2002 |
Employers are required to report to workers' compensation within five days of knowledge every occupational injury or illness which results in lost time beyond the date of the incident OR requires medical treatment beyond first aid. For more information on reporting, download the form or visit the CA DIR's Division of Workers' Compensation website linked below.
Download & Links
File |
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Form 5020 |
Link to CA Dept. of Industrial Relations - Division of Workers' Compensation (DWC) Forms directory |
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