Form 5020 Employer’s Initial Report of Injury

Login is required to access this page
  • Version Rev 7 June 2002
  • Download 1
  • File Size 97.48 KB
  • File Count 2
  • Create Date August 16, 2016
  • Last Updated October 26, 2016

Form 5020 Employer's Initial Report of Injury

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.

Attached Files

Form 5020.pdf
0 replies

Leave a Reply

Want to join the discussion?
Feel free to contribute!

Leave a Reply