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California
California
WORK RELATED INJURY PROCEDURE
WC Forms PDF Version
PDF Refused Medical Treatment Forms
Form 1 – Employee’s Report of Injury
Form 5 – Supervisor’s Report
Form D – Refusal of Medical Treatment
PDF Sent to Medical Forms
Form A – 5020
Form B – DWC Botton-Portion
Form C – Auth. for Treatment
Form 1 – Employee’s Report of Injury
Form 3 – Consent to Release Medical Information
Form 4 – WC Supplemental Forms
Form 5 – Supervisor’s Report of Injury
Form 6 – Accident-Root Cause
Form 7 – Witness Statements
Form 8 – Modified Duty Form
CA Claims Kit
CA Claims Kit