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1800 Century Park East
Suite 600
Los Angeles CA 90067
Phone: (310) 791-4880
Toll-Free: (800) 520-5111
Fax: (310) 791-4883

Workers' Compensation Forms

As your agent, we assist you to report claims and stay updated on the claim status.  We want your claims closed as quickly as possible.  Once a claim occurs, it is very important your agent stays involved until closure. 

We maintain routine contact with the claims adjuster to monitor the progress of your the claims and intercede when necessary. 

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FORM - Employer's report of occupational injury or illness

Simplified flow chart for claims process acrobat image Includes Employees Report of Injury

FORM - Doctor's first report of occupational injury or illness

FORM - Notice of employee death

FORM - Notice to employees poster (English and Spanish)

Information for Injured Employee:

Topics covered in this FAQ include:
The basics
Medical care
Navigating the workers comp system
Temporary disability benefits
Permanent disability benefits
Returning to work
Employer responsibilities


Report of suspected medical care provider fraud

Glossary of workers'compensation terms:

Fact sheet B
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version acrobat image version

EAMS general public search

new image EAMS and legacy case number lookup tool

arrow image More workers' compensation topics

Reporting suspected medical care provider fraud

Workers' compensation reference materials
Libros de referencia de compensacion de trabajadores

Division of Workers' Compensantion/Workers' Compensation Appeals Board - Policy and Procedural Manual

A Guidebook for Injured Workers, 2006 acrobat image
CompensaciĆ³n del Trabajador de California

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