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Fact sheets and guides for injured workers

When injured workers have problems with their claims, they may need to go to the local workers' compensation office for help. Each of the guides below provides information on how to fill out a form they may need to get the problem resolved. Most have samples attached. The forms may also be downloaded from the DWC forms page.

Injured worker fact sheets

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Injured Worker guides

Guide 1 How to file a workers' compensation claim form

REQUIRED CHECKLIST FOR FILING THIS FORM  (Please file the forms in the order indicated)

Guide 2 How to request a qualified medical evaluation

REQUIRED CHECKLIST FOR FILING THIS FORM  (Please file the forms in the order indicated)

Guide 3 How to object to your summary rating

REQUIRED CHECKLIST FOR FILING THIS FORM  (Please file the forms in the order indicated)

Guide 4 How to file an application for adjudication of claim

REQUIRED CHECKLIST FOR FILING THIS FORM  (Please file the forms in the order indicated)

Guide 5 How to file a declaration of readiness to proceed

REQUIRED CHECKLIST FOR FILING THIS FORM  (Please file the forms in the order indicated)

Guide 6 How to request an expedited hearing

REQUIRED CHECKLIST FOR FILING THIS FORM  (Please file the forms in the order indicated)

Guide 7 How to file a petition for discrimination (Labor Code 132a)

REQUIRED CHECKLIST FOR FILING THIS FORM  (Please file the forms in the order indicated)

Guide 8 How to file a serious and willful misconduct petition

REQUIRED CHECKLIST FOR FILING THIS FORM  (Please file the forms in the order indicated)

Guide 9 How to file a petition for commutation

REQUIRED CHECKLIST FOR FILING THIS FORM  (Please file the forms in the order indicated)

Guide 10 How to file a lien

REQUIRED CHECKLIST FOR FILING THIS FORM  (Please file the forms in the order indicated)

Guide 11 How to file a petition to reopen

REQUIRED CHECKLIST FOR FILING THIS FORM  (Please file the forms in the order indicated)

Guide 12 How to file a petition for reconsideration

REQUIRED CHECKLIST FOR FILING THIS FORM  (Please file the forms in the order indicated)

Guide 13 How to file an appeal of the administrative director

REQUIRED CHECKLIST FOR FILING THIS FORM  (Please file the forms in the order indicated)

Guide 14 How to file a complaint with the Audit Unit

REQUIRED CHECKLIST FOR FILING THIS FORM  (Please file the forms in the order indicated)

Guide 15 How to dismiss your attorney

REQUIRED CHECKLIST FOR FILING THIS FORM  (Please file the forms in the order indicated)

Guide 16 How to file a claim with the Uninsured Employers Benefits Trust Fund

REQUIRED CHECKLIST FOR FILING THIS FORM 

  • Refer to the text in this guide to see which forms are needed
Guide 16A How to correctly name your employer for the Uninsured Employers Benefit Trust Fund
Guide 16B How to serve your employer in an Uninsured Employers Benefit Trust Fund case
Guide 17 How to complete a document cover sheet

REQUIRED CHECKLIST FOR FILING THIS FORM  (Please file the forms in the order indicated)

Guide 18 How to complete a document separator sheet

REQUIRED CHECKLIST FOR FILING THIS FORM  (Please file the forms in the order indicated)

Guide 19 How to file a petition appealing administrative director’s independent medical review determination

REQUIRED CHECKLIST FOR FILING THIS FORM  (Please file the forms in the order indicated)

Guide 20 How to file a petition for change of venue

REQUIRED CHECKLIST FOR FILING THIS FORM  (Please file the forms in the order indicated)

Guide 21 How to file a petition for penalties

REQUIRED CHECKLIST FOR FILING THIS FORM  (Please file the forms in the order indicated)

January 2016