|
Select one of the following reporting options:
- By Phone - Call First Notice at (888) 709-3651
- By Fax - Fax the completed forms below to CompWest at (866) 506-5800
- Online Reporting (California Only) - If you are a registered CompWeb user, click here. If you are not a registered CompWeb user and would like to enroll,
Click here.
California Policyholders:
Please fill out
two forms:
Employers' Report of Injury (Form 5020), then fill out the employer's section of
Workers'
Compensation Claims Form (Form DWC-1) and
have the injured employee fill out the rest. Please fax
both forms to us.
Policyholders outside of California:
Please Click Here
to download the appropriate forms.
|
