Claims Materials
California Claims Materials
- CompWest Claims Kit
- Claims Management
- Employee’s Claim for Workers’ Compensation Benefits DWC-1
- First Report of Injury Form 5020
- Medical Service Order form California
- MPN Handout English
- MPN Handout Spanish
- MPN Implementation Instructions
- MPN Poster English
- MPN Poster Spanish
- Notice to Employees Poster for Injuries Caused on the Job (DWC 7) (for CompWest Policies)
- Notice to Employees Poster for Injuries Caused on the Job (DWC 7) (for Accident Fund Policies)
- Notice to Employees Poster for Injuries Caused on the Job (DWC 7) (for United Heartland or Third Coast Underwriters Policies)
- WCAB Office Information Sheet
- Workers’ Compensation Temporary Prescription ID Card
- Time of Hire Pamphlet – English
- Time of Hire Pamphlet – Spanish
Utah Claims Materials
- Employer’s Report of Injury – Utah
- Information for Employers for Workers Compensation – Utah
- Information for Injured Workers – Utah
- Information for Injured Workers (Spanish) – Utah
- Injured Worker’s Right and Responsibilities – Utah
- Injured Worker’s Right and Responsibilities (Spanish) – Utah
- Medical Services Order Form – Arizona, Colorado, Utah
- Workplace Safety and Health
- Workplace Safety and Health – Spanish
- Workers’ Compensation Notice Poster – Utah
- Workers’ Compensation Notice Poster (Spanish) – Utah
- Workers’ Compensation Temporary Prescription ID Card
