Workers' Compensation Forms & Bulletins

Workers' Compensation Claims

• Arizona - Employer's Report of Injury -
• California - Medical Provider Network (MPN) -
• California - Employer's First Report of Injury or Illness 5020 -
• California - Workers' Compensation Claim Form (DWC 1) -
• Florida - First Report of Injury or Illness (DWC 1) -
• Illinois - Form 45: Employer's First Report of Injury -
• Nevada - C-3 (Employer's Report of Accident) -

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