Report and Manage Claims
COVID-19 claims in California
If an employee contracts COVID-19 at work, report the incident by following the steps below.
If an employee contracts COVID-19 and it’s not work-related, you are required to report the exposure using the SB 1159 California Employer Reporting Form.
For resources on COVID-19 and your workers’ comp policy, visit our COVID-19 Resources page.
What to do when an incident occurs
1Get medical treatment if necessary
If your employee’s need for treatment appears urgent — for example, bleeding profusely, unconscious or may be having a heart attack — get them to the nearest emergency room or call 911.
For non-emergency injuries, the Nurse Triage Hotline is available. Your employee can call 855.469.6877 (855-4MY-NURSE) to speak to a nurse specializing in workplace injuries. This service is accessible 24/7, offers English and Spanish-speaking nurses, and will start the claims process for you.
Note: If your employee needs medical treatment, you must approve treatment at a Medical Provider Network (MPN) facility within one working day after you receive a claim form from your employee. If your employee has pre-designated a personal physician to treat on-the job injury or illness, the employee should go to this physician.
2Complete California’s claim form
Submit a claim
Please select one of these ways to submit a claim:
Give us your claim details over
the phone by calling
FaxDownload the PDF form and fax
it to 858.436.8916
First Notice of Loss
PO Box 509039
San Diego, CA 92150
Give form DWC1 to the injured employee within one working day after learning about the employee’s work injury or illness. The employee should complete the Employee section and return the form to you. Within one day of receiving the completed and signed form from your employee, complete the Employer section, provide one copy to the injured employee, and one copy to ICW Group. Keep a copy for your records.
4Fulfill OSHA requirements
All California employers are required to notify OSHA when an employee suffers a work-related death, hospitalization, amputation, or loss of an eye.
Learn more about OSHA requirements ›