How to file a workers' comp claim in California

You fill out the "Employee" part of the DWC-1, keep a copy, and give it to your employer. From that moment your employer has one working day to sign it, give you a dated copy and send it to its insurance company. That's the whole filing. The rest of this page is about doing it so nobody can argue with it later.

Where to get the form

Labor Code section 5401 says your employer must give you the claim form within one working day after it learns about an injury that costs you time beyond your shift or needs more than first aid. It comes stapled to a cover sheet called the Notice of Potential Eligibility, which explains your benefits in English and Spanish. Hang on to that cover sheet.

Nobody gave you one? You don't need permission. The form is on the state's website at dir.ca.gov/dwc/DWCForm1.pdf.

Your section, box by box

There are nine items. Most take ten seconds. Item 6 is the one to slow down on.

Items in the employee section of the DWC-1 claim form

Item	What to write
1. Name and today's date	Your full legal name and the date you're filling it out
2-3. Home address	Wherever you want mail about the claim to go
4. Date and time of injury	When it happened. If it built up over time, give your best estimate of when it started affecting your work, and say that's what you did
5. Where it happened	The address plus something specific, like "loading dock, Building B"
6. The injury and body parts	What happened, and every body part that hurts. Even the ones that seem minor today
7. Social Security number	The form asks for it. If this box worries you, call us before you turn the form in
8. Email notices (optional)	Check it only if you'd rather get claim notices by email
9. Signature	Sign it

Why item 6 matters: the state's own instructions say to describe the injury completely and include every affected body part. Leave your shoulder off because the knee hurt more, and you may end up fighting later over whether the shoulder is covered.

The form also carries a fraud warning required by law. Knowingly making a false statement to get or deny benefits is a felony. Be accurate, and be complete.

Hand it in so you can prove it

In person is fine. Give it to your supervisor or HR, then write on your copy the date and the name of whoever took it. By mail, the state recommends first-class or certified, and a return receipt gives you proof of delivery. Either way, keep the copy marked "Employee's Temporary Receipt" until your employer gives you a signed and dated one.

Call (323) 656-9040 or send us the short form to discuss what happened.

The clock your employer is on

Employer and claims administrator deadlines after a claim form is filed

Deadline	What has to happen
1 working day	Your employer fills in its section, gives you a dated copy and sends a copy to the claims administrator
1 working day	Up to $10,000 in medical treatment gets authorized while the claim is decided (Labor Code § 5402(c))
14 days	The claims administrator tells you the claim is accepted or needs more investigation
14 days	If you can't work, your first temporary disability check is due (Labor Code § 4650)
90 days	No denial by now? The claim is presumed covered (Labor Code § 5402(b))

Sources: DWC-1 claim form and Notice of Potential Eligibility; California Labor Code § 5401, § 5402, § 4650.

"It's not serious enough to file." Yes it is.

Some employers drag their feet. You'll hear "just use your own insurance," or "let's see how it feels next week," or the form just never shows up. None of that changes your right to file. Ask for the form by text or email so there's a record. If it still doesn't come, print it, fill in your part, and deliver it with a witness or by certified mail. Save every message about the injury. If you get punished for reporting it, that can be illegal retaliation under Labor Code section 132a, which our retaliation guide covers.

Can't get treatment approved while you wait? The DWC-1 notice says you can use your own health insurance, and your health plan will collect from the claims administrator. No insurance at all? Some doctors, clinics and hospitals will treat you and bill the claims administrator later. And if no workers' comp checks are coming, you may qualify for State Disability Insurance or unemployment through the EDD at (800) 480-3287.

Filing the form doesn't open a court case

People mix these up all the time. The DWC-1 starts a claim with your employer's insurance company. It doesn't put you in front of a judge. That happens only if there's a fight, say your claim gets denied or your benefits get cut off. Then someone files an Application for Adjudication of Claim with the Workers' Compensation Appeals Board. You have one year for that, counted from the injury or your last benefit, whichever is later (Labor Code section 5405).

After the case is open, either side can ask for a hearing with a Declaration of Readiness. A settlement conference lands 10 to 30 days later. If it doesn't settle, trial is supposed to happen within 75 days of that Declaration (Labor Code section 5502). The glossary decodes the acronyms.

Sources: California Labor Code § 5405, § 5502; DWC Injured Worker Guidebook, Chapter 11.

Free help, and what a lawyer costs

The state runs Information and Assistance officers who answer questions and help sort out problems for free. Call 1-800-736-7401 for recorded info and a list of local offices.

If you'd rather have someone in your corner, a workers' comp lawyer's fee in California has to be approved by a judge and comes out of your benefits, not your pocket. The state says it's typically 9 to 15 percent of a permanent disability settlement or award. Talk to one if the claim is denied, your employer is pushing back, treatment is refused, or someone puts a settlement in front of you.

Quick questions