DWC Forms

File this form to report a work injury or illness to your employer. Must be filed within 1 year of the injury date.

Used by treating physicians to request authorization for medical treatment from the claims administrator.

This voucher is issued when the employer cannot offer modified or alternative work and the worker has a permanent partial disability.

File this form to request a hearing before a WCAB judge when the case is ready for trial or expedited hearing.

File this form to request an Independent Medical Review (IMR) when a utilization review decision denies or modifies medical treatment.

File this form to open a case at the Workers' Compensation Appeals Board when there is a dispute over benefits.