California Workers' Compensation Claim Form

Form Template

If you are injured or become ill, either physically or mentally, because of your job, including injuries resulting from a workplace crime, you may be entitled to workers’ compensation benefits.

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Complete this California Workers' Compensation Claim Form app to file a workers’ compensation claim with your employer.

Features
  • Signature Capture
  • Submission Editing
  • Reference Data
  • Dispatch
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Platforms
  • iPhone
  • iPad
  • Android
  • Windows
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Integrations
  • Quickbooks
  • Salesforce
  • Google Docs
  • Dropbox
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