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State Fund is the largest provider of workers’ compensation insurance in California. State Fund plays a stabilizing role in California’s economy by maintaining an open door policy, ensuring all employers have a strong and stable option for their workers’ compensation needs.

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Employee Forms

Downloadable Forms
Workers' Compensation Claim Form (DWC 1) e3301
Medical Mileage Expense Form e3065
For Workers: Making a Successful Return to Work e13090

Informational Materials
New Employee’s Guide to Workers’ Compensation (English/Spanish) e13286
Reporting An Injury e13704
Employee’s Guide to the State Fund MPN (English/Spanish) e13176
Employee’s Guide to the State Fund MPN (Chinese) e13144
Employee’s Guide to the State Fund MPN (Vietnamese) e13145
Employee’s Guide to the State Fund MPN (Hmong) e13146
Employee’s Guide to the State Fund MPN for Claims Management Service (English/Spanish) e13177

Mandated Forms
Employee’s Guide to the State Fund MPN (English/Spanish) e13176
Employee’s Guide to the State Fund MPN (Chinese) e13144
Employee’s Guide to the State Fund MPN (Vietnamese) e13145
Employee’s Guide to the State Fund MPN (Hmong) e13146
Employee’s Guide to the State Fund MPN for Claims Management Service (English/Spanish) e13177
New Employee’s Guide to Workers’ Compensation (English/Spanish) e13286
Notice to Employees (English) e13708
Notice to Employees (Spanish) e13709