Downloadable Forms
Employer's First Report of Injury e3067
Workers' Compensation Claim Form (DWC 1) e3301
ACORD 130 (Non-Broker Accounts) ACORD 130
Supplemental Application Form (SAF) e10328
Notice Of Temporary Staffing Client Letter e10383
Partnership Exclusion Letter e10200
Corporate Officers or Directors Exclusion Letter e10201
Limited Liability Company Exclusion Letter e10202
Medical Mileage Expense Form e3065
Safety Materials Order Form e17614
Express Scripts Pharmacy Registration Form
Informational Materials
State Compensation Insurance Fund - California's Workers' Compensation Specialist e13837
Group Insurance Savings and Opportunities e13400
Association Membership with State Fund e13219
Understanding Your Final Premium Bill e10170
Experience Modification Rating e13702
Understanding Your Annual Rating Endorsement e10350
Understanding Your Declarations Page e10355
Understanding Your Quote for Insurance e10502
Audit Questions and Answers e13649
Classifications by Wage Level in the Construction Industry e13721
Classifications by Wage Level in the Construction Industry (Spanish) e13722
New Requirements for Separate Classifications by Wage Level in the Construction Industry 14296
Understanding Your Policy Surcharges e13724
Directory of Workers' Compensation Administrators by State
For Employers: Developing a Successful Return to Work Program e13088
For Employers: Return to Work Programs (brochure) e13089
For Workers: Making a Successful Return to Work e13090
Return to Work Programs e13891
Developing and Maintaining a Successful Return to Work Program e13490
For Employers: Facts for the California Employer e13701
Understanding First Aid Claims e13492
Modified Jobs, Reduced Costs e13720
10 Steps to Lower Workers' Compensation Costs e13726
Association Membership with State Fund e13219
Safety Audio Visual Catalog e17804
Small Employer Safety Materials Catalog e17839
Sample Ergonomics Program
Reporting An Injury e13704
State Fund's Financial Strength and Lasting Value e13646
The Choice of California Employers e13051
Find it Fast and Easy Online, 24/7 e13986
State Fund Online e13893
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
MPN Implementation Notice (English/Spanish) e3841
New Employee’s Guide to Workers’ Compensation (English/Spanish) e13286
Notice to Employees (English) e13708
Notice to Employees (Spanish) e13709
