- Audio-Visual Request Form
- Claim FAX Coversheet
- Employee's Claim for Workers' Compensation Benefits (English/Spanish)
- Employee’s Guide to The State Fund MPN
- Employer's First Report of Injury - STATES
- Employer's First Report of Injury – CDCR
- Employer's First Report of Injury – Department of State Hospitals
- Guide to Workers' Compensation for State of California Employees
- Medical Mileage Expense Form
- New California State Employee’s Guide to Workers’ Compensation
- New Disaster Service Worker's Guide to Workers' Compensation
- Notice to Employees
- MPN Website: www.statefundca.com/sfmpn
- MPN Effective Date: 07/27/2020
- MPN Identification Number: 3136
- MPN Access Assistant: (888) 782-8338, Fax (800) 371-5905
- MPN Contact Person: (877) 636-0606
- Claims Administrator: State Compensation Insurance Fund; Phone: (888)-782-8338
- Workers’ Compensation Insurance Carrier: State Compensation Insurance Fund
- DWC’s Information & Assistance Office: www.dir.ca.gov/dwc/ianda.html