Administration Building, Room 601
Hours: Monday - Friday from 8 a.m. to 5 p.m.
Phone (323) 343-3657 | Fax (323) 343-3662
Titles |
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Word |
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Employee's Report of Occupational Injury or Illness |
Employee's Report of Occupational Injury or Illness-PDF | |
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Supervisor's Report of Occupational Injury or Illness |
Supervisor's Report of Occupational Injury or Illness-PDF | |
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Workers' Compensation Personal Physician Designation |
Workers' Compensation Personal Physician Designation-PDF | Workers' Compensation Personal Physician Designation-DOC |
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Workers' Compensation Claim Form (DWC 1) |
Workers' Compensation Claim Form (DWC 1)-PDF |