helP ME

Someone is hurt.

The following information and materials will help you when an injury occurs in the workplace.

Call 911 for emergency and life-threatening situations.

Report a Claim

Tackle workplace injuries in 4 steps

1

IMMEDIETELY REPORT THE CLAIM

Call (888) 472-9001 or report the claim using the link below.

Report a Claim

2

LOCATE A PHYSICIAN

Send the injured employee to a physician within our Medical Provider Network (MPN). To help find a provider, call (888) 472-9001 or use the link below.

Find a Doctor

3

ACCESS YOUR pharmacy CARD

After a physician from our MPN is selected for treatment, please provide the employee with a Pharmacy Card for initial pharmaceutical needs due to an injury-related claim.

Get the Card

4

COMPLETE OUR INJURY FORM

Fill out this form, print it out, and present it to the clinic of your choice for documentation.

Get the Form

5

Need Help?

Our team is ready to answer any questions you might have. Call us at (888) 472-9001 or email us using the link below.

Contact Us

What do I do next?

complete the DWC-1

Within 1 working day of receiving notice of a work-related illness or injury, you must provide the injured employee with necessary documents. You must complete the Workers’ Compensation Claim Form (DWC-1) .

Get the DWC-1 Form

share the mpn notice

After the DWC-1 (Workers’ Compensation Claim Form) is completed, the next step is providing the injured employee with a copy of the MPN Notice.

Get The MPN Notice

GET OUR FREE MPN+ APP

Triage access is available year-round, 24/7 with our MPN+ app. Injured workers get instant access to California board certified ER physicians. Spanish-speaking services are also available.

Enroll here

SUPPLY ADDITIONAL info

Also provide the Information for Injured Workers brochure to the injured employee. Don’t have it? Order copies by calling (888) 472-9001 or the link below.

Call Us

COMPLETE THE CAL/OSHA 300 FORMS

Record the injury or illness on the OSHA log (Form 300).

If a fatality or serious injury/illness has occured, you must report the incident to the nearest Cal/OSHA office within 8 hours. To find the nearest Cal/OSHA office, call (510) 286-7000.

300 Form

300A Form

301 Form