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California Department of Industrial Relations - Division of Workers' Compensation Forms

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Form I&A21 Information and Assistance Unit Guide - How to File a Petition for Penalties - California PDF DOCX

Form I&A21 Information and Assistance Unit Guide - How to File a Petition for Penalties - California
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Form I&A4 Information and Assistance Unit Guide - How to File an Application for Adjudication of Claim - California PDF

Form I&A4 Information and Assistance Unit Guide - How to File an Application for Adjudication of Claim - California
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Form I&A13 Information & Assistance Unit Guide - How to File an Appeal of the Administrative Director - California PDF DOCX

Form I&A13 Information & Assistance Unit Guide - How to File an Appeal of the Administrative Director - California
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Medical Mileage Expense Form - California (English/Spanish) PDF DOCX

Medical Mileage Expense Form - California (English/Spanish)
Legal United States Legal Forms California Legal Forms Mileage Reimbursement Form Expense Reimbursement Form Travel Expense Form California Department of Industrial Relations Language Options Healthcare Expenses Healthcare Reimbursement
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DWC Form RFA Request for Authorization - California PDF DOCX

DWC Form RFA Request for Authorization - California

This form is used as a legal document and filled out by a treating physician of an employee with a work-related injury or illness to request authorization of special medical treatment, services, and procedures.

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Form DWC-851 Annual Report of Claims Inventory - California PDF DOCX

Form DWC-851 Annual Report of Claims Inventory - California
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QME Form 31.5 Replacement Panel Request - California PDF DOCX

QME Form 31.5 Replacement Panel Request - California
Legal United States Legal Forms California Legal Forms Workers Compensation Forms California Department of Industrial Relations Panel Request Injured Worker
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Instructions for QME Form 123 Qme or Ame Conflict of Interest Disclosure Form - California PDF DOCX

Instructions for QME Form 123 Qme or Ame Conflict of Interest Disclosure Form - California
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DWC-AD Form 101 Request for Summary Rating Determination of Qualified Medical Evaluator's Report - California PDF DOCX

DWC-AD Form 101 Request for Summary Rating Determination of Qualified Medical Evaluator's Report - California
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Medical Mileage Expense Form (For Mileage After 01/01/2024) - California (English/Spanish) PDF DOCX

Medical Mileage Expense Form (For Mileage After 01/01/2024) - California (English/Spanish)
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Form DWC-AU-906 Audit Complaint Form - California PDF DOCX

Form DWC-AU-906 Audit Complaint Form - California
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Request for Public Records or Data - California PDF DOCX

Request for Public Records or Data - California
Legal United States Legal Forms California Legal Forms California Department of Industrial Relations
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Form I&A7 Information & Assistance Unit Guide - How to File a Petition for Discrimination (Labor Code Section 132a) - California PDF DOCX

Form I&A7 Information & Assistance Unit Guide - How to File a Petition for Discrimination (Labor Code Section 132a) - California
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Form I&A11 Information & Assistance Unit Guide - How to File a Petition to Reopen - California PDF DOCX

Form I&A11 Information & Assistance Unit Guide - How to File a Petition to Reopen - California
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Form I&A3 Information & Assistance Unit Guide - How to Object to Your Summary Rating - California PDF DOCX

Form I&A3 Information & Assistance Unit Guide - How to Object to Your Summary Rating - California
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Form I&A5 Information & Assistance Unit Guide - How to File a Declaration of Readiness to Proceed - California PDF DOCX

Form I&A5 Information & Assistance Unit Guide - How to File a Declaration of Readiness to Proceed - California
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Form I&A10 Information & Assistance Unit Guide - How to File a Lien - California PDF DOCX

Form I&A10 Information & Assistance Unit Guide - How to File a Lien - California
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QME Form 31.7 Additional Panel Request - California PDF DOCX

QME Form 31.7 Additional Panel Request - California
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Formulario DWC-AU-906 Formulario De Queja De Auditoria - California (Spanish) PDF DOCX

Formulario DWC-AU-906 Formulario De Queja De Auditoria - California (Spanish)
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DWC Form IBR-1 Request for Independent Bill Review - California PDF DOCX

DWC Form IBR-1 Request for Independent Bill Review - California
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Form I&A8 Information and Assistance Unit Guide - How to File a Serious & Willful Misconduct Petition (Labor Code Section 4553) - California PDF DOCX

Form I&A8 Information and Assistance Unit Guide - How to File a Serious & Willful Misconduct Petition (Labor Code Section 4553) - California
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Form I&A9 Information and Assistance Unit Guide - How to File a Petition for Commutation - California PDF DOCX

Form I&A9 Information and Assistance Unit Guide - How to File a Petition for Commutation - California
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Form I&A1 Information and Assistance Unit Guide - Workers' Compensation Claim Form - California (English/Spanish) PDF

Form I&A1 Information and Assistance Unit Guide - Workers' Compensation Claim Form - California (English/Spanish)
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Form I&A19 Information and Assistance Unit Guide - How to File a Petition Appealing Administrative Director's Independent Medical Review Determination - California PDF DOCX

Form I&A19 Information and Assistance Unit Guide - How to File a Petition Appealing Administrative Director's Independent Medical Review Determination - California
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Form I&A20 Information and Assistance Unit Guide - How to File a Petition for Change of Venue - California PDF DOCX

Form I&A20 Information and Assistance Unit Guide - How to File a Petition for Change of Venue - California
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Form I&A12 Information and Assistance Unit Guide - How to File a Petition for Reconsideration - California PDF DOCX

Form I&A12 Information and Assistance Unit Guide - How to File a Petition for Reconsideration - California
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Form I&A6 Information and Assistance Unit Guide - How to Request an Expedited Hearing - California PDF DOCX

Form I&A6 Information and Assistance Unit Guide - How to Request an Expedited Hearing - California
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DWC-CA Form 10214(C) Compromise and Release - California PDF

DWC-CA Form 10214(C) Compromise and Release - California
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DWC/WCAB Form 1A Application for Adjudication of Claim - California PDF

DWC/WCAB Form 1A Application for Adjudication of Claim - California
Legal United States Legal Forms California Legal Forms California Department of Industrial Relations
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Aviso Para El Nuevo Empleado - California (Spanish) PDF

Aviso Para El Nuevo Empleado - California (Spanish)
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