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Form DLSR5020 Employer's Report of Occupational Injury or Illness - California
What Is Form DLSR5020?
This is a legal form that was released by the California Department of Industrial Relations - Division of Workers' Compensation - a government authority operating within California. As of today, no separate filing guidelines for the form are provided by the issuing department.
FAQ
Q: What is Form DLSR5020?
A: Form DLSR5020 is the Employer's Report of Occupational Injury or Illness, specifically for the state of California.
Q: Who needs to fill out Form DLSR5020?
A: Employers in California need to fill out Form DLSR5020 if an employee has a work-related injury or illness.
Q: What information needs to be provided on Form DLSR5020?
A: Form DLSR5020 requires information about the injured or ill employee, details of the incident, and the employer's contact information.
Q: When should Form DLSR5020 be submitted?
A: Form DLSR5020 should be submitted within five days of the employer's knowledge of the injury or illness.
Q: Why is Form DLSR5020 important?
A: Form DLSR5020 is important for recording and reporting work-related injuries or illnesses, as required by the state of California.
Q: Are there any penalties for not submitting Form DLSR5020?
A: Failure to submit Form DLSR5020 in a timely manner can result in penalties imposed by the state of California.
Form Details:
- Released on June 1, 2002;
- The latest edition provided by the California Department of Industrial Relations - Division of Workers' Compensation;
- Easy to use and ready to print;
- Quick to customize;
- Compatible with most PDF-viewing applications;
- Fill out the form in our online filing application.
Download a fillable version of Form DLSR5020 by clicking the link below or browse more documents and templates provided by the California Department of Industrial Relations - Division of Workers' Compensation.
