Unfortunately, injuries do happen on the job. If you or an employee gets injured, you must complete both these forms:
Complete both forms, sign, and fax to 818-546-8475. If you wish to email to firstname.lastname@example.org, please do NOT enter your Social Security number on the form.
Upon receiving these forms, the Human Resources office will then file the claim with our worker's compensation administrator, Sedgwick . HR will give the original DWC1 form to the injured employee to take to the healthcare provider so that the doctor can charge the visit to worker's compensation.