Workers' Compensation Forms
The forms referenced on this page are the state required Workers' Compensation forms.
Employees should contact their supervisor or campus Workers' Compensation Coordinator
to obtain campus-specific forms.
Workers' Compensation New Hire Pamphlet
CSU provides a pamphlet to NEW employees regarding worker's compensation, also referred
to as the "Time of Hire Pamphlet". The content for this pamphlet is specified in Labor
Code 3551 and Section 9880 of Title 8, California Code of Regulations. The Administrative
Director must approve all pamphlets per Regulation 9883.
The Time of Hire Pamphlet shall be given to new employees by the time of their
Workers' Compensation Claim Form
The Workers' Compensation Claim Form, known as the DWC1 form, is given to injured workers within one day of the knowledge of an injury. Current forms may be found at the State of California Division of Workers' Compensation website listed below.
Workers' Compensation Predesignated Personal Physician Forms
The current versions of the forms are the Predesignated
Personal Physician and the Notice of Personal
Chiropractor or Personal Acupuncturist.
These forms are given to new employees. Current employees may also use these forms to change