Form 5020 for Orange California 2025

Form 5020 for Orange California: What You Should Know

An S T A T O F L I S T Aug 24, 2025 — If you are an injured worker you must file a Claim for the County's workers' compensation program. To do so, submit your claim form (DWC-1) to the Employee Benefits Department (401 W. 3rd Street, Sacramento). Form 5020 includes a one-page description of your injuries and symptoms. You file the paperwork in person or by mail. Notice of Workers' Compensation Insurance Premium Rates. Sept 24, 2025 — The rate schedule for the worker's compensation program for 2025 is posted on the County's website here. If you are an employee, then you must file a Statement of Work Injury and Illness. To do so you must fill out Form 5020 (REV 7). Dec 16, 2025 — You will receive a form (WSC-5020) which describes the injuries you experienced under California's Workers' Compensation program. A letter is mailed to you from the DWC which contains more information about your situation. DWC 1 S.S. 10, Section 10.4.(a) (8) Form 5020 — Form for Employers Filing Information With the DWC The form, the instructions for filing for all workers' compensation claims, and additional information at S.S. 10, Section 10.5.(d)(2) (E) (2) The worker's compensation program is not an admission of liability against the worker's employer, his employer's agent, his agent's agent, the worker, or the worker's employer, but may be used to protect personal property, medical expenses, and reasonable compensation for any injury that caused a loss to the worker. No claim shall be approved without written notification of the injured worker. All claims shall be filed in person. The following provisions apply: (a) You need only fill out and complete Form DWC-1. You are not required to give your reasons or give a detailed description of how the injury occurred. (b) You need to fill out and complete a Statement of Work Injury and Illness, including a medical description of your injuries.  You do not need to sign form COWI-2022-02.

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