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Form 5020 online DE: What You Should Know

DWC 1–1 — Workers' Compensation Claim Form (Spanish) If employees report a serious injury, they must report it to HR within 6 weeks after the event, otherwise, it will only be as long as the 6 weeks before the week in which the claim is filed. The injury can be an “Actual Event” or an “Incidental Event”. The report has to be made in person to a health-care provider. The report must be made within 3 days after the event. It also should be filed in the Employers' Report of Occupational Injury or Illness (Form 5020) within 30 days. “Incidental Event”: The injury is the result of an act taken for the sole purpose of self-protection or self-preservation by a person while engaged in an activity for which he or she is licensed, privileged, or trained — California Labor Code Form 5020 — Employer's Report of Occupational Injury or Illness · DWC 2 — Civil Penalties Notice (English and Spanish) DWC 2–1 — Civil Penalties Notice (Spanish) DWC 2–2 — Civil Penalties Notice (Spanish) ✓ Instantly. Try Now! “Actual Event”: The injury was the results of an injury to an employer, employee, or third party other than oneself, caused by an act or conduct that the person, including a business agent, voluntarily undertakes, to an extent that such injury or consequential loss is foreseeable at the time the act is done. Form 5020 — Employer's Report of Occupational Injury or Illness. · DWC 3 — Employee Notice of Intent to Sue (English and Spanish) DWC 3–1 — Employee Notice of Intent to Sue (Spanish) DWC 3–2 — Unauthorized Substitute for Civil Penalties Notice (English and Spanish) ✓ Instantly. Try Now! Employees should consult their health-care provider and file a Report of Occupational Injury or Illness (Form 5020) with his or her health-care provider. Any other form that the employee must fill out by hand or in the form is not needed. The report is only required to be filed by an employee if the employee has requested to file a report and has not failed to file the report.

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