Please give us your feedback on this version of WorkCompCentral

WorkCompCentral – Workers' Compensation Education, Courses, News and Information

Call or email us anytime
(805) 484-0333
Search Guide
Today is Friday, August 18, 2017 -

WCC PDF Forms

Form NameForm Number
Petition For ReconsiderationWCAB 45
Petition for Reconsideration - Form and Instructions - SPANISH (05-2007)I&A12(sp)
Petition for Reconsideration - with Instructions (05-2007)I&A 12
Petition for Resolution of Reimbursment DisputeAHCA Form 3160-0023
Petition To ReopenWCAB 42
Petition to Reopen - Form and Instructions - SPANISH (05-2007)I&A11(sp)
Petition to Reopen - with Instructions (05-2007)I&A 11
Petition To Terminate Liability For Temporary Disability Indermnitywcab46
Physician Contract Application (Independant Medical Reviewer) 05-2007DWC 9768.5
Pre-Trial Conference Statement (Liens)Pre-Trial
Pre-Trial Conference Statement(rev 09-2010)10253.1
Predesignation of Personal Physician (03-01-2007)DWC 9783
Primary treating physician's permanent and stationary report - 1997 permanent disability rating schedule (06-2005)DWC PR-3
Primary treating physician's permanent and stationary report - 2005 permanent disability rating schedule (06-2005)DWC PR-4
Primary treating physician's progress report (6-2005)DWC PR-2
Proof of Personal ServiceFL-330
Proof of Service by MailFL-335
QME Appointment Notification FormQME Form 110
QME disclosure of specified financial interestsQME Form 124
QME Notice of UnavailabilityQME Form 109
QME or AME Conflict of Interest Disclosure FormQME Form 123
QME/AME Report Time Frame Extension RequestQME Form 112
Qualified medical evaluator (QME) complaint form (04-2006)
Qualified medical evaluator (QME) exam packet (04-28-2007)QME exam
Qualified medical evaluator's findings summary form (unrepresented cases only)QME Form 111
Qualified or Agreed Medical Evaluator's Findings Summary FormIMC-1002
Reappointment Application as Qualified Medical EvaluatorQME Form 104
Reappointment Application as Qualified Medical Examiner (QME)IMC-101
Registration for QME Competency ExaminationQME Form 102
Replacement Panel Request 05/10QME 31.5

Form Filters

  • All CA Forms
  • Legal
  • Insurance
  • Medical
  • Voc Rehab
  • EAMS Forms (CA)

Featured Video

Upcoming Events

  • Aug 24-25, 2017

    The Big 2017 Fraud Fighting Co

    The Employers’ Fraud Task Force, in association with The San Bernardino District Attorney’s …

  • Sep 6-8, 2017

    CWC & Risk Conference

    Risk Management Education Associates have announced the keynote speaker for the 2017 CWC & Risk C …

  • Sep 12-15, 2017

    CAJPA 2017 Conference

    Save the date September 12-15, 2017 Registration will be opening in April 2017. The conferen …

Workers' Compensation Events

Social Media Links


WorkCompCentral Workers' Compensation
News and Education
4081 Mission Oaks Blvd
Camarillo, CA 93012
(805) 484-0333