New Calculators launching soon. Try them now!

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

Call or email us anytime
(805) 484-0333
Search Guide
Today is Friday, August 14, 2020 -

WCC PDF Forms

Form NameForm Number
10107 Tables10107 TABLES
9792.1 Appendix B (DRG Weights and Revised DRG Weights)Appendix B
A Guidebook for Injured Workers, 3rd Ed. (Nov. 2006)
A Guidebook for Injured Workers, 3rd Ed. - Spanish (Nov. 2006)
Addendum To Application And/or AnswerWC 004
Additional Panel Request (05/10)QME 31.7
Affidavit Of Defendant Re: Resolution Of LiensWCAB 003
After You've Been Hurt on the JobFact Sheet #2
After You've Been Hurt on the Job (SP)Fact Sheet #2 (SP)
AME or QME declaration of service of medical - legal reportQME Form 122
Answers to your questions about permanent disability benefits (12-2005)Fact Sheet D
Answers to your questions about permanent disability benefits - Spanish (01-2006)Fact Sheet D
Answers to your questions about qualified medical evaluators and agreed medical evaluators (12-2005)Fact Sheet E
Answers to your questions about qualified medical evaluators and agreed medical evaluators - Spanish (04-2007)Fact Sheet E
Answers to your questions about temporary disability benefits (12-2005)Fact Sheet C
Answers to your questions about temporary disability benefits - Spanish (01-2006)Fact Sheet C
Answers to your questions about the state's Uninsured Employers Fund (01-2006)Fact Sheet F
Answers to your questions about the state's Uninsured Employers Fund - Spanish (10-2005)Fact Sheet F
Answers to your questions about utilization review (01-2006)Fact Sheet A
Answers to your questions about utilization review - Spanish (08-2006)Fact Sheet A
Appeal from Determination and Order of the Rehabilitation Unit - Form and Instructions - SPANISH (05-2007)I&A13(sp)
Appeal from Determination and Order of the Rehabilitaton Unit - with Instructions (05-2007)I&A 13
Appendix A: Payment Of Inpatient Services Of Health FacilitiesAppendix A
Appendix C: Ratios Applied To Revise Certain DRG Weights In CaliforniaAppendix C
Application for accreditation or re-accreditation as education providerQME Form 118
Application for Appointment as Qualified Medical EvaluatorQME Form 100
Application for benefits for serious and willful misconduct of employer
Application for discrimination benefits pursuant to Labor Code section 132(A)
Application for Spinal Surgery 2nd Opinion Physician List (05/2007)Form 232
Apportionment (01-01-2005)DEU 105

Form Filters

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

Featured Video

Upcoming Events

  • Aug 17-19, 2020

    WCIvirtual

    WCI strives to be the premier conference where the industry can come together to learn, connect, a …

  • Aug 19, 2020

    2020 DMEC Virtual Annual Confe

    Based on member feedback, we know the coronavirus and its implications for employers is at the for …

  • Aug 20, 2020

    LatinoComp Substance Abuse Web

    In this presentation, Mr. Mann provides a review of the brain chemistry of addiction and alcoholis …

Workers' Compensation Events

Social Media Links


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