CA Division of Workers’ Compensation (DIR - DWC) Forms and Documents
The CA Division of Workers’ Compensation (DIR - DWC) is California’s government division focused on workers’ compensation. Its name identifies the agency’s broad subject area without specifying the details of any particular filing or service.
Forms represented here include workers’ compensation claim materials, an application for adjudication, compromise-and-release paperwork, a subpoena, and verification forms for specific petitions and appeals. The collection also includes claim-form titles identifying Chinese, Vietnamese, Korean, or Tagalog versions, so users can distinguish those options from other case-related documents.
CA Division of Workers’ Compensation (DIR - DWC) forms
- DWC/WCAB Form 1A · CA-DOWC-DIRDWC · CaliforniaDWC/WCAB Form 1A, Application for Adjudication of Claim – California
DWC/WCAB Form 1A, the Application for Adjudication of Claim, is the California Division of Workers' Compensation form that begins formal proceedings before the Workers' Compensation Appeals Board. Fill it out online on FillingPDF and download or print the completed PDF.
6 pages - DWC-CA form 10214 (c) · CA-DOWC-DIRDWC · CaliforniaForm 10214 (c), Compromise and release – California
DWC-CA form 10214 (c), Compromise and release, is the California Division of Workers' Compensation settlement agreement. Fill it out online on FillingPDF and download or print the completed PDF.
9 pages - DWC 1 · CA-DOWC-DIRDWC · CaliforniaForm DWC 1, Workers' compensation claim form (Chinese) – California
Form DWC 1 (Chinese) is the California Division of Workers' Compensation claim form, printed in English and Chinese, that an injured or ill employee gives to the employer. Fill out the fillable PDF online and download or print it.
4 pages - DWC 1 · CA-DOWC-DIRDWC · CaliforniaForm DWC 1, Workers' compensation claim form (Vietnamese) – California
Form DWC 1 (Vietnamese) is the California Division of Workers' Compensation claim form, with its Notice of Potential Eligibility, that an injured employee gives to the employer. Fill out the PDF online on FillingPDF and download or print it.
4 pages - DWC WCAB 32 · CA-DOWC-DIRDWC · CaliforniaForm DWC WCAB 32, Subpoena Duces Tecum – California
Subpoena Duces Tecum (DWC WCAB 32) is the California Workers' Compensation Appeals Board subpoena that commands a person to appear and produce documents. Fill it out online on FillingPDF and download or print the completed PDF.
2 pages - CA-DOWC-DIRDWC · CaliforniaVerification Form for Commutation Petition – California DWC
The Verification form is a California Division of Workers' Compensation (DIR – DWC) declaration signed under penalty of perjury to verify a Petition for Commutation of Future Payments. Fill it out online on FillingPDF and download or print the completed PDF.
1 page - CA-DOWC-DIRDWC · CaliforniaVerification Form for IMR Petition Appeal – California DWC
The Verification form is a California Division of Workers' Compensation (DWC) declaration that the petitioner signs under penalty of perjury for a Petition Appealing Administrative Director's IMR Determination. Fill it out online on FillingPDF and download or print the PDF.
1 page - CA-DOWC-DIRDWC · CaliforniaVerification Form for Petition to Reopen – California DWC
The Verification form is a California Division of Workers' Compensation (DIR – DWC) document in which a petitioner declares under penalty of perjury that a Petition to Reopen is true. Fill it out online on FillingPDF and download or print the PDF.
1 page - CA-DOWC-DIRDWC · CaliforniaVerification Form: Labor Code 132a Discrimination Benefits
The Verification is the declaration under penalty of perjury that a petitioner signs to confirm an Application for Discrimination Benefits Pursuant to Labor Code Section 132a, published by the California DWC. Fill it out online on FillingPDF and download or print the PDF.
1 page - CA-DOWC-DIRDWC · CaliforniaVerification Form: Serious and Willful Misconduct Petition
The Verification is a California Division of Workers' Compensation (DWC) form in which a petitioner declares under penalty of perjury that a Petition for Benefits for Serious and Willful Misconduct of Employer is true. Fill it out online on FillingPDF and download or print the completed PDF.
1 page - DWC 1 · CA-DOWC-DIRDWC · CaliforniaWorkers’ Compensation Claim Form (DWC 1) & Notice of Potential Eligibility (Korean) – California
The DWC 1 is California's workers' compensation claim form with its Notice of Potential Eligibility, here in the Korean-English version from the Division of Workers' Compensation. Fill it out online on FillingPDF and download or print the completed PDF.
4 pages - DWC 1 · CA-DOWC-DIRDWC · CaliforniaWorkers’ Compensation Claim Form (DWC 1) & Notice of Potential Eligibility (Tagalog)
The Tagalog version of California's Workers’ Compensation Claim Form (DWC 1) & Notice of Potential Eligibility, published by the Division of Workers’ Compensation (DWC). Fill out the fillable PDF online on FillingPDF and download or print it.
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About the CA Division of Workers’ Compensation (DIR - DWC)
The forms represented in this collection cover both workers’ compensation claim materials and filings connected with specific proceedings. Claim-form options include DWC 1 documents, with some titles identifying Chinese, Vietnamese, Korean, or Tagalog versions; one also names a Notice of Potential Eligibility. These language-specific titles help distinguish claim materials from the application and petition documents elsewhere in the catalog.
Other forms address different case-related purposes. The Application for Adjudication of Claim is an application, while the compromise-and-release document is a separate type of filing. A Subpoena Duces Tecum is also represented. Verification forms are associated with particular petitions or issues, including commutation, an IMR petition appeal, reopening a case, Labor Code 132a discrimination benefits, and serious and willful misconduct. These titles indicate distinct document categories, not interchangeable forms.
This page reflects published forms currently associated with the CA Division of Workers’ Compensation; it may not include every document the agency issues. Before relying on a form, check the issuing agency’s current instructions for the applicable version, supporting documents, deadlines, and submission method. Those details can matter for claim materials and case filings alike.