Form |
Instructions |
Campus |
|---|---|---|
| UC Davis Workers' Compensation | For the Davis campus: The link at the left leads to Safety Services, where you will find Workers' Compensation forms, information and assistance. | UC Davis |
| Workers' Compensation Claim Form (DWC 1) & Notice of Potential Eligibility | For the Health campus: Complete this form to file a workers’ compensation claim with your employer. Submit to: Workers' Compensation, Fax: 916-734-2484 |
UC Davis Health |
| Workers' Compensation Departmental Injury/Illness Worksheet | For the Health campus: Complete this form to file a workers’ compensation claim with your employer. Submit to: Workers' Compensation, Fax: 916-734-2484 |
UC Davis Health |
