DWC Fact Sheets
DWC Fact Sheets are documents that can be used by both the injured workers and the Policyholders to provide an overview of the laws that govern the claims administration process in the State of California. These forms are also available on the DWC website at www.dir.ca.gov
Medical Records Release of Injured Worker
When injured workers sign this form, they give PacificComp permission to obtain their medical records so that PacificComp can evaluate their claim.
Mileage Reimbursement Request for Injured Worker Use
Injured workers should use this form to log their mileage for travel related to their medical treatment so that PacificComp can reimburse them.