California · Workers' Compensation
California workers' compensation forms
Every California workers' comp form BlueHive has verified against the issuing agency. Download PDFs we host, or jump directly to the official source for the rest.
- Forms tracked
- 2
- PDFs hosted
- 2
- State
- CA
Filing workers’ comp forms in California
Operational notes BlueHive coordinators rely on. For statute-level detail, see the compliance overview linked below.
- 1
Provider completes the DWC PR-2 progress report after each visit and the PR-3 / PR-4 at MMI.
- 2
Treating physician must be in the employer’s MPN (Medical Provider Network) unless the employee pre-designated.
- 3
PR-2 is due to the claims administrator within 20 days of the exam (8 CCR §9785).
California forms at a glance
Quick reference for who completes each form and where it goes. Tap a form code for full detail.
| Form | Who fills out | Who signs | Where it goes | |
|---|---|---|---|---|
| DWC Form 5021Doctor's First Report of Occupational Injury or Illness | Treating physician of record. NPs and PAs are not included in the definition of 'physicia… | NPs and PAs are not included in the definition of 'physician' under L… | Form 5021: within 5 working days of initial examination; PR-2: within 20 days of triggeri… | Open |
| PR-2Primary Treating Physician's Progress Report | Treating physician of record. NPs and PAs are not included in the definition of 'physicia… | NPs and PAs are not included in the definition of 'physician' under L… | Form 5021: within 5 working days of initial examination; PR-2: within 20 days of triggeri… | Open |
All California workers' comp forms
2 forms tracked. PDFs we host are downloadable; the rest deep-link to the issuing agency.
- Workers’ CompPDF hosted Verified
DWC Form 5021 — Doctor's First Report of Occupational Injury or Illness
California Division of Workers' Compensation (DWC)
Doctor's First Report of Occupational Injury or Illness (DWC Form 5021) — state-prescribed clinician report used by the state workers’ comp agency.
View form - Workers’ CompPDF hosted Verified
PR-2 — Primary Treating Physician's Progress Report
California Division of Workers' Compensation (DWC)
Primary Treating Physician's Progress Report (PR-2) — state-prescribed clinician report used by the state workers’ comp agency.
View form
Federal forms that also apply in California
Federal forms providers in California encounter alongside the state workers’ comp paperwork. Same data we publish on the federal pages.
- USCG MarinerCG-719K
Application for Merchant Mariner Medical Certificate
U.S. Coast Guard – National Maritime Center
View form - DOT / FMCSAMCSA-5875
Medical Examination Report Form (DOT)
Federal Motor Carrier Safety Administration (FMCSA)
View form - OSHA & SafetyOSHA 300
Log of Work-Related Injuries and Illnesses
Occupational Safety and Health Administration (OSHA)
View form
More states with forms
Important Legal Notice
The regulatory information presented on BlueHive Compliance Watch is provided for general informational purposes only and should not be construed as legal advice. While we strive to maintain accurate and up-to-date information, regulations can change rapidly and may be subject to interpretation.
You should always:
- Consult with qualified legal counsel before making compliance decisions
- Verify information with official government sources
- Review the full text of any regulation cited herein
- Consider jurisdiction-specific requirements that may apply to your organization
BlueHive Health, LLC makes no warranties or representations about the accuracy, completeness, or timeliness of this information. We are not responsible for any actions taken or not taken based on this content.
Coordinating workers' comp visits in California?
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