This following information is intended for California Workers’ Compensation policyholders utilizing managed care. In such cases, a letter describing needed information and resources (similar to this page) is included with the policy.
Employers should complete the following notice and post in a conspicuous location frequented by employees during the hours of the work day:
All employees should receive a copy of this pamphlet:
According to California Labor Code, all employers are required within one working day of receiving notice or knowledge of injury to provide their employee with the following form:
Employers should also provide a copy of the form below to any ill/injured worker at the time of an injury or transfer of care:
MPN ID# 2397 | Medical Access Assistant Phone Number 1-844-752-1144
California managed care forms in other languages: