Some injuries must be reported to Cal/OSHA within 8 hours of the incident or they will, not can, they will issue a $5,000 citation for late injury reporting. Find out what injuries to report.
- Call 888-472-9001 to report ALL work injuries to Preferred Employers Insurance Company.
- Our staff will complete the “Employers’ Report of Occupational Injury or Illness” (Form 5020) and a copy will be mailed to you for your records.
- We will provide a claim number and assist in locating a medical facility in the Preferred Select Medical Provider Network (MPN).
- Provide a “Workers’ Compensation Claim Form” (DWC-1) and the Initial Written Employee Notification to the injured worker within one working day of receiving notice of a work related injury or illness.
- If this is a fatality or serious injury/illness, you must report the incident to the nearest Cal/OSHA office within 8 hours.
- Examples of serious injuries are amputation, disfigurement, or in-patient hospitalization in excess of 24 hours for other then observation.
- Failure to report serious injuries/illnesses as described may result in a $5,000 fine.
- Start planning for your employee’s return to regular or modified work by working closely with your claim examiner.
For Emergency and Life Threatening Injuries or Illnesses CALL 9-1-1.