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When a Work Injury Occurs

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.

  1. 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).
  2. 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.
  3. 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.
  4. 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.