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CA WCAB 32 (Side 1) 2018-2025 free printable template

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PRINTCLEARSTATE OF CALIFORNIA DEPARTMENT OF INDUSTRIAL RELATIONS DIVISION OF WORKERS COMPENSATIONWORKERS COMPENSATION APPEALS BOARD Case No. (IF APPLICATION HAS BEEN FILED, CASE NUMBER MUST BE INDICATED
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How to fill out california workers compensation board

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How to fill out CA WCAB 32 (Side 1)

01
Begin by entering the 'Employee's Name' at the top of the form.
02
Fill in the 'Employer's Name' and 'Address' in the designated fields.
03
Provide the 'Date of Injury' and select the appropriate 'Injury Type'.
04
Include the 'Claim No.' if applicable.
05
Enter the 'Employee's Social Security Number' for identification.
06
Detail the 'Date of Birth' of the employee.
07
Write the 'Address of Employee' with complete information.
08
Record the 'Phone Number' of the employee.
09
If there’s an attorney involved, include their 'Name' and 'Address' as necessary.
10
Finally, review all information for accuracy before submission.

Who needs CA WCAB 32 (Side 1)?

01
Individuals who have sustained a work-related injury or illness.
02
Employers who need to report worker's compensation claims.
03
Legal representatives of employees filing for workers' compensation.
04
Insurance carriers handling workers' compensation claims.
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CA WCAB 32 (Side 1) is a form used in California workers' compensation cases, specifically designed to report the details of an injured worker's claim.
The form CA WCAB 32 (Side 1) must be filed by the claims administrator or the employer when there is a workers' compensation claim involving an injured employee.
To fill out CA WCAB 32 (Side 1), follow the instructions provided on the form, including entering the employee's information, the details of the injury, and relevant dates. Ensure all required fields are completed accurately.
The purpose of CA WCAB 32 (Side 1) is to provide the Workers' Compensation Appeals Board with essential information regarding the workers' compensation claim, facilitating the processing and management of the case.
The information that must be reported on CA WCAB 32 (Side 1) includes the injured worker's name, case number, injury date, type of injury, and the contact information of the claims administrator.
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