Policyholders can report an injury immediately through our Claims Reporting Center, which is available 24 hours a day, 7 days a week. To report an injury using this service, simply call us toll-free at (888) 782-8338 and a representative will assist you in completing the Employer’s Report of Occupational Injury or Illness (form 3067) and mail you a copy. You may also fax your injury report to our toll-free fax line at (800) 371-5905 and a representative may contact you for additional information. Another option is for State Fund Online (SFO) registered users to file a claim online.
File a Claim
Workers’ Compensation Claim Form
Employer’s Report of Injury form
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Tutorial on how to fill out an Employer’s Report of Injury (3067)
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State Fund’s MPN Provider Finder look-up tool provides easy access to our Medical Provider Network. You can customize your search with several specifications, including provider distance from your home or workplace, provider name, urgent-care facilities, and regional listings. Policyholders may also call (888) 782-8338 and a Medical Access Assistant will be happy to connect you with doctors and specialists who will provide prompt and professional treatment.
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Claim forms are available online via the Forms tab on the homepage or on State Fund Online. Policyholders can request claim forms and claims kits to be mailed to their business address by calling our Claims Reporting Center’s toll free number (888) 782-8338.
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Note: State Compensation Insurance Fund is not a branch of the State of California.