Department of Industrial Relations

State of California

Official Website: https://www.dir.ca.gov/

The Department of Industrial Relations (DIR) was established in 1927. Its mission is to improve working conditions for California's wage earners and to advance opportunities for profitable employment in California. DIR administers and enforces laws governing wages, hours and breaks, overtime, retaliation, workplace safety and health, apprenticeship training programs, and medical care and other benefits for injured workers.

Forms & Documents

Browse all Department of Industrial Relations government forms

21 - 40 of 65 forms

Form Title Topics
Medical mileage expense form Formulario de gastos de viajes para asuntos médicos
Medical mileage expense form Formulario de gastos de viajes para asuntos médicos
NOTICE OF OFFER OF MODIFIED OR ALTERNATIVE WORK FOR INJURIES OCCURRING BETWEEN 1/1/04 - 12/31/12, INCLUSIVE DWC
NOTICE OF OFFER OF REGULAR, MODIFIED, OR ALTERNATIVE WORK FOR INJURIES OCCURRING ON OR AFTER
NOTICE OF OPTIONS FOLLOWING DISABILITY RATING
Notice to Employees--Injuries Caused By Work
Physician's Return-to-Work & Voucher Report
PRE-TRIAL CONFERENCE STATEMENT
PRIMARY TREATING PHYSICIAN'S PERMANENT AND STATIONARY REPORT(PR-3)
PRIMARY TREATING PHYSICIAN'S PERMANENT AND STATIONARY REPORT(PR-4)
PRIMARY TREATING PHYSICIAN'S PROGRESS REPORT (PR-2)
Provider’s Request for Second Bill Review
QME/AME Report Time Frame Extension Request
Replacement Panel Request-8 Cal. Code of Regulations section 31.5
REQUEST FOR CONSULTATIVE RATING
Request for Factual Correction of an Unrepresented Panel QME Report
REQUEST FOR QUALIFIED MEDICAL EVALUATOR PANEL
REQUEST FOR SUMMARY RATING DETERMINATION of Primary Treating Physician Report
REQUEST FOR SUMMARY RATING DETERMINATION of Qualified Medical Evaluator’s Report (QME) Report
STATE OF CALIFORNIA DIVISION OF WORKERS’ COMPENSATION WORKERS' COMPENSATION APPEALS BOARD

Contact Information & Office Locations

1 contact point

Main Office

Phone numbers:
  • (800) 794-6900 (Division of Workers’ Compensation Medical Unit)
  • (877) 252-1987 (File an appeal regarding Cal/OSHA citations)
  • (800) 963-9424 (Free workplace safety advice for business owners)
  • (877) 992-2567 (Heat Illness Prevention helpline)

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