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First Name (required) Last Name (required) Your Phone (required) Your Email (required) Mailing Address (required) City (required) State (required) Zip Code (required) Employer At Time of Injury [Use the name on your paycheck or W-2] (required) Date of Injury(s) for Your Claim(s) (required) Body Parts / Health Condition Related for Your Claim (required) Best Time Ranges to Reach You What is the answer? 6 + 8 is: (We're making sure this a person filling out the form.)

This website is for information purposes only. If you are looking for legal advice, you should contact our office at 877-840-5353. We will not give advice to anyone outside of California, since we are only licensed to practice law in California.

The information that is found on this website is for California Workers' Compensation cases only. In addition, discussion surrounding CalPERs in the rural areas of California. Other counties or cities in California may have their own retirement programs and do not use CalPERS. Those counties could be different.

Filing a false or fraudulent workers' compensation claim is a felony subject to up to 5 years in prison or fine of up to $50,000 or double the value of the fraud, whichever is greater, or by both imprisonment & fine.

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