What Is the CA‑1 Workers' Compensation Form?
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The CA‑1 is a California state‑required document that reports an employee's injury or illness to the state's workers' compensation system. Filed by the employer, it initiates the claim process and provides the employee with access to medical benefits, wage replacement, and potential future compensation.
Who Must File the CA‑1?
Under California law, any employer who has a paid employee who sustains a work‑related injury or illness must file a CA‑1 within 30 days of the injury. The form is also required for certain "self‑injury" claims, such as a worker who injures themselves while performing work duties.
Key Sections of the CA‑1 Form
Employee Information: Name, address, and Social Security number.
Injury Details: Date, time, location, and description of the incident.
Employer Information: Business name, address, and California Employer Identification Number (CEIN).
Medical Treatment: Details of treatment received and whether a medical provider has been designated.
Signature and Date: Employer's signature confirming accuracy of the information.
How to File a CA‑1
Employers can file the CA‑1 electronically through the California Department of Industrial Relations (DIR) portal or submit a paper copy to the DIR's local office. Electronic filing is faster and reduces the risk of errors.
Step‑by‑Step Electronic Filing
1. Log in to the DIR portal. 2. Select "Workers' Compensation" and then "File CA‑1." 3. Enter employee and injury details. 4. Attach any supporting documentation. 5. Review, submit, and print a confirmation receipt.
Paper Filing Instructions
1. Obtain the latest CA‑1 form from the DIR website. 2. Complete all required fields. 3. Sign and date the form. 4. Mail to the appropriate DIR office or drop it off in person.
Common Mistakes to Avoid
• Failing to file within 30 days. • Omitting the employee's Social Security number. • Providing incomplete injury descriptions. • Not attaching medical reports when required.
What Happens After Filing?
Once the CA‑1 is accepted, the employee can receive medical treatment and wage replacement. The employer's insurance carrier will review the claim, and the employee may file for additional benefits if the injury leads to permanent impairment.
Key Dates and Timelines
| Attribute | Verified Detail | Source Type |
|---|---|---|
| Filing Deadline | Within 30 days of injury | California Labor Code § 6500 |
| Initial Medical Treatment | Within 14 days of filing | California Workers' Compensation Law |
| Maximum Wage Replacement Period | Up to 2 years, plus 2 years of temporary disability benefits | California Workers' Compensation Board |
FAQs About the CA‑1
Can an employee file a CA‑1? No, only the employer can file.
What if I miss the 30‑day deadline? The claim may be denied, but the employee can still file a late claim under certain circumstances.
Do I need to keep a copy of the CA‑1? Yes, employers should retain a copy for at least 5 years.
When to Seek Legal Advice
If the injury is severe, the employer disputes the claim, or the employee believes benefits are incorrectly denied, consulting a workers' compensation attorney can clarify rights and potential remedies.