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Alameda County Law Library Building
125 - 12th Street, 3rd Floor, Oakland, CA 94607 · 510-272-6920

Risk Management Unit, a part of the CAO

Resources for Injured Employees

A nurse-staffed injury hotline is available to assist you in reporting industrial injuries and initiate the filing of a workers' compensation claim.

If you are injured on the job, CLICK HERE for information on reporting your injury and obtaining medical treatment.

IN AN EMERGENCY CALL 911 OR GO TO THE NEAREST EMERGENCY ROOM.

Forms Needed if Injury Requires More Than First Aid Treatment

  • DWC1 FORM (English (PDF - 104kb)* / Spanish (PDF - 104kb)*): Supervisor provides this form to employee within 24 hours of notice of injury requiring medical treatment beyond first aid or if physician certifies disability beyond the employees work shift at the time of the injury. ONLY THE EMPLOYEE MAY COMPLETE THE EMPLOYEE SECTION. Supervisor completes the employer section and submits to WCL/TPA.
  • FIRST FILL PHARMACY FORM (English) (PDF - 293kb)*: Give this notice to any pharmacy listed on the form to expedite the processing of your prescriptions.
  • FIRST FILL PHARMACY FORM (Spanish) (PDF - 345kb)*: Give this notice to any pharmacy listed on the form to expedite the processing of your prescriptions.
  • WORK STATUS REPORT (PDF - 156kb)*: Bring this form to each medical appointment. Your medical provider must complete at every appointment, and you must provide a copy to your supervisor/WCL.

General Information on Workers' Compensation Benefits

  • NOTICE TO COUNTY OF ALAMEDA EMPLOYEES (PDF - 363kb)*: This notice describes what benefits are mandated by the State of California.
  • NOTICE TO INJURED COUNTY OF ALAMEDA EMPLOYEES ( English (PDF - 91kb)* / Spanish (PDF - 313kb)*): This brochure provides an overview of Workers' Compensation information specific to County of Alameda Employees.
  • PRE-DESIGNATION OF TREATING PHYSICIAN FORM (PDF - 120kb)*: Before an injury, use this form to notify the County if you wish to have your personal medical doctor treat you for a work-related injury or illness and the requirements are met.

Other Resources

  • CLAREMONT EAP offers services that may be helpful for employees who are dealing with an occupational injury. Services are confidential and in most cases free to Alameda County, within service level limits. You may also contact Claremont EAP 24 hours a day, 7 days a week at 1-800-834-3773.
  • DESIGNATED PHYSICIAN AND MEDICAL FACILITY (PDF - 102kb)*: For non-emergency treatment, CarivaCare will direct the employee to go to an approved occupational health facility, unless they have pre-designated a physician prior to an injury. Even with a pre-designated provider, an employee may either go to that provider or an approved occupational health facility.

Mileage Forms

If you have to travel to get treatment for your work injury, you are entitled to re-payment of your travel costs. Please use correct form based on travel dates. For travel before 01/01/2015, please contact the third party administrator.

Your workers' compensation liaison can guide you through the process, or call the Risk Management Unit at 510-272-6920 or tie-line 2-6920.