b'WORK INJURY GUIDEWho Qualifies ForWorkers CompensationBenefits?WorkersCompensationbenefitsmay beavailableifyousustainawork related injury or illness. Your injury may be the result of a single event at work, or repeated exposures at work.Afteryouhavesufferedaninjuryor illnessatwork,youshouldpromptly notifyyouremployer.Ifyouremployer does not learn about your injury within 30daysofitsoccurrence,youcould loseyourrighttoreceiveWorkers Compensation benefits.AcopyoftheWorkersCompensation ClaimForm(DWC1)publishedbythe StateofCaliforniaDepartmentof IndustrialRelationsisincludedatthe end of this booklet for your reference.Your employer is required to provide you with a larger version of this form, which must be filled out by both you and your employers representative.If you have not completed this form, or have not received it from your employer, please let us know and we will take the steps necessary to complete it on your behalf.6'