Workers’ Compensation Documents

Please read the The Claremont Colleges EHS Employee Handbook

Workers’ Compensation (WC)

• WC packet [fillable PDF]
• Workers’ Compensation Claim Form (DWC 1) & Notice of Potential Eligibility [fillable PDF] (State of California)
• Travelers new hire packet
  • English
  • Spanish
• Predesignation of Personal Physician (Pitzer College)

Voluntary Disability Insurance (VDI)

• VDI packet [fillable PDF]

Paid Family Leave (PFL)

• PFL packet [PDF]

Medical Provider Network (MPN)

• {Division}’s acknowledgement form [PDF]

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