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Ca-1 Form: What You Should Know

When filing the claim, the worker and/or the employer must attach a notarized copy of a doctor's letter attesting to the fact of the claim as well in providing the reason for filing the claim. The DWC-CA 10214-n.1 also indicates that if the claimant meets the definition of severe or permanent mental or physical impairment as specified in the Mental and Physical Disability Discrimination Act of 1991, 42 U.S.C. § 12101 et seq., the claimant can receive up to 2,000.00 per month, for a maximum of six months in addition to a claimant's already available disability compensation. For information about filing an injury claim, please visit the DWC website.

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