Report the Incident to the Insurance Company

You must file the Form 5020 - Employer’s Report of Occupational Injury or Illness for every workplace injury which results in either:

• Lost time beyond the day of the incident (employee misses more than one day of work); or
• Medical treatment beyond first aid.

Form 5020 should be filed as soon as possible, but no later than five days after the employer obtains knowledge of the occupational illness or injury.¹

If you are self-insured, file the form electronically with the Department of Industrial Relations. If you are an insured employer, the report must be filed with your workers’Form