- Audio-Visual Request Form
- Claim FAX Coversheet
- Employee's Claim for Workers' Compensation Benefits (English/Spanish)
- Employee’s Guide to The State Fund MPN
- Employer's First Report of Injury - STATES
- Employer's First Report of Injury – CDCR
- Employer's First Report of Injury – Department of State Hospitals
- Guide to Workers' Compensation for State of California Employees
- Medical Mileage Expense Form
- New California State Employee’s Guide to Workers’ Compensation
- New Disaster Service Worker's Guide to Workers' Compensation
- Notice to Employees
- MPN Website: www.statefundca.com/sfmpn
- MPN Effective Date: 07/27/2020
- MPN Identification Number: 3136
- MPN Access Assistant: (888) 782-8338, Fax (800) 371-5905
- MPN Contact Person: (877) 636-0606
- Claims Administrator: State Compensation Insurance Fund; Phone: (888) 782-8338
- Workers’ Compensation Insurance Carrier: Legally uninsured
- DWC’s Information & Assistance Office: www.dir.ca.gov/dwc/ianda.html
Claims Services
File a Claim
Find a Medical Provider
How To Manage Claims in State Fund Online
Managing Your Worker's Claim
Policy Management
Renewing Your Policy
Updating Your Policy
Certificates of Insurance
Waivers of Subrogation
Opt in to receive paperless invoices, payroll reports, and other documents
I'm a Policyholder
Benefits of State Fund Online
Sign Up For Paperless Services
Employment Status Resource Center
Excluding Officers, Directors, General Partners
Minimum Premium Policies
Services and Contact Information
Downloadable Forms
Search All Forms
Policyholder Forms
Broker Forms
Injured Worker Forms
Medical Provider Forms