Request For Public Records

DWC REQUEST FOR PUBLIC RECORDS OR DATA. Use this form to request records or data maintained by the Division of Workers' Compensation (DWC). If you are requesting DWC data or records in a workers' compensation case file, please submit your request to the DWC district office closest to you. DWC'S Routine Exemptions from Disclosure. When it responds to a Public Records Act request (Gov. Code, § 7922.000 et seq.) for data or records in a workers' compensation case file, DWC (a) withholds all records or data that have been sealed (Cal. Code Regs., tit. 8, §10813); and (b) redacts this information from data or records: Social Security or other taxpayer identification number (42 U.S.C. §405(c)(2)(C)(viii)(I)); driver's license number (Veh. Code, § 1810); residential address (lab. Code, § 138.7); health insurance policy,financial account, and insurance claim numbers; dates of birth; minor's name; and individual's personal contact information (Gov.Code,§7927.700). Note: If you are a party/party representative to the workers' compensation case whose data or records you are requesting, or a law enforcement agency, please use the “Requester Type” box to identify yourself as such. DWC will provide the requested case data or records to you pursuant to Labor Code section 138.7, not under the PRA. Please review Labor Code section 138.7 for restrictions governing your use of such information. www.FormsWorkflow.com