Form dwc au 906 2000-2026

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The document provides guidelines on how to file a complaint with the Audit Unit of the Division of Workers' Compensation in California. It outlines the process for submitting complaints against workers' compensation claims administrators, including required information and documentation. The Audit Unit uses these complaints to determine which claims administrators may be audited, although not all complaints will result in an audit due to volume limitations. Confidentiality restrictions prevent complainants from receiving results of audits.

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Click ‘Get Form’ to open the DWC AU 906 2000 in the editor.
Begin by entering the Claims Administrator Company Name, Address, and Telephone Number in the designated fields.
Next, fill in the Injured Worker’s Name, Address, and Telephone Number accurately.
Provide the Claim Number and Date of Injury. Note that injuries prior to January 1, 1990 cannot be considered.
Input the Employer's Name and any applicable Workers' Compensation Appeals Board Case Number.
In the 'Specific Details of Complaint' section, clearly outline the nature of your complaint. Be as specific as possible regarding issues like late payments or failure to provide services.
If you have supporting documentation, attach it using our platform’s upload feature for a complete submission.

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