Workers’ Compensation State Documents

View Important Information Regarding Your State

Workers’ compensation varies in each state. To learn more about important programs and updates, find your state information below:

  • California Workers’ Compensation Required Reporting for First Aid Claims (english/spanish)
  • California Medical Provider Network (CA MPN) – CorVel Corporation

    The new CA MPN has been approved by the California Department of Industrial Relations to treat workers injured on the job. Experience has shown that medical outcomes for injured workers can be improved when employees are given a choice of provider(s) in an approved medical provider network.

    The CA MPN offers a wide range of benefits, including:

    • Earlier return to work – state documented
    • Lower medical costs – state documented
    • Reduced litigation through internal dispute resolution process
    • Access to care within 24 hours
    • Limited provider change once enrolled in program
    • Limited initial provider selection. Employee risks suspension of compensation benefits if treatment is received from a non-network physician
    • No ceiling on control of care, as long as specialty is certified
    • Network discounts
    • Utilization review is mandated


    Visit this page to find a provider near you through the CorVel website or download their app for remote access.

    Alternatively enter your email address here for remote access and to create a formal panel of physicians.
    (Please note an instant automatic reply will be sent to your email address with the log-in information).
    NOTE: MSIG urges all policyholders to participate in our MPN.
    Utilization of this program provides an excellent opportunity to control workers’ compensation costs, while simultaneously providing quality medical care to your injured workers

    How to Get Started Utilizing the MPN

    POST at each work site:

    • MPN provider panel
    • DWC-7, which includes MPN-specific information
    • Pre-designation of personal physician form

    How to Transfer From One MPN to Another MPN

    CA MPN End of Coverage and Implementation Notice must be distributed:

    • To all injured workers when changing from an existing MPN to another MPN within 60 days.
    • To all employees when changing from an existing MPN to another MPN if more than 60 days have lapsed since ceasing use of a prior MPN.


    POST at each work site:

    • MPN provider panel
    • DWC-7, which includes MPN-specific information
    • Pre-designation of personal physician form

    MSIG will provide the Complete Employee Information notice (0056 Mitsui Sumitomo Ins of America or 2039 Mitsui Sumitomo Ins USA) to the employee once the injury has been reported to MSIG. This will serve to educate the employee regarding the MPN and advise the employee how to access the MPN network.

    CorVel Corporation may be contacted via:

    Phone (Toll Free): (855) 857-7556
    Fax: (866) 708-4331.

    The MSIG Claims Office in Los Angeles, CA, can assist you with any questions.Please contact one of our representatives at (800) 365-4671. Press 3 to reach the Workers’ Compensation Claim Department.

    Please click on the links to the following forms that are available for your use:

    Standard Claims and MPN Materials:


    Optional Kaiser MPN Documents

  • Illinois Preferred Provider Program (PPP) and Employee Information

    Dear Policyholder:

    Under the Illinois workers’ compensation system, employers can create Preferred Provider Programs (PPP) for workers’ compensation. MSIG is offering the availability of a PPP for our policyholders. To assist you in complying with the new regulations, we are providing the PPP Employee Notification Packet.

    Here’s what you need to know:


    Finding an Illinois PPP Provider

    Opt-Out Tracking

    If an employee does not want to use the PPP, he or she must notify the employer in writing. Employer/policy holder should keep an active log of opt-out notices received. Please notify MSIG if the injured worker has opted out. This is very important to the claims handling process to ensure appropriate care is provided.

    At MSIG, we believe that timely, early reporting of a claim is the best approach to containing your workers’ compensation costs and assuring your employees receive appropriate medical care. Participation in the PPP will help support medical cost containment and facilitate prompt return to work. If you are interested in participating, please notify MSIG.



    PPP Program Goals and Objectives:

    • To ensure that the injured worker receives quality, cost-effective medical care
    • To ensure that medical care is geared toward expedient recovery
    • To ensure appropriate steps are taken regarding hospitalization
    • To ensure an appropriate discharge plan
    • To channel injured employees to the PPP providers and physicians
    • To return the employee back to work as quickly as medically feasible


    The PPP Helps Injured Workers:

    • Receive quality, cost-effective medical care
    • Expedite their recovery
    • Receive the appropriate hospitalization care
    • Ensures an appropriate discharge plan
    • Receive access to the network providers
    • Ensure a timely return to work


    Employer Advantages:

    • Manage cost and improve care
    • Reduce medical payout
    • Provide lifetime medical control of the claim
    • Ensure timely recovery and return-to-work outcomes
    • Ensure shorter TTD durations (Temporary Total Disability)
    • Provide assistance with implementation

  • New York Workers’ Compensation

    Important Announcement — to Our New York State Workers’ Compensation Policy Holders:

    The New York State Workers’ Compensation Board Rule 300.37 mandates that a New York employer provide a “Claimant Information Packet” to an injured worker at the time of the injury.

    To assist you in complying with this mandatory regulation, you can download the Claimant Information Packet, here.

    This requirement applies only to New York State workers’ compensation claims.

    If you have any questions, please contact:

    MSIG Claims Department
    15 Independence Boulevard
    Warren, NJ 07059
    Phone: (866) 676-6272
    Fax: (908) 604-2835

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