Skip to content
News
Events
Search
Log In
About CCCSIG
About
Accomplishments
Member Districts
Board of Directors
Executive Committee
Minutes & Agendas
Programs & Resources
Strength Testing (PEP)
Online Training
Facility Use
Workers’ Compensation
For Injured Workers
How to Report New Claims
Return to Work Program
Medical Panels
Member District Claim Teams
Cost Containment
Benefits
FAQ
Workers’ Compensation Updates
Glossary
Workers’ Compensation Links
WC Claims Coordinator Orientation Information
Health & Safety
Instructor-Led Trainings
Request a Workshop
Online Training
Ergonomic Services
Incentive Program
Regulatory Compliance (Cal OSHA)
Discounted Gym Memberships
H&S Coordinator Orientation
Healthy Lifestyle Programs
New Employee Resources
Safety Briefs/Tailgate Talks
Safety by Design
Useful Links
Health Benefits
Member Districts
Program History
Affordable Health Care Information
Membership Requirements
Discounted Gym Memberships
Employee Assistance Program
Bill Review Inquiry
Publications & Forms
For Injured Workers
Careers
Contact
Bill Review Inquiry
wcc_lira_admin
2020-03-06T12:39:39-08:00
Please enable JavaScript in your browser to complete this form.
Type of Inquiry
Original Bill
Appeal
Claimant Name
*
Claim Number
Date of Service
*
Amount
*
Provider
*
Contact Name
Telephone
Fax
Email
*
Reference #
Additional Comments
Name
Submit
