To file a claim for injury or property damage against Contra Costa County please read and complete the form and send to: Clerk of the Board of Supervisors. âś“ Tort Claim form is typed or printed clearly in ink.âś“ Tort Claim form is filled out completely. Providing effective management of liability, medical malpractice, and workers' compensation claims against the County. Before filing a Tort Claim, please read these instructions the Tort Claim form and other appropriate forms in their entirety. This article provides guidance on now to prevent a Workers' Compensation subrogation attorney from extorting an improper recovery on their lien. Giving the injured party the information they need to understand what a tort claim is, when it's needed, and how to file a tort claim. Injuries to the worker during the course of employment, which typically take the form of a claim against the state for workers' compensation. Especially when figuring your total income, Federal income tax withheld, and your refund or amount you owe. 9. Attach your W-2 form(s) and any other required.