Type or write clearly within the boxes provided. Download a claim form below and fill it out completely.To submit a claim, fill out the. "Employee" section of the DWC-I. Please provide a copy of all attachments supporting your claim. (estimates, bills, receipts, police report, etc.) 1. Find benefit summaries, formularies (list of covered drugs), and all necessary forms to get the most out of your EmblemHealth coverage. IHSS Payroll must give or mail you a claim form within one working day after learning about your injury or illness. The City of Oakland has a standard claim form that can be used for your convenience. – Melissa Wilk, Auditor-Controller.