Individuals and/or firms who want to provide vocational services to Washington injured workers, must:

• Meet the requirements in WAC 296-19A-210 (www.leg.wa.gov).
• Complete a Provider Application and Agreement form (F252‑017‑000).
  and
• Be assigned at least one provider number.

Interns not previously registered with L&I prior to December 1, 2000 must also complete an Intern Supplemental Application (33 KB doc).

These requirements include vocational providers who:

• Provider service to injured workers covered by:
  • State Fund or
  • Self-insured employers.
• Work in other settings, such as pain clinics or hospitals.
• Work both in-state and out-of-state, individuals and firms.

What is the difference between a payee provider and a service delivery provider?

A payee provider is the entity that receives payment for services performed (e.g., an individual or firm). The payee is responsible for tax issues related to these payments. L&I sends payment information, by each taxpayer identification number, to the IRS.

A service delivery provider is the individual practitioner. A service delivery provider must submit a separate application for each payee provider with whom they are associated.

How many applications must be completed?

• Firms complete one vocational provider application.
• Individuals complete an application for each firm they are associated with.
  For example, if you work for three firms:
  1. You would submit three applications, and
  2. Receive three provider numbers.

What constitutes a change in status?

Leaving a firm, a change of address or obtaining a credential are examples of a change in status. You would let L&I know of these changes by submitting:

• A Firm Vocational Provider Account Change form (F252‑022‑000).
  and/or
• A Individual Vocational Provider Account Change form (F252‑021‑000).
  or
• A Vocational Provider Application and Notice form (F252‑017‑000).
  • The Change form instructions will help you determine whether your change(s) can be done on a change form or whether you need to submit a Provider Application and Agreement form.

Changes are effective when L&I notifies the applicant, by letter of their new status.

For more information

WAC 296-19A-210 (www.leg.wa.gov) - What are the qualifications to provide vocational rehabilitation services to industrially injured or ill workers?

WAC 296-19A-220 (www.leg.wa.gov) - Can a vocational rehabilitation provider deliver vocational rehabilitation services pursuant to RCW 51.32.095 (www.leg.wa.gov) without receiving a provider number from the department?