Workers' Compensation Filing Information

Workers'' Compensation Filing Information - (Forms/Publications)
Document Information
  Get help downloading & printing files.   How to complete a fillable form.
Title Workers'' Compensation Filing Information (A fillable form - 266 KB PDF)

Used by only self-insured employers to comply with WAC 296-15-400. The form provides information and instructions to employees of self-insured employers in case of an injury or development of an occupational disease.

Form number F207-155-000
Online only. See document above to download.
Keywords espanol, industrial insurance, injured worker, injuries, instructions, required forms, self insurance, self insurer, self-insurance, self-insurer, spanish, worker's compensation, workers compensation
Languages English , Spanish
Valid dates 12-2012
Contact information Claims for Job Injuries
Web pages Self-Insured Employers
Insurance for Business

End of main content, page footer follows.

Access Washington official state portal

© Washington State Dept. of Labor & Industries. Use of this site is subject to the laws of the state of Washington.