Cómo Registrar un Reclamo para la Compensación del Trabajador con Empresas Autoaseguradas


Document Information
  Get help downloading & printing files.   How to complete a fillable form.
Title Cómo Registrar un Reclamo para la Compensación del Trabajador con Empresas Autoaseguradas
Description

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.

Document number F207-155-999
How to get this document
Keywords espanol, filing information, industrial insurance, injured worker, injuries, required forms, self insurance, self insurer, self-insurance, self-insurer, spanish, worker's compensation, workers compensation, workers' compensation
Alt Language(s) English
Valid dates 12/2012
Contact information Claims for Job Injuries, Employer Services
Websites Insurance for Business, Self-Insured Employers

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.