Report of Accident (ROA) Workplace Injury, Accident or Occupational Disease

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Title Report of Accident (ROA) Workplace Injury, Accident or Occupational Disease
Description

You can submit a Report of Accident (ROA) online https://secure.lni.wa.gov/home This form is not on the internet. If you are an injured worker, ask your doctor for a copy of this form. Order F242-130-999 from the warehouse to receive the instructions in Spanish to complete the form in English.
Detail
Form number F242-130-000
Availability
Order it
Keywords accident report, claim information, claims, coverage, diseases, espanol, industrial insurance, medical forms, most requested forms, most requested forms, occupational diseases, occupational injuries, report of injury or occupational disease, reporting accidents, worker's compensation, workers compensation, workers' compensation
Languages English , Spanish
Valid dates 10-2012
Contact information
Web pages Workers' Comp Claims

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