Get a Form or Publication: beneficios

Your search for "beneficios" returned 14 documents.

Title Type Number
A Guide to Workers' Compensation Benefits For Employees of Self-Insured Businesses 252-004-000 - Spanish (Guía de Beneficios de Compensación para los Trabajadores)
Also available in: English

Pamphlet/booklet: Explains to employees of self-insured businesses their rights and responsibilities under industrial insurance law. Describes benefits and how to file a claim.

Publication F207-085-999
Accountability Agreement - Spanish Acuerdo de Responsabilidad
Also available in: English

This document provides the facts necessary to make an informed decision regarding vocational retraining benefits and explains the responsibilities you and your vocational counselor (VRC) have.

Form F280-016-999
Application for Benefits- Crime Victims Spanish Instrucciones para: Solicitud para Beneficios para Víctimas de Crimen
Also available in: English

Instructions in Spanish to complete the English form F800-042-000 Application for Crime Victim benefits. The form is used by victims of a crime in Washington State to receive benefits for time lost from work, loss of financial support, medical or mental health treatment. This 12-10 version is internet only.

Form F800-042-999
Workers' Compensation Benefits: A Guide for Injured Workers - Spanish (Beneficios de Compensación para los Trabajadores: Una guía para los Trabajadores Lesionados)
Also available in: English

Pamphlet/booklet: Explains a worker's rights and responsibilities under industrial insurance law. Describes benefits and how to file a claim. Note: Previously titled Una gua de los trabajadores para beneficios del seguro industrial.

Publication F242-104-999
Application for Pension Benefits by Spouse or Children - Spanish Aplicación para beneficios de pensión presentado por el cónyuge o hijos
Also available in: English

Used by a spouse or dependent that was chosen by the deceased worker to receive a survivor benefit. At the time the worker was determined to be totally permanently disabled he/she made a decision to leave a survivor benefit to a spouse or dependent if the worker dies.

Form F242-391-999
Claim for Pension by Spouse or Children - Spanish Reclamo para Pensión de Esposo(a) o Los Niños
Also available in: English

Used by a spouse or dependents of a deceased worker. The workers' fatal accident or occupational disease incurred in the course of their employment. This application is needed to determine if applicant(s) is/are entitled to a survivor benefit.

Form F242-056-999
Declaración De Derechos Para Dependiente Del Trabajador Fallecido Bajo El Programa De Compensación Y Beneficios Para Trabajadores
Also available in: English

Used by a dependent of a worker whose death was related to an on the job injury or accident. This form must be completed, signed, notarized and returned to L&I within 30 days for non interruption of benefits.

Form F242-173-933
Declaración De Derechos Para Padres O Tutor Bajo El Programa De Compensación Y Beneficios Para Trabajadores
Also available in: English

Used by a guardian or other person having custody of the minor or disabled children or dependents of a deceased worker to declare their entitlement to receive the pension benefits for those children/dependents in their care and custody.

Form F242-173-922
Declaración De Derechos Para Trabajador Totalmente Discapacitado Bajo El Programa De Compensación Y Beneficios Para Trabajadores
Also available in: English

Used by a totally permanently disabled worker. This form must be completed, signed, notarized and returned to L&I within 30 days for non interruption of benefits.

Form F242-173-944
Declaración De Derechos Para Viuda(O) Bajo El Programa De Compensación Y Beneficios Para Trabajadores
Also available in: English

Used by the widow/widower whose spouse died of a work related injury or accident. This form must be completed, signed, notarized and returned to L&I within 30 days for non interruption of your benefits.

Form F242-173-911
Help for Crime Victims/Ayuda para víctimas de crimen (English/Spanish)

Pamphlet/booklet: Answers questions about Washington State's Crime Victims Compensation Program, who may be eligible for benefits and how to apply.

Publication F800-006-909
Is a Structured Settlement Right for You?-Spanish (Es un acuerdo sobre beneficios de compensacin para trabajadores adecuado para usted?)
Also available in: English

Pamphlet/booklet: Explains structured settlement and provides an overview of eligibility and the application and approval processes. The audience for this pamphlet is injured workers who might be eligible.

Publication F240-003-999
Pension and Survivor Benefits in Washington State's Workers' Compensation Program--English/Spanish (Beneficios de pensin y para sobrevivientes del programa de compensacin para trabajadores de Washington)

Pamphlet/booket: Answers the most common questions about pension and survivor benefits under Washington's workers' compensation program.

Publication F242-352-909
Pension Benefits Questionnaire - Spanish CUESTIONARIO PARA BENEFICIOS DE PENSIN
Also available in: English

Used by an injured worker who receives an order that states he or she is totally permanently disabled. This questionnaire must be completed in full and all necessary documents attached before his or her pension benefit options can be calculated.

Form F242-393-999



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.