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Title Number / Language
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A Guide to Workers' Compensation Benefits For Employees of Self-Insured Businesses  F207-085-000 (English)
 F207-085-999 (Spanish)
Affidavit for Time Loss Compensation Benefits  F242-395-000 (English)
 F242-395-999 (Spanish)
Application for Benefits - Crime Victims  F800-042-000 (English)
 F800-042-999 (Spanish)
Application for Benefits - Homicide Claims  F800-120-000 (English)
 F800-120-999 (Spanish)
Application for Pension Benefits by Spouse or Children  F242-391-000 (English)
 F242-391-999 (Spanish)
Declaration of Entitlement - Disabled Child or Guardian Benefits  F242-421-000 (English)
 F242-421-999 (Spanish)
Declaration of Entitlement for Dependent of Deceased Worker Benefits Under Industrial Insurance  F242-422-000 (English)
 F242-422-999 (Spanish)
Declaration of Entitlement for Totally Disabled Worker Benefits Under Industrial Insurance  F242-423-000 (English)
 F242-423-999 (Spanish)
How Social Security Benefits May Reduce Your Workers' Compensation Payments  F242-427-999 (Spanish)
 F242-427-000 (English)
L&I Benefits for Workers Who Are Terminally Ill  F252-094-000 (English)
Option 2 Vocational Benefits Training Enrollment Application  F280-024-909 (English/Spanish)
Option 2 Vocational Benefits Training Enrollment Application and Verification  F280-024-000 (English)
Pension and Survivor Benefits in Washington State's Workers' Compensation Program  F242-352-909 (English/Spanish)
Pension Benefits Questionnaire  F242-393-000 (English)
 F242-393-999 (Spanish)
Quarterly Statement of Supplemental Benefits Paid for Self-Insured Employers  F207-011-000 (English)
Request for Survivor Counseling Benefits  F800-057-909 (English/Spanish)
Workers' Compensation Benefits: A Guide for Injured Workers  F242-104-000 (English)
 F242-104-999 (Spanish)





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