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Title Number / Language
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Application for Benefits - Homicide Claims  F800-120-000 (English)
 F800-120-999 (Spanish)
Application for Benefits - Injury Claims  F800-042-000 (English)
Application to Reopen Claim Due to Worsening Condition  F242-079-201 (Amharic)
 F242-079-211 (Bosnian)
 F242-079-213 (Burmese)
 F242-079-214 (Cambodian)
 F242-079-220 (Chinese Simplified)
 F242-079-221 (Chinese Traditional)
 F242-079-000 (English)
Application to Reopen Claim due to Worsening Condition  F242-079-909 (English/Spanish)
Application to Reopen Claim Due to Worsening Condition  F242-079-232 (French)
 F242-079-255 (Korean)
 F242-079-294 (Russian)
 F242-079-303 (Somali)
Application to Reopen Claim due to Worsening Condition  F242-079-999 (Spanish)
Application to Reopen Claim Due to Worsening Condition  F242-079-307 (Tagalog/Filipino)
 F242-079-312 (Tigrinya/Tigrigna)
 F242-079-319 (Vietnamese)
Application to Reopen Crime Victim Claim Due to Worsening of Condition  F800-031-999 (Spanish)
Application to Reopen Crime Victims Claim Due to Worsening Condition  F800-031-000 (English)
Application to Reopen to Crime Victim Claim Due to Worsening of Condition  F800-031-214 (Cambodian)
 F800-031-220 (Chinese Simplified)
 F800-031-221 (Chinese Traditional)
 F800-031-255 (Korean)
 F800-031-294 (Russian)
 F800-031-303 (Somali)
 F800-031-319 (Vietnamese)
Authorization to Release Claim Information  F101-010-000 (English)
Beneficiary Application for Claim Benefits  F242-056-000 (English)
 F242-056-999 (Spanish)
Claim for Pension By Dependents  F242-062-000 (English)
 F242-062-999 (Spanish)
Claim Suppression Complaint  F262-024-214 (Cambodian)
 F262-024-220 (Chinese Simplified)
 F262-024-221 (Chinese Traditional)
 F262-024-000 (English)
 F262-024-255 (Korean)
 F262-024-294 (Russian)
 F262-024-303 (Somali)
 F262-024-999 (Spanish)
 F262-024-319 (Vietnamese)
Crime Victims' Application for Benefits - Injury Claims  F800-042-999 (Spanish)
Crime Victims’ Application for Benefits – Homicide Claims  F800-120-214 (Cambodian)
 F800-120-220 (Chinese Simplified)
 F800-120-221 (Chinese Traditional)
 F800-120-255 (Korean)
 F800-120-294 (Russian)
 F800-120-303 (Somali)
 F800-120-319 (Vietnamese)
Crime Victims’ Application for Benefits – Injury Claims  F800-042-214 (Cambodian)
 F800-042-220 (Chinese Simplified)
 F800-042-221 (Chinese Traditional)
 F800-042-255 (Korean)
 F800-042-294 (Russian)
 F800-042-319 (Vietnamese)
Know What to Expect: How Recoveries and Settlements May Impact Your Crime Victim Claim  F800-074-000 (English)
Occupational Disease Claims in Workers' Compensation  F252-117-000 (English)
Physical Therapy / Occupational Therapy Progress Report to Claim Managers  F245-059-000 (English)
Request for Claim Information  F242-430-000 (English)
 F101-010-999 (Spanish)
Self-Insured Employers' Medical Only Claim Closure Order and Notice  F207-020-111 (English)
 F207-020-999 (Spanish)
Self-Insured Employers' Time Loss Claim Closure Order and Notice  F207-070-000 (English)
 F207-070-999 (Spanish)
Settling your injured worker's L&I claim: A new option for injured workers 50 and older  F240-004-000 (English)
Settling your L&I claim might be right for you: An option for injured workers 50 or older  F240-003-000 (English)
 F240-003-999 (Spanish)
SIF-4 Self Insured Employer's Request for Denial of Claim  F207-163-000 (English)





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