Forms and Publications

Enter all or part of a document title, description or number:     

Browse By Subject  |  Most Requested  |  Required L&I Workplace Posters  |  Spanish Language Documents  |  Show all L&I Forms/Pubs


Results for: dorso-lumbar
View:    Sort by:       
Title/Description:

Keyword search within results:  
Type:

Doctor's Worksheet for Rating Dorso-Lumbar & Lumbo-Sacral Impairment
This worksheet is to help the attending physician perform impairment rating on their patients with permanent partial disability of the Dorso-Lumbar or Lumbo-Sacral spine.

Form
F252-006-000
 





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.