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Results for: Claims and Insurance - Insurance Coverage
Title Number / Language
3 Things to Know about L&I's Medical Provider Network  F242-406-000 (English)
 F242-406-999 (Spanish)
A Guide to Workers' Compensation Benefits For Employees of Self-Insured Businesses  F207-085-000 (English)
 F207-085-999 (Spanish)
Amendment of Irrevocable Standby Letter of Credit  F207-112-111 (English)
Application for Elective Coverage - Sole Proprietor, Partners, For-Profit Corporate Officers, or Member/Managers of Limited Liability Company (LLC)  F213-042-000 (English)
Application for Elective Coverage of Excluded Employments  F213-112-000 (English)
Application for Exclusion/Inclusion - Mandatory Coverage (Family Farm)  F213-113-000 (English)
Application for Limited Elective Coverage for Licensed Pony Riders  F250-026-000 (English)
Application for out of State Supplemental Reporting  F212-234-000 (English)
Application for Self-Insurance Certification  F207-001-000 (English)
Assessing Your Ability to Work: Your Rights and Responsibilities  F280-017-000 (English)
 F280-017-999 (Spanish)
Avoid Liability for Your Farm Labor Contractor's Unpaid Debits  F700-154-909 (English/Spanish)
Cancellation of Elective Coverage - Sole Proprietors/Partner, Member of Limited Liability Company (LLC), Member of Limited Liability Partnership (LLP) or For-Profit Corporate Officers  F213-004-000 (English)
Cancellation of Elective Coverage for Excluded Employments  F213-005-000 (English)
Carrying Out Your Vocational Plan: Your Rights and Responsibilities During Plan Implementation  F280-019-000 (English)
Certificate of Coverage - SAMPLE ONLY  F211-141-000 (English)
 F211-141-999 (Spanish)
Construction Contractor's Application for Workers' Compensation Account with No Workers or Hours  F625-077-000 (English)
Construction Industry Classification Guide  F213-008-000 (English)
 F213-008-999 (Spanish)
Contract: Report By Contractor - Forest, Range & Timber Industry  F213-011-000 (English)
Contract: Report By Landowner - Forest, Range & Timber Industry  F213-010-000 (English)
Corporate Officers  F214-010-000 (English)
Coverage Agreement  F212-044-000 (English)
Development of the plan: What are my rights and responsibilities? Vocational Rehabilitation Services  F280-018-999 (Spanish)
Drywall Industry - Owner/Sub-Contractor Report  F212-050-000 (English)
Employer's Return-to-Work Guide  F200-003-000 (English)
Employers' Guide to Self-Insurance in Washington State  F207-079-000 (English)
Employers' Guide to Workers' Compensation Insurance in Washington State  F101-002-000 (English)
 F101-002-999 (Spanish)
Excluded and Exempt Employments  F214-013-000 (English)
Independent Contractor Guide: A Step-by-Step Guide to Hiring Independent Contractors in Washington State  F101-063-000 (English)
 F101-063-999 (Spanish)
Independent Contractor or Covered Worker? - Your rights to workers' compensation, minimum wage and overtime  F212-250-000 (English)
 F212-250-999 (Spanish)
Injured by a third party?  F249-008-000 (English)
Injured Workers: Leaving Washington, But Still Need Treatment  F242-412-909 (English/Spanish)
Instructions for completing the Workers' Compensation Employer's Quarterly Report  F212-239-000 (English)
Irrevocable Standby Letter of Credit  F207-112-000 (English)
L&I Benefits for Workers Who Are Terminally Ill  F252-094-000 (English)
Limited Liability Companies (LLC)  F214-021-000 (English)
Maritime Coverage  F212-034-000 (English)
Massage Therapist: Independent Contractor or Covered Worker?  F212-248-000 (English)
Mechanized Logging Supplemental Quarterly Report  F212-223-000 (English)
Memorandum of Understanding Irrevocable Standby Letter of Credit  F207-113-000 (English)
Overpayment Reimbursement Fund Request Coversheet  F207-212-000 (English)
Plan Development: What Are My Rights & Responsibilities?  F280-018-000 (English)
Quarterly Reporting for Drywall  F212-224-000 (English)
Reforestation Contract Supplemental Report - Forest, Range and Timber Industry  F213-013-000 (English)
Reforestation Industry Continuation Sheet (Over $10,000)  F213-015-000 (English)
Self-Insured Employer Certificate of Excess Insurance  F207-095-000 (English)
Self-Insured Employers' Medical Only Claim Closure Order and Notice  F207-020-111 (English)
 F207-020-999 (Spanish)
Self-Insured Employers' Permanent Partial Disability Closure Order and Notice - PPD-NTL  F207-164-999 (Spanish)
 F207-165-999 (Spanish)
 F207-165-000 (English)
Self-Insured Employers' Permanent Partial Disability Closure Order and Notice - PPD-TL  F207-164-000 (English)
Self-Insured Employers' Time Loss Claim Closure Order and Notice  F207-070-999 (Spanish)
Self-Insurer's Bond - Existing Liabilities  F207-068-000 (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-5A Cover Sheet: Wage Calculations  F207-156-000 (English)
Sports Player Coverage Agreement  F212-242-000 (English)
Sports Teams Coverage Agreement  F212-196-000 (English)
Standard Exception Classification  F214-016-000 (English)
Statement for Home Nursing Services  F248-160-000 (English)
Statement for Miscellaneous Services  F245-072-999 (Spanish)
Statement for Pharmacy Services  F245-100-000 (English)
Student Volunteers and Workers' Compensation Coverage  F213-023-000 (English)
Supplemental Quarterly Report for the Drywall Industry  F212-051-000 (English)
Temporary Services Guide to Workers' Compensation Insurance  F213-019-000 (English)
Transfer of Care Card  F245-037-000 (English)
 F245-037-999 (Spanish)
What Are Your Rights as a Worker?  F101-061-404 (English/Russian)
 F101-061-505 (English/Vietnamese)
 F101-061-606 (English/Cambodian)
 F101-061-707 (English/Korean)
 F101-061-909 (English/Spanish)
When a Loved One Dies at Work  F417-240-000 (English)
 F417-240-999 (Spanish)
Workers' Compensation Benefits: A Guide for Injured Workers  F242-104-000 (English)
 F242-104-999 (Spanish)
Workers' Compensation Employer's Quarterly Report  F212-055-000 (English)
Workers' Compensation Requirements for the Marijuana Industry  F242-415-000 (English)
Your Independent Medical Exam  F245-224-000 (English)
 F245-224-999 (Spanish)
Your Workers' Compensation Rate Notice - SAMPLE ONLY  F225-004-000 (English)





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