Obtenga un formulario o publicación: return to work

Su búsqueda de "return to work" consiguió 19 resultados.

Título Tipo Número

Insurer Activity Prescription Form


Also available in: English/Spanish

Used by health-care providers to communicate an injured worker's status, physical capacities, inability to work (time-loss) and treatment plans. To print an APF, click on the title of the form in the box above.

Form F242-385-000

Physical Therapy / Occupational Therapy Progress Report to Claim Managers


The physical / occupational therapist uses this report to identify the clinical goals and return to work objectives of the injured worker.

Form F245-059-000

Request for Preferred Workers Status


Used by vocational providers to apply for preferred worker status on behalf of an industrially injured worker.

Form F280-023-000

Self-Insurance Vocational Reporting Form


Used by self-insured employers and their representatives to report to L&I an injured worker's eligibility for vocational services or ability to work. This replaces F207-121-000 Employability Assessment Report (EAR).

Form F207-190-000
Are You an Employer Who Can Provide On-the-Job Training?

Fact sheet: Explains how employers play an important role in helping injured or ill workers return to meaningful employment and a productive life by offering on-the-job training opportunities.

Publication F280-033-000
Attending Provider's Return-to-Work Desk Reference

Book: Discusses best practices in occupational medicine that help return an injured worker to his/her job as soon as medically possible. Identifies resources available from L&I and explains how to bill for return-to-work services. Three hours of Category 1 CME credit are offered for completing an online self-assessment. Go to www.CMECredits.Lni.wa.gov.

Publication F200-002-000
Employer's Return-to-Work Guide

Pamphlet/booklet: Explains the benefits of 'return to work' from the employer's perspective, describes RTW options, and provides resource and contact information.

Publication F200-003-000
Getting Back to Work: It's Your Job and Your Future
Also available in: Spanish

Pamphlet/booklet: Briefly explains steps to return to work quickly and minimize the economic impact of time-loss. Also provides helpful resources. Intended for injured workers.

Publication F200-001-000
Getting Back to Work: It's Your Job and Your Future-Spanish (Regresando a trabajar es su trabajo y su futuro)
Also available in: English

Pamphlet/booklet: Briefly explains steps to return to work quickly and minimize the economic impact of time-loss. Also provides helpful resources. Intended for injured workers.

Publication F200-001-999
Intent to Hire Preferred Worker

Used by employers when hiring a preferred worker. This form must be received within 60 days of the hiring and the Preferred Worker Employer's Job Description (F280-022-000) form must be attached.

Form F280-010-000
Intent to Hire Preferred Worker with Developmental Disabilities

Used by employers rehiring developmentally disabled workers after an industrial injury. This form requests preferred worker status and shows the physical demands of the work to be performed by the worker. The Preferred Worker Employer's Job Description (F280-022-000) should be attached.

Form F280-011-000
Job Analysis

Used by vocational rehabilitation counselors (VRCs) to document the physical demands of jobs.

Form F252-072-000
Non-accredited or Unlicensed Training Provider Application Supplemental Requirements

Used by non-accredited or unlicensed training providers in order to be reviewed for approval to become a training provider for Washington injured workers. Must be submitted with the Provider Account Application (F248-011-000).

Form F280-045-000
Plan Time Encumbrance

To record the work plan time. For use only with plans approved after 1/1/2008.

Form F245-376-000
Preferred Worker Employers Job Decsription

Used by the employer to describe the job for the preferred worker. This form is reviewed by a vocational services consultant to ensure that the offered job is consistent with the worker's medical restrictions.

Form F280-022-000
Preferred Worker Program
Also available in: Spanish

Pamphlet/booklet: Describes the Preferred Worker Program and the benefits employers receive when hiring a preferred workers. Iin general, these are workers whose work-related injury or occupational disease prevents them from returning to their old job.

Publication F280-021-000
Preferred Worker Program-Spanish (Programa con incentivos para reemplear trabajadores lesionados)
Also available in: English

Pamphlet/booklet: Describes the Preferred Worker Program and the benefits employers receive when hiring a preferred workers. In general, these are workers whose work-related injury or occupational disease prevents them from returning to their old job.

Publication F280-021-999
Sample Self-Employment Agreement

Sample of a letter a return to work person would use to assist L&I in determining whether services or funds should be authorized to assist them in becoming self-employed.

Form F252-032-000
Self-Insurance Vocational Services Closing Cover Sheet

Used by self-insured employers, their representatives, and vocational counselors to summarize the outcome of a vocational rehabilitation plan when submitting the closing report.

Form F207-171-000

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