Locate the tools and resources by the category:
- Benefit Calculations: Calculators and worksheets to help process worker benefits.
- PPD Award Schedule: Annual permanent partial disability award schedules from 2000 to present.
- Forms & Templates: Frequently used forms and templates last updated July, 2019. A complete list of self-insurance forms is available.
- Checklists & Coversheets: Frequently used tools for claims processing.
- MPNSR & RCL: Medical Provider Network Status Report and Reasonably Convenient Location tools
Use this information and these tools to help you calculate worker benefits:
If you have questions or need assistance completing the form, contact our training unit at 360-902-6904.
- Loss of Earning Power (LEP) Calculation Worksheet
- Minimum Time-Loss Rates
- Maximum Time-Loss Rates
- Cost of Living Adjustment (COLA) Chart, 5-decimal increment and cumulative factors
- Cost of Living Adjustment (COLA) Chart, 10-decimal increments only
- Death and Burial Rates
A permanent partial disability (PPD) is a permanent impairment that results from the workplace injury or occupational disease. When this occurs, a worker may be eligible to receive a PPD benefit.
In order to qualify for a PPD benefit, the impairment must be rated by a qualified doctor.
Reference PPD Down Payment Amounts.
Every year the PPD award schedules are updated. We have included the most recent schedules below to help you calculate the award.
- 7/1/2023 through 6/30/2024 PPD schedule
- 7/1/2022 through 6/30/2023 PPD schedule
- 7/1/2021 through 6/30/2022 PPD schedule
- 7/1/2020 through 6/30/2021 PPD Schedule
- 7/1/2019 through 6/30/2020 PPD schedule
- 7/1/2018 through 6/30/2019 PPD schedule
- 7/1/2017 through 6/30/2018 PPD schedule
- 7/1/2016 through 6/30/2017 PPD schedule
- 7/1/2015 through 6/30/2016 PPD schedule
- 7/1/2014 through 6/30/2015 PPD schedule
- 7/1/2013 through 6/30/2014 PPD schedule
- 7/1/2012 through 6/30/2013 PPD schedule
- 7/1/2011 through 6/30/2012 PPD schedule
- 7/1/2010 through 6/30/2011 PPD schedule
- 7/1/2009 through 6/30/2010 PPD schedule
- 7/1/2008 through 6/30/2009 PPD schedule
- 7/1/2007 through 6/30/2008 PPD schedule
- 7/1/2006 through 6/30/2007 PPD schedule
- 7/1/2005 through 6/30/2006 PPD schedule
- 7/1/2004 through 6/30/2005 PPD schedule
- 7/1/2003 through 6/30/2004 PPD schedule
- 7/1/2002 through 6/30/2003 PPD schedule
- 7/1/2001 through 6/30/2002 PPD schedule
- 7/1/2000 through 6/30/2001 PPD schedule
Note: If you need a PPD award schedule from earlier years, email us at SItrainerQuestions@Lni.wa.gov
Forms
A complete list of self-insurance forms is on the Forms & Publications page. Many of these forms and templates are available in other frequently used languages.
Effective July 1, 2019, Self-Insured Employers began using specific forms to request the following orders from the department: allowance, closure, denial, interlocutory, or overpayment. The Forms and templates were updated May of 2020. Refer to the new and updated forms summary and the training matrix for more information on these changes.
- Claim Allowance Request (F207-215-000)
- Claim Closure (F207-216-000)
- Claim Denial (F207-217-000)
- Interlocutory Request (F207-218-000)
- Overpayment Request (F207-219-000)
Templates
Effective July 1, 2019 Self-Insured Employers will use letter templates to communicate key actions to workers during the course of a claim, including: wage calculation, starting, stopping or denying compensation benefits, accepting or denying newly-contended conditions, authorizing or denying treatment, and assessing overpayments or underpayments.
- Calculation of Monthly Wage as a Basis for Time-Loss Compensation (F207-227-000)
- Accept Newly Contended Condition (F207-220-000)
- Deny Newly Contended Condition (F207-221-000)
- Assessment of Overpayment (F207-222-000)
- Notice of Underpayment (F207-223-000)
- Provisional Compensation Benefits (F207-224-000)
- Start, Stop or Deny Compensation Benefits (F207-225-000)
- Treatment Decision (formerly Treatment Authorized/Denied) (F207-226-000)
- Self-Insurer Beneficiary Application Letter (F207-236-000)
- Self-Insurance IME Assignment Letter (F207-238-000)
Note: Unless disputed, L&I will no longer issue wage orders, overpayments, or acceptance/denial of newly contended conditions.
- Substantially Similar Forms
Make sure your forms or templates meet the definition of substantially similar.
To make it easier for claim managers to do business with L&I, we have created useful coversheets and checklists.
- Pension Review Coversheet
Use this coversheet when requesting L&I review a claim for pension. - Stipulation Coversheet
Required information for self-insured employers/worker attorneys requesting a stipulation. - Suspension Request Coversheet
A checklist for self-insured employers requesting suspension of benefits for non-cooperation. - No-Show Fee Request Checklist
Required information for self-insured employers requesting a no-show fee order. - Willful Misrepresentation Checklist
Use this when requesting a willful misrepresentation order on a claim. - Release of Medical Records and Patient Privacy In Workers' Compensation
Use this to help obtain worker medical records.
Medical Provider Network Status Report (MPNSR)
Self-insured employers can use the network status MPNSR tool or download the Provider Network Status Report (PNSR), a daily file of providers' network status to determine which providers can provide ongoing treatment to injured workers in Washington State.
The network status tool will allow self-insured payers and providers to have access to the same timely accurate information. Additional provider information can be found on the self-insurance providers page.
If you have questions or concerns, please contact our Provider Account Credentialing team at provnet@Lni.wa.gov.
Reasonably Convenient Location (RCL) Tool
L&I developed the Reasonably Convenient Location tool to help self-insured employers identify where residents in the worker’s community likely travel for care to various medical specialties (RCW 51.36.070). These locations are determined by:
- The number of providers in each county participating in the Medical Provider Network (MPN).
- The closest driving distance between the starting location and each county seat.
Additional Resources:
The RCL tool does not list or display where individual medical providers are available. If you wish to find where an IME might be scheduled, access the Find a Medical Examiner (FAME) search engine. To find individual locations of medical providers, use the Find a Doctor search engine.
How to use the search feature on the Reasonably Convenient Location tool:
- Open the RCL Location Tool (Excel)
- Start with the cursor in the city field next to “Enter Worker’s Location”
- Type in the workers starting city or select the city from the drop down options
- Review the list of specialties to find the location where worker will likely travel
Example:
This tool is updated monthly.
If you need to determine what county an IME location is in, please use this list:
https://www.courts.wa.gov/court_dir/?fa=court_dir.countycityref
For more information on compliance, please see the penalty table.