Select the tabs in the section below to locate the tools and resources available by these categories:
- 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:
- Medical Bill Interest Calculator (currently disabled for repair)
- Loss of Earning Power (LEP) Calculator.
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.
- 2020 PPD schedule
- 2019 PPD schedule
- 2018 PPD schedule
- 2017 PPD schedule
- 2016 PPD schedule
- 2015 PPD schedule
- 2014 PPD schedule
- 2013 PPD schedule
- 2012 PPD schedule
- 2011 PPD schedule
- 2010 PPD schedule
- 2009 PPD schedule
- 2008 PPD schedule
- 2007 PPD schedule
- 2006 PPD schedule
- 2005 PPD schedule
- 2004 PPD schedule
- 2003 PPD schedule
- 2002 PPD schedule
- 2001 PPD schedule
- 2000 PPD schedule
Note: If you need a PPD award schedule from earlier years, email us at SItrainerQuestions@Lni.wa.gov
A complete list of self-insurance forms is on the Forms & Publications page.
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) - Updated May 2020 - View what's changed
- Claim Closure (F207-216-000) - Updated May 2020 - View what's changed
- Claim Denial (F207-217-000) - Updated May 2020 - View what's changed
- Interlocutory Request (F207-218-000) - Updated May 2020 - View what's changed
- Overpayment Request (F207-219-000) - Updated May 2020 - View what's changed
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) - Updated May 2020 - View what's changed
- Accept Newly Contended Condition (F207-220-000) - Updated May 2020 - View what's changed
- Deny Newly Contended Condition (F207-221-000) - Updated May 2020 - View what's changed
- Assessment of Overpayment (F207-222-000) - Updated May 2020 - View what's changed
- Notice of Underpayment (F207-223-000) - Updated May 2020 - View what's changed
- NEW: Provisional Compensation Benefits (F207-224-000)
- Start, Stop or Deny Compensation Benefits (F207-225-000) - Updated May 2020 - View what's changed
- Treatment Decision (formerly Treatment Authorized/Denied) (F207-226-000) - Updated May 2020 - View what's changed
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.
- 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.
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
This tool is updated on the 10th of every month.
If you need to determine what county an IME location is in, please use this list: