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Get Claim Manager Authorizations - L&I - Access Washington 2017-2024

SIF-5 Instructions Self-insurers must file complete and accurate SIF-5 s. Please use the following instructions to complete the form. If you have questions about completing this form for a particular claim please call L I at 360-902-6901 to speak with the claim adjudicator assigned to the claim. 1. If time loss / LEP were paid for more than four periods of time please attach an additional page for the additional time periods and indicate on this .

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