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  • Wa F245-224-000 2014

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For you to ensure that you receive appropriate care for your workplace injury or occupational disease. Medical exams are required for any of the following reasons: Your doctor, employer or claim manager asked for an evaluation of your condition. We need to evaluate the extent of your impairment. There is a question about the type or duration of treatment you need. You asked to have your claim closed, reopened or allowed. You appealed our decision regarding your claim.

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How to fill out the WA F245-224-000 online

This guide provides you with clear, step-by-step instructions on filling out the WA F245-224-000 form online. It is designed to assist users with varying levels of experience in completing their documents accurately and efficiently.

Follow the steps to complete the WA F245-224-000 online.

  1. Click 'Get Form' button to obtain the form and open it in the editor.
  2. Carefully read the form instructions provided in the document. Ensure all fields are understood before entering information.
  3. Fill in your personal information in the designated fields, ensuring accuracy in details such as your name, address, and date of birth.
  4. Provide information regarding your workplace injury or occupational disease as prompted, including any relevant medical history.
  5. If applicable, indicate if you are bringing any medical documents, such as x-rays or MRIs, to the examination.
  6. If you need assistance due to a physical or mental disability, make sure to mention this in the form so arrangements can be made.
  7. Review all the information entered for completeness and correctness before proceeding.
  8. Once all sections are filled out and checked, save your changes. You can then download, print, or share the completed form as needed.

Complete your documents online today to ensure a smooth process for your independent medical examination.

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The benefit amount is 60 to 75% of the wage you were earning, depending on how many dependents you have. The minimum and maximum L&I can pay is set by the state legislature. You may have better options available - ask your employer if there are other jobs you can do to earn your wage or salary while you recover.

The Department of Labor & Industries (L&I) is a diverse state agency dedicated to the safety, health, and security of Washington's 3.3 million workers.

L&I or your self-insured employer must receive your Report of Accident within 1 year of your injury date to file a claim. We must receive it within two years from the date of your doctor's diagnosis for occupational disease claims.

L&I strives to make filing a claim as easy as possible, and you have options: Online via our FileFast tool. By phone: 1-877-561-FILE (3453) At your doctor's office (if you complete the Report of Accident at your doctor's office, the doctor files the form for you)

General information. Contact the Washington State Department of Labor & Industries for information about agency programs and services in your language at 1-800-547-8367.

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