Washington Request for Claim Information

State:
Washington
Control #:
WA-SKU-3895
Format:
PDF
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Description

Request for Claim Information Washington Request for Claim Information is a form used by Washington state employers and insurers to obtain records related to a worker's injury claim. This form is typically used when an employee has been injured on the job and the employer or insurer needs to collect necessary information from the employee. It includes sections for the employee's name, date of injury, address, phone number, and other pertinent information. It also includes questions about the employee's medical history, work history, and the details of the injury and treatment received. Depending on the situation, the employer or insurer may also request additional information, such as the opinions or recommendations of medical professionals related to the claim. There are two types of Washington Request for Claim Information forms. The first is the Request for Claim Information form (L&I Form F207-003-000), which is used when an employee has been injured on the job and the employer or insurer needs to collect necessary information from the employee. The second is the Request for Claim Information-Attending Physician statement (L&I Form F207-004-000), which is used to gather information from the employee's attending physician.

Washington Request for Claim Information is a form used by Washington state employers and insurers to obtain records related to a worker's injury claim. This form is typically used when an employee has been injured on the job and the employer or insurer needs to collect necessary information from the employee. It includes sections for the employee's name, date of injury, address, phone number, and other pertinent information. It also includes questions about the employee's medical history, work history, and the details of the injury and treatment received. Depending on the situation, the employer or insurer may also request additional information, such as the opinions or recommendations of medical professionals related to the claim. There are two types of Washington Request for Claim Information forms. The first is the Request for Claim Information form (L&I Form F207-003-000), which is used when an employee has been injured on the job and the employer or insurer needs to collect necessary information from the employee. The second is the Request for Claim Information-Attending Physician statement (L&I Form F207-004-000), which is used to gather information from the employee's attending physician.

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Washington Request for Claim Information