Some state worker's compensation acts also provide that a formal claim for compensation be made, either to the employer, the compensation board, or to the state commission board with notice to the employer that the claim is being made. This claim or notice of claim is different from the notice of injury and is governed by a different, and sometimes longer, statute of limitations. This form is a generic example that may be referred to when preparing such a form for your particular state. It is for illustrative purposes only. Local laws should be consulted to determine any specific requirements for such a form in a particular jurisdiction.
Washington Notice of Work-Related Injury and Claim for Worker's Compensation
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How to fill out Notice Of Work-Related Injury And Claim For Worker's Compensation?
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Wage replacement If your worker misses time from work and their doctor certifies they are unable to work, L&I may pay for a portion of their lost wages, which is called "time?loss compensation." However, the first 3 days immediately following the worker's injury are considered a waiting period.
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.
How Does Workers' Comp Work in Washington State? If one of your employees is injured or becomes ill from their job, Washington workers' compensation can help pay for their medical bills and prescriptions. It can also help recover some of their lost wages if they're unable to return to work right away.
Workers' comp waiting periods by state StateWaiting period to receive workers' compWashington3 daysWest Virginia3 daysWisconsin3 daysWyoming3 days48 more rows ?
Today, L&I is one of four states that administers its own workers' compensation benefits, either through a public State Fund (covering 2/3 of WA workers) or through self-insured employers (covering 1/3 of WA workers).
Employees may also file a claim form online at or by phone at 1-877-561-FILE (3453). Workers' compensation claims must be filed within one year of an injury, and within two years of being notified that an illness is work-related.
L&I or your self-insured employer can approve your claim if your doctor certifies that you were injured at a specific time and place at work, or have an occupational disease. If your claim is approved, you may be eligible for a variety of benefits, including medical care, if it's directly related to your injury.
Workers' compensation claims must be filed within one year of an injury, and within two years of being notified that an illness is work-related. For additional information on Washington State Injury/Illness definitions, see the L&I website.