Washington Workers' Compensation Acknowledgment Form
Description
How to fill out Workers' Compensation Acknowledgment Form?
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FAQ
Employers purchase coverage through the Department of Labor & Industries (L&I). L&I manages all claims and pays benefits out of an insurance pool called the Washington State Fund. The fund is financed by premiums paid by employers and employees, not by general revenue taxes.
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.
Industrial Injury Claims: You must file your industrial injury claim with L&I or your self-insured employer within one year of the date of the accident.
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).
The Department of Labor and Industries (L&I) is the Washington State agency that administers these benefits. Consequently, it's L&I's job to determine the benefits to provide in every workers' compensation claim.
Workers' compensation insurance protects your business from financial costs when a worker sustains a work-related injury or disease. It also protects injured workers by providing weekly payments to cover loss of earning capacity, payment of reasonable medical and rehabilitation expenses, and other entitlements.
How does workers' comp work in Washington? Workers' compensation benefits can cover medical and hospital expenses resulting from a workplace injury. It can also cover partial wage replacement if the employee is unable to work, or is delegated to light duty because of an impairment.
Workers' Compensation Insurance in Washington State Workers' compensation insurance, also known as workman's comp or workers' comp, gives your employees benefits that can help them recover from a work-related injury or illness. Washington workers' compensation coverage is only available through the state fund.
Instructions for Workers. Workers. You have the right to an interpreter to help you understand and complete this form in your language of preference.
Employers purchase coverage through the Department of Labor & Industries (L&I). L&I manages all claims and pays benefits out of an insurance pool called the Washington State Fund. The fund is financed by premiums paid by employers and employees, not by general revenue taxes.
