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Individuals and/or firms who want to provide vocational services to Washington injured workers, must:
- Meet the requirements in WAC 296-19A-210 (www.leg.wa.gov).
- Complete a Provider Application and Agreement form (F252-017-000).
and - Be assigned at least one provider number.
Interns not previously registered with L&I prior to December 1, 2000 must also complete an Intern Supplemental Application (33 KB doc).
Get Help Downloading Files (files open in a new window).These requirements include vocational providers who:
- Provider service to injured workers covered by:
- State Fund or
- Self-insured employers.
- Work in other settings, such as pain clinics or hospitals.
- Work both in-state and out-of-state, individuals and firms.
What is the difference between a payee provider and a service delivery provider?
A payee provider is the entity that receives payment for services performed (e.g., an individual or firm). The payee is responsible for tax issues related to these payments. L&I sends payment information, by each taxpayer identification number, to the IRS.
A service delivery provider is the individual practitioner. A service delivery provider must submit a separate application for each payee provider with whom they are associated.
How many applications must be completed?
- Firms complete one vocational provider application.
- Individuals complete an application for each firm they are associated with.
For example, if you work for three firms:- You would submit three applications, and
- Receive three provider numbers.
What constitutes a change in status?
Leaving a firm, a change of address or obtaining a credential are examples of a change in status. You would let L&I know of these changes by submitting:
- A Firm Vocational Provider Account Change form (F252-022-000).
and/or - A Individual Vocational Provider Account Change form (F252-021-000).
or - A Vocational Provider Application and Notice form (F252-017-000).
- The Change form instructions will help you determine whether your change(s) can be done on a change form or whether you need to submit a Provider Application and Agreement form.
Changes are effective when L&I notifies the applicant, by letter of their new status.
For more information
WAC 296-19A-210 (www.leg.wa.gov) - What are the qualifications to provide vocational rehabilitation services to industrially injured or ill workers?
WAC 296-19A-220 (www.leg.wa.gov) - Can a vocational rehabilitation provider deliver vocational rehabilitation services pursuant to RCW 51.32.095 (www.leg.wa.gov) without receiving a provider number from the department?
