Job Modification Assistance Application

Document Information
  How to complete a fillable form.
Title Job Modification Assistance Application

For use by an vocational counselor, employer, etc. to request modification for the injured workers job. This may involve tools and equipment that is purchased through L&I.

Document number F245-346-000
How to get this document
Alt Language(s) Español
Valid dates 12/2008
Contact information Claims for Job Injuries , Managing Injured Workers' Claims , Vocational Resources
Related information

Vocational Training Plan Ownership Agreement for Tools and Equipment

Websites For Medical Providers , Workers' Comp Claims

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