Stay at Work Expense Reimbursement Application for Employers Tools, Clothing, Training.


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Title Stay at Work Expense Reimbursement Application for Employers Tools, Clothing, Training.
Description

Employer of record can request reimbursement for tools, clothing, or training expenses required to enable an injured worker to return to light duty or transitional work. After completing the form, the employer submits it, along with supporting documentation, to the Stay at Work program for review and approval. For wage reimbursements see F243-001-000.

Document number F243-003-000
How to get this document
  • Download (192 KB MS Word .doc) 
  • Contact the Stay at Work Program, 866-406-2482 (toll-free) or 360-902-4411. Please have the document number ready so we can process your request quickly. The title is also helpful.
  • Email your request to StayAtWork@Lni.wa.gov
Alt Language(s)
Valid dates 09/2014
Contact information Stay at Work
Websites Stay at Work

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