Forms and Publications

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Title Number / Language
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Application to Reopen Claim Due to Worsening Condition  F242-079-000 (English)
Application to Reopen Claim due to Worsening Condition  F242-079-999 (Spanish)
 F242-079-909 (English/Spanish)
Authorization to Release Claim Information  F101-010-000 (English)
Claim for Pension By Dependents  F242-062-000 (English)
 F242-062-999 (Spanish)
Claim for Pension by Spouse or Children  F242-056-000 (English)
 F242-056-999 (Spanish)
Claim Suppression Complaint  F262-024-000 (English)
 F262-024-999 (Spanish)
Physical Therapy / Occupational Therapy Progress Report to Claim Managers  F245-059-000 (English)
Request for Claim Information  F101-010-111 (English)
 F101-010-999 (Spanish)
Self-Insured Employers' Medical Only Claim Closure Order and Notice  F207-020-111 (English)
 F207-020-999 (Spanish)
Self-Insured Employers' Time Loss Claim Closure Order and Notice  F207-070-999 (Spanish)
 F207-070-000 (English)
Settling your L&I claim might be right for you: An option for injured workers 50 or older  F240-003-000 (English)
 F240-003-999 (Spanish)





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