Get a Form or Publication: return to work program

Your search for "return to work program" returned 8 documents.

Title Type Number
Request for Preferred Workers Status

Used by vocational providers to apply for preferred worker status on behalf of an industrially injured worker.

Form F280-023-000
Self-Insurance Vocational Reporting Form

Used by self-insured employers and their representatives to report to L&I an injured worker's eligibility for vocational services or ability to work. This replaces F207-121-000 Employability Assessment Report (EAR).

Form F207-190-000
Intent to Hire Preferred Worker

Used by employers when hiring a preferred worker. This form must be received within 60 days of the hiring and the Preferred Worker Employer's Job Description (F280-022-000) form must be attached.

Form F280-010-000
Intent to Hire Preferred Worker with Developmental Disabilities

Used by employers rehiring developmentally disabled workers after an industrial injury. This form requests preferred worker status and shows the physical demands of the work to be performed by the worker. The Preferred Worker Employer's Job Description (F280-022-000) should be attached.

Form F280-011-000
Job Analysis

Used by vocational rehabilitation counselors (VRCs) to document the physical demands of jobs.

Form F252-072-000
Non-accredited or Unlicensed Training Provider Application Supplemental Requirements

Used by non-accredited or unlicensed training providers in order to be reviewed for approval to become a training provider for Washington injured workers. Must be submitted with the Provider Account Application (F248-011-000).

Form F280-045-000
Plan Time Encumbrance

To record the work plan time. For use only with plans approved after 1/1/2008.

Form F245-376-000
Preferred Worker Employers Job Decsription

Used by the employer to describe the job for the preferred worker. This form is reviewed by a vocational services consultant to ensure that the offered job is consistent with the worker's medical restrictions.

Form F280-022-000



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