Job Modification Assistance Application

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Job Modification Assistance Application

(Un formulario electrónico)- 434 KB PDF)

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.

Número del formulario F245-346-000
Disponibilidad Online only
Palabras claves accident, claims, disability, disabled, employability, industrial insurance, injury, occupational injuries, provider, returning to work, voc rehab, vocational, vocational provider, vocational rehab, workers compensation, workers' compensation
Idiomas English, Spanish
Fechas válidas 12-2008
Contacto Managing Injured Workers' Claims
Vocational Resources
Claims for Job Injuries
Información relacionada

Vocational Training Plan Ownership Agreement for Tools and Equipment

Páginas de Internet Workers' Comp Claims
For Medical Providers

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