Pension Benefits Questionnaire

Información del documento
  Obtenga ayuda para descargar e imprimir archivos. Cómo completar formularios electrónicos.

Pension Benefits Questionnaire

(177 KB PDF)

Used by an injured worker who receives an order that states he or she is totally permanently disabled. This questionnaire must be completed in full and all necessary documents attached before his or her pension benefit options can be calculated.

Número del formulario F242-393-000
Disponibilidad Online only
Palabras claves claims, disability pension benefits, disabled, industrial insurance, pension disability benefits, permanent total disability, social security offset, sso, worker's compensation, workers compensation, workers' compensation
Idiomas English, Spanish
Fechas válidas 11-2014

End of main content, page footer follows.

Access Washington en Español

© Depto. de Labor e Industrias del Estado de Washington. El uso de éste sitio del Internet está sujeto a las leyes del Estado de Washington.