Obtenga un formulario o publicación

Escriba todo el título del documento o una parte, la descripción o el número:     

Formularios más populares  |  Carteles requeridos del lugar de trabajo  |  Formularios y publicaciones en español

Resultados para: Schedule
Vea:    Ordenar por:       

Búsqueda de palabras clave:  

Schedule of Future Payments for the Balance of the Permanent Partial Disability Award

Used by Self-Insured companies to document future payments for the balance of the Permanent Partial Disability Award.

Psychiatric Services Fee Schedule

Card for administrative staff for providers of psychiatric or counseling services: lists procedure codes and fees for services. The back of the card highlights the Psychiatric Conditions web page where providers and their staff can find a number of resources.

Mental Health Fee Schedule and Billing Guidelines

Manual: This manual is for providers who bill the Crime Victims Compensation Program for mental health services for crime victims.

An Employer's Intro to L&I

Info card: Provides information on the Employer's Intro to L&I workshop, including statewide schedule of workshops. Designed for employers and managers, the workshop covers a number of topics, including workers' compensation insurance, workplace safety, and overtime.

Preauthorization Request for Services for State Fund Workers' Compensation Patients

This form can only be used for services that can be authorized by the claim manager and it should not be used for Utilization Review (Qualis), Provider Hotline or requests to the Occupational Nurse Consultant.  If you are unsure of what services need to be authorized see L&I fee lookup utility at www.Lni.wa.gov/apps/FeeSchedules/

For complete information on all authorization processes please see:  www.Lni.wa.gov/ClaimsIns/Providers/AuthRef/GetAuth.asp

Manufactured/Mobile Home Permit Application

This form is used by homeowners and contractors to purchase permits for changes made to manufactured/mobile homes. Please purchase your permit(s) before you start working. After your work is complete, you will need to schedule an inspection. 

Panel Load Calculations

Listing of Connected Loads and the Demand Loads. Used for all appliances that are fastened in place, permanently connected on specific circuit. Single Phase Panel Schedule and Three Phase Panel Scheule inlcude. Sample diagram included.

Food Truck / Trailers / Temporary Structures

This form is used to purchase permits for changes made to food trucks, trailers, and other temporary or mobile structures. Please purchase your permit(s) before you start working. After your work is complete, you will need to schedule an inspection

Parent Authorization Summer Work

This form is for summer employment of minors, only, and is for parents or legal guardians to approve the hours and work activities for a minor employee to work according to terms listed by the employer.  All parties must sign to approve the work schedule and duties for a minor prior to permitting them to work.  This is NOT a work permit.  Employers must obtain a minor work permit endorsement on their Business License where they employ workers under 18.

Quick Reference Card for Providers

Flyer or small poster for administrative staff for health-care and vocational providers: lists the most frequently used procedure codes and fees. The back highlights the most popular or frequently used web pages for providers and their staff. Provides tips for speeding up authorizations and for billing self-insured employers.


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.