Job Modification Assistance Application
See also
| Document Information | ||
|---|---|---|
 Get help downloading & printing files.  How to complete a fillable form. |
||
| Title |
Job Modification Assistance Application (A fillable form - 434 KB PDF)
|
|
| Description | 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. | |
| Detail | ||
| Form number | F245-346-000 | |
| Availability | Online only. See document above to download. |
|
| Keywords | 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 | |
| Languages | English | |
| Valid dates | 12-2008 | |
| Contact information |
Managing Injured Workers' Claims
Vocational Resources Claims for Job Injuries |
|
| Related information | ||
| Documents | Vocational Training Plan Ownership Agreement for Tools and Equipment |
|
| Web pages | Workers' Comp Claims For Medical Providers |
|
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