Pre-Job Accommodation Assistance Application

Document Information
  How to complete a fillable form.
Title Pre-Job Accommodation Assistance Application

For use by a therapist or vocational provider to request job modification for an injured worker before the injured workers is employed, possibly in a retraining program. This may involve tools and equipment that is purchased through L&I.

Document number F245-350-000
How to get this document
Alt Language(s) Español
Valid dates 07/2013
Contact information Claims for Job Injuries, Managing Injured Workers' Claims, Treating Injured Workers, Vocational Resources
Related information

Vocational Training Plan Ownership Agreement for Tools and Equipment

Websites For Medical Providers, Workers' Comp Claims

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