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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