Application for L.E.P. Compensation Medical
See also
| Document Information | ||
|---|---|---|
 Get help downloading & printing files.  How to complete a fillable form. |
||
| Title |
Application for L.E.P. Compensation Medical (A fillable form - 168 KB PDF)
|
|
| Description | Completion of this form is not a guarantee of benefits. Payment of benefits will be decided by your claim manager. |
|
| Detail | ||
| Form number | F242-208-000 | |
| Availability | Online only. See document above to download. |
|
| Keywords | claims, compensation, L.E.P., medical | |
| Languages | English , English/Spanish , Spanish | |
| Valid dates | 12-2004 | |
| Contact information |
Claims for Job Injuries
|
|
We value your feedback!
Please take this survey to help improve the L&I website.
Take survey
(About 3 minutes)
© Washington State Dept. of Labor & Industries. Use of this site is subject to the laws of the state of Washington.