Locate the tools and resources by these categories:

  • Benefit Calculations: Calculators and worksheets to help process worker benefits.
  • PPD Award Schedule: Annual permanent partial disability award schedules from 2000 to present.
  • Forms & Templates: Frequently used forms and templates last updated July, 2019. A complete list of self-insurance forms is available.
  • Checklists & Coversheets: Frequently used tools for claims processing.
  • MPNSR & RCL: Medical Provider Network Status Report and Reasonably Convenient Location tools
Benefit Calculations

Use this information and these tools to help you calculate worker benefits:

If you have questions or need assistance completing the form, contact our training unit at 360-902-6904.

PPD Award Schedules

A permanent partial disability (PPD) is a permanent impairment that results from the workplace injury or occupational disease. When this occurs, a worker may be eligible to receive a PPD benefit.

In order to qualify for a PPD benefit, the impairment must be rated by a qualified doctor.

Reference PPD Down Payment Amounts.

Every year the PPD award schedules are updated. We have included the most recent schedules below to help you calculate the award.

Note: If you need a PPD award schedule from earlier years, email us at SItrainerQuestions@Lni.wa.gov

Forms & Templates

Forms

A complete list of self-insurance forms is on the Forms & Publications page.

Effective July 1, 2019, Self-Insured Employers began using specific forms to request the following orders from the department: allowance, closure, denial, interlocutory, or overpayment. The Forms and templates were updated May of 2020. Refer to the new and updated forms summary and the training matrix for more information on these changes. 

Templates

Effective July 1, 2019 Self-Insured Employers will use letter templates to communicate key actions to workers during the course of a claim, including: wage calculation, starting, stopping or denying compensation benefits, accepting or denying newly-contended conditions, authorizing or denying treatment, and assessing overpayments or underpayments.

Note: Unless disputed, L&I will no longer issue wage orders, overpayments, or acceptance/denial of newly contended conditions.

Checklists & Coversheets

To make it easier for claim managers to do business with L&I, we have created useful coversheets and checklists.

MPNSR & RCL

Medical Provider Network Status Report (MPNSR)

Self-insured employers can use the network status MPNSR tool or download the Provider Network Status Report (PNSR), a daily file of providers' network status to determine which providers can provide ongoing treatment to injured workers in Washington State.

The network status tool will allow self-insured payers and providers to have access to the same timely accurate information. Additional provider information can be found on the self-insurance providers page.

If you have questions or concerns, please contact our Provider Account Credentialing team at provnet@Lni.wa.gov.

Reasonably Convenient Location (RCL) Tool

L&I developed the Reasonably Convenient Location tool to help self-insured employers identify where residents in the worker’s community likely travel for care to various medical specialties (RCW 51.36.070). These locations are determined by:

  • The number of providers in each county participating in the Medical Provider Network (MPN).
  • The closest driving distance between the starting location and each county seat.

Additional Resources:
The RCL tool does not list or display where individual medical providers are available. If you wish to find where an IME might be scheduled, access the Find a Medical Examiner (FAME) search engine. To find individual locations of medical providers, use the Find a Doctor search engine.

How to use the search feature on the Reasonably Convenient Location tool:

  • Open the RCL Location Tool (Excel)
  • Start with the cursor in the city field next to “Enter Worker’s Location”
  • Type in the workers starting city or select the city from the drop down options
  • Review the list of specialties to find the location where worker will likely travel

Example:

RCL

This tool is updated monthly.

If you need to determine what county an IME location is in, please use this list:
https://www.courts.wa.gov/court_dir/?fa=court_dir.countycityref