The Washington Application For Award of Compensation And Reimbursement is a state form used to apply for financial assistance related to an injury or illness caused by the negligence or wrongdoing of another party. This application is used in Washington state to seek reimbursement for medical expenses, lost wages, and other related costs. There are two types of Washington Application For Award of Compensation And Reimbursement: the Standard Application and the Self Represented Litigant Application. The Standard Application is to be used by those who are being represented by an attorney, while the Self Represented Litigant Application is to be used by those who are representing themselves. The Standard Application requires information such as the injured party’s name, address, Social Security number, medical records, proof of lost wages, and other documents related to the injury or illness. The Self Represented Litigant Application provides a simpler form and requires only basic information such as the injured party’s name, address, Social Security number, and a brief description of the injury or illness. Both forms must be completed and submitted to the appropriate Washington state agency for review and approval.
Washington Application For Award of Compensation And Reimbursement
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How to fill out Washington Application For Award Of Compensation And Reimbursement?
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FAQ
The workers' compensation scheme operates on mutual obligations. The employer and insurer have obligations to pay you a salary and cover the cost of your treatment. In return for accepting that salary, you must attend work and undertake duties that are medically appropriate, as indicated on your certificates.
Online via our FileFast tool. By phone: 1-877-561-FILE (3453) At your doctor's office (if you complete the Report of Accident at your doctor's office, the doctor files the form for you)
Workers' compensation insurance (also known as Industrial Insurance) provides wage replacement and medical benefits to workers injured on the job. Workers' compensation is no-fault insurance, which means in most cases your business cannot be sued when a work-related injury or illness occurs.
We determine your premium rates by multiplying your experience factor by the sum of the accident fund, medical aid fund and the Stay at Work base rates, then adding the supplemental pension fund assessment.
File a claim online with FileFast (24-hours per day). Workers can also file by phone at 1-877-561-FILE (3453) Monday ? Friday, 8 a.m. ? 5 p.m.
The benefit amount is 60 to 75% of the wage you were earning, depending on how many dependents you have. The minimum and maximum L&I can pay is set by the state legislature. You may have better options available - ask your employer if there are other jobs you can do to earn your wage or salary while you recover.
Workers' Compensation Insurance in Washington State Workers' compensation insurance, also known as workman's comp or workers' comp, gives your employees benefits that can help them recover from a work-related injury or illness. Washington workers' compensation coverage is only available through the state fund.
If you're completely unable to work, time-loss benefits are based on your average monthly gross income at the time of your injury, including wages, health benefits, bonuses, and tips. You'll receive 60% to 75% of that income, depending on your marital status and number of dependents.