Washington Address Change Request for Injured Workers is a form used by workers in Washington State to update their address information on file with the Washington State Department of Labor & Industries (L&I). This form is used when a worker has been injured on the job and needs to change the address where they receive their benefits. This form can also be used to update the address of a worker's authorized representative, such as a lawyer, doctor, or union representative. There are two types of Washington Address Change Request for Injured Workers. The first is the Notice of Change of Address form which is used when a worker needs to update their address on file with L&I. The second is the Authorization for Change of Address form which is used when a worker needs to update the address of their authorized representative. Both forms must be completed in full and submitted to the Washington State Department of Labor & Industries.
Washington Address Change Request for Injured Workers
Description
How to fill out Washington Address Change Request For Injured Workers?
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FAQ
You can apply to reopen a claim at any time, but after seven years, it is at L&I's Director's discretion whether or not benefits other than medical will be paid.
After an injury or illness occurs, your employer must: Provide a workers' compensation claim form to you within one working day a work-related injury or illness is reported. Return a completed copy of the claim form to you within one working day of receipt.
Initial payment: At least 25% of the state's average monthly wage, but no more than 6 times the state's average monthly wage. Subsequent payments: At least 25% of the state's average monthly wage, but no more than 150% the state's average monthly wage.
Go to .Lni.wa.gov/Verify, select the option that applies to you, and search by name. To change your address online, just put in your information and make selections ingly. Update your mailing address, phone number, and email address. Repeat for each of your licenses and certificates.
Important: Employers by law must report to L&I the death or in-patient hospitalization of any worker (within 8 hours) and any non-hospitalized amputation or loss of eye (within 24 hours) due to an on-the-job injury by calling 1-800-423-7233.
Right to get medical care needed for treatment at no cost. Right to get time loss benefit payment if unable to work for more than 3 days. Right to turn down (decline) ?light duty? work offer unless approved by your doctor. Right to get a permanent partial disability payment if your injury is permanent.
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.