Washington State Department of Labor and Industries Forms

This form is used for applying for compensation for loss of earning power in case of a work-related injury in Washington. It is available in both English and Cambodian languages.

This Form is used for applying for Loss of Earning Power (LEP) compensation medical benefits in Washington. It is available in both English and Chinese (Simplified) languages.

This Form is used for applying for Loss of Earning Power (LEP) compensation medical benefits in Washington state. It is available in both English and Burmese.

This form is used for applying for compensation for loss of earning power due to a medical condition in Washington. It is available in both English and Oromo languages.

This form is used for applying for compensation for loss of earning power due to a medical condition in Washington state. The form is available in English and Marshallese languages.

This form is used for applying for compensation medical benefits in Washington State for the loss of earning power (LEP). The form is available in both English and Korean languages.

This form is used for applying for compensation for loss of earning power due to a work-related injury or illness. It is specifically for residents of Washington and is available in both English and Farsi.

This form is used for filing an application for loss of earning power (LEP) compensation medical benefits in Washington. The form is available in both English and Punjabi languages.

This Form is used for applying for compensation for loss of earning power due to a work-related injury or illness. It is available in both English and Tagalog and is specific to the state of Washington.

This Form is used for applying for compensation for loss of earning power (LEP) due to a medical condition in Washington State. The form is available in both English and Lao languages.

This form is used to apply for Loss of Earning Power (LEP) compensation medical benefits in Washington. The form is available in English and Somali languages.

This form is used for applying for Loss of Earning Power (LEP) compensation in Washington. It is available in English and Swahili.

This Form is used for applying for Loss of Earning Power (LEP) compensation medical in Washington. It is available in both English and Chinese.

This form is used for applying for compensation medical benefits in Washington for loss of earning power. It is available in both English and Vietnamese.

This Form is used for applying for compensation due to income reduction for medical reasons in Washington.

This form is used for applying for compensation under the L.E.P. program in Washington state for vocational training.

This document is used for notifying the Washington state authorities about an occupational disease or infection.

This Form is used for applying for compensation for loss of earning power due to work-related injury in Washington. It is available in both English and Ukrainian languages.

This form is used for applying for Loss of Earning Power (LEP) compensation medical benefits in Washington. The form is available in both English and Thai languages.

This document is a letter of intent to register at a school in Washington.

This document is an application form for compensation medical loss of earning power in Washington. It is available in English and Urdu.

This form is used for injured workers in Washington to request a change of address.

Este formulario se utiliza para solicitar compensación por la reducción de ingresos en el estado de Washington con fines vocacionales. Esta compensación puede aplicarse a diferentes situaciones laborales que hayan generado una disminución en los ingresos del solicitante.

This form is used for doctors in Washington to provide an estimate of a patient's physical capacities.

This form is used for applying for Loss of Earning Power (LEP) compensation medical benefits in Washington State. It is available in Russian.

This form is used for a Pension Benefits Questionnaire in Washington. It is available in Bosnian.

This form is used for completing a questionnaire related to pension benefits in Washington state.

This form is used for completing a pension benefits questionnaire in Washington state for Croatian speakers.

This document is for Somali-speaking individuals in Washington who need to file an affidavit to claim time loss compensation benefits.

Este formulario se utiliza para completar un cuestionario de beneficios de pensión en el estado de Washington. El formulario recopila información sobre los beneficios de pensión a los que puede ser elegible una persona.

This document is an affidavit form used for claiming time loss compensation in the state of Washington. It is available in Russian language.

This form is used for obtaining a worker's release for union dispatch records in the state of Washington.

This document is a pension benefits questionnaire form specific to Washington state. It is in Russian language.

This form is used for completing a questionnaire related to pension benefits in Washington. It is available in Vietnamese language.

This type of document is a Form F242-410-999 used for the authorization of workers to obtain dispatch records from the union in Washington.

This type of document is a Worker Release form for Union Dispatch Records in Washington. It is used when a worker wants to request the release of their union dispatch records. The form is available in Vietnamese.