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Washington employers and business owners can download and use these forms and documents from our free forms library. We make every effort to keep our forms and guides updated with the most recent versions for your convenience.
Washington Department of Labor and Industries is a monopolistic state fund. It is part of a state controlled workers compensation plan. The state does not allow private insurance carriers to provide policy coverage in this state and therefore we do not offer any forms at the present time.
We are happy to help your business find other states workers compensation insurance quotes if you work out of state or hire employees in other states.
Washington Acord 130 Workers Compensation Application
The standard Acord 130 application form for workers comp coverage in Washington.
Washington First Report of Injury Form
First Report of Injury Form. Employers should complete this form and send to their insurance company each time an injury occurs.
Washington Application for Exclusion of Officers and Stockholders
Owners and Officers of corporations should complete this form to exclude themselves from a workers' compensation policy.
Washington Application for Self Insurance
Complete this form if you wish to apply for the right to self insure your company.
Washington File Fast Handouts
This is a brochure outlining the File Fast online claims reporting.
Washington File Fast Poster
This is a poster outlining the File Fast online claims reporting.
File Information Contract
Contract covering secure access to the Labor and Industry computer database and application.
Washington Guide to Industrial Insurance Benefits
This is a brief guide to workers' compensation insurance.
Washington Help for Injured Workers
This contains helpful information for injured employees.
Home Modification for Workers with Catastrophic Injuries
This document is an overview of what modifications are covered by the Department of Labor and Industry for catastrophically injured workers.
WA Notice to Employees
This document is a brief overview of workers' compensation for employees.
Preferred Worker Program Pamphlet
This is a n overview of the Washington Preferred Worker Program.
Residential Care Services for Injured Workers
Complete this form to assess the level of residential assisted care is required for the injured employee.
Safety for Teen Workers
Information about safety for teen workers in regards to operating power lawn and yard-care equipment.
Form containing the required filing information.
Each state has its own laws and requirements regarding when and how employers are allowed to opt-out of coverage under their workers compensation policy. Some states make it easier than others because they don't require anything to be filed. Other states require special inclusion or exclusion affidavit documentation. Failure to comply often causes employers to have to pay premium on themselves even when they wanted to be excluded form coverage.
A waiver of subrogation means that a business and their insurance company is foregoing all rights to file suit, or seek damages, from another business. This is common in the construction industry as builders attempt to protect their company from negligence. A workers' comp waiver of subrogation does not prevent an injured employee from filing a lawsuit for damages. This coverage typically add about $100 to the cost of a work comp policy.
A Certificate of Insurance is a document that serves as evidence of insurance or proof of coverage. Certificates indicate your current coverages and policy limits. Insurance Agencies issue on an insured's behalf and they often list a third party as a certificate holder. This means they should be notified if a policy cancels prior to expiration. Requests for any special wording should be carefully checked against the policy language before being added to a certificate as they can create legal issues with coverage.
Improve your business cash flow with our Agency Pay As You Go Workers' Comp plans. Available through most of our insurance companies.
State Resources for Washington
Washington Department of Labor and Industries
PO Box 4400Olympia, WA 98504-4000360-902-5798 WA Dept. of Labor and Industries
Washington Board of Industrial Insurance Appeals
2430 Chandler Court SWPO Box 42401Olympia, WA 98504-2401360-753-6823 Board of Industrial Insurance Appeals
Workers compensation insurance is required by law for all Washington employers.
Washington insurance forms and workers comp applications such as owners inclusion or exclusion forms are sometimes updated by the state. Contact us if you need help or can't find the workers' compensation form your need for Washington.
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