Forms updated

Washington State Department of Labor & Industries sent this bulletin at 04/29/2025 09:23 AM PDT

Having trouble viewing this email? View it as a Web page.
washington state department of labor and industries - claims and insurance

Self-Insurance

Forms updated

The forms listed below have been updated based on feedback from external users, and to support the Claims Process Project. The updated forms are available for use, and must be used beginning July 1, 2025.

The updated forms are:

     • Interlocutory Request
     • Claim Denial Request
     • Claim Closure
     • Overpayment Request

Both the current and updated versions of the forms are now available.

If you need an “unlocked” version to create a substantially similar version in your system, contact SITrainerQuestions@lni.wa.gov.

The Self-Insurance Training Team will be offering training on all the upcoming changes on June 5th and June 10th. Sign up for Self-Insurance email updates for more details and information on how to sign up for training.

Email Starla Treznoski with questions