September 23, 2020
by Michael Godfrey

Department of Labor & Industries Requiring New and Updated Forms on October 1, 2020

The Department of Labor & Industries has created new forms and templates for use by self-insured employers, third-party administrators, and Physical and Occupational Therapists. The new forms are required as of October 1, 2020.  Several of the existing templates and forms that were part of the 2019 claim processing changes were updated with minor changes in language. Employers should make sure to update their form library to ensure the most recent version is submitted. Most notably, however, are several forms that are entirely new. There is a new form for starting/stopping/denying benefits, appropriately titled “Start, Stop, or Deny Compensation Benefits.” The new form combined previous forms for starting and stopping compensation benefits. Self-insured employers and claims administrators should use the Start, Stop, or Deny Compensation Benefits form to communicate whenever time-loss compensation or LEP benefits on a claim are started, denied, or stopped. Additionally, claims administrators should keep in mind that notification to the injured worker must be sent within 5 business days pursuant to WAC 296-15-425. This form does not create any obligation for claims administrators and should help streamline claim processing as there is one less form to worry about.

Another new form, Provisional Compensation Benefits, was created for use when an injured worker is receiving provisional time-loss or Loss-of-Earning Power (“LEP”)benefits. This form should almost always be utilized when a claim administrator has medical certification for ongoing temporary disability benefits but has not yet made a determination regarding claim compensability.

For Physical medicine and Occupational Therapists, there is a new form titled Physical Medicine Progress Reports (“PMPR”) was created to provide a standard measure baseline and progress over the course of treatment and to help promote best practices among physical and occupational therapists. The form is required for therapists who provide standard outpatient therapy in accordance with WAC 296-23-220 and WAC 296-23-230, or any work conditioning program that does not fall under the “work hardening” program umbrella. The form is not required for inpatient rehabilitation, consulting therapists, work hardening programs, or out-of-state providers. If you’re a self-insured employer, make sure to monitor any claims involving physical therapy to ensure the providers are submitting the required forms. These forms should serve as an another tool to help monitor an injured workers’ recovery.

If you have any questions regarding the use or implementation of the Departments forms, please do not hesitate to contact me via email at or via phone at (503) 595-6105.