This version of the form is not currently in use and is provided for reference only. Download this version of Form F207-202-000 for the current year.
This is a legal form that was released by the Washington State Department of Labor and Industries - a government authority operating within Washington. As of today, no separate filing guidelines for the form are provided by the issuing department.
Q: What is Form F207-202-000?
A: Form F207-202-000 is the Independent Medical Exam (IME) Travel and Wage Reimbursement Request form.
Q: What is an Independent Medical Exam?
A: An Independent Medical Exam (IME) is an examination conducted by a physician or medical professional to assess or evaluate a person's medical condition.
Q: What is the purpose of Form F207-202-000?
A: The purpose of Form F207-202-000 is to request reimbursement for travel and wage expenses incurred during an Independent Medical Exam.
Q: Who should use this form?
A: This form should be used by individuals who have undergone an Independent Medical Exam and need to request reimbursement for their travel and wage expenses.
Q: Is there a deadline for submitting this form?
A: Yes, there is a deadline for submitting this form. It should be submitted within one year from the date of the Independent Medical Exam.
Q: What expenses can be reimbursed through this form?
A: Travel expenses, such as transportation and lodging, and wage loss due to attending the Independent Medical Exam can be reimbursed through this form.
Q: Are there any specific requirements for documentation?
A: Yes, documentation such as receipts or invoices for travel expenses and employer verification of wage loss is required to be submitted along with this form.
Q: How long does it take to receive reimbursement?
A: The processing time for reimbursement may vary, but it usually takes around four to six weeks.
Q: Who can I contact for further assistance or questions?
A: For further assistance or questions, you can contact the Washington State Department of Labor and Industries.
Form Details:
Download a printable version of Form F207-202-000 by clicking the link below or browse more documents and templates provided by the Washington State Department of Labor and Industries.