Form F242-421-000 Declaration of Entitlement for Disabled Child or Guardian Benefits Under Industrial Insurance - Washington

Notification Icon This version of the form is not currently in use and is provided for reference only. Download this version of Form F242-421-000 for the current year.

Form F242-421-000 Declaration of Entitlement for Disabled Child or Guardian Benefits Under Industrial Insurance - Washington

What Is Form F242-421-000?

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.

FAQ

Q: What is Form F242-421-000?
A: Form F242-421-000 is a declaration of entitlement for disabled child or guardian benefits under industrial insurance in Washington.

Q: Who can use Form F242-421-000?
A: Form F242-421-000 can be used by individuals seeking disabled child or guardian benefits under industrial insurance in Washington.

Q: What are disabled child or guardian benefits?
A: Disabled child or guardian benefits are financial benefits provided to eligible individuals who are disabled or have a disabled child and qualify under industrial insurance in Washington.

Q: Is there a fee to submit Form F242-421-000?
A: No, there is no fee to submit Form F242-421-000.

Q: What supporting documents are required with Form F242-421-000?
A: Supporting documents such as medical evidence, birth certificates, or legal guardianship papers may be required with Form F242-421-000.

Q: What is the processing time for Form F242-421-000?
A: The processing time for Form F242-421-000 may vary, so it is recommended to contact your local L&I office for more information.

Q: What if my application for disabled child or guardian benefits is denied?
A: If your application for disabled child or guardian benefits is denied, you have the right to appeal the decision within specified timeframes. Contact your local L&I office for more information on the appeals process.

ADVERTISEMENT

Form Details:

  • Released on February 1, 2017;
  • The latest edition provided by the Washington State Department of Labor and Industries;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a fillable version of Form F242-421-000 by clicking the link below or browse more documents and templates provided by the Washington State Department of Labor and Industries.

Download Form F242-421-000 Declaration of Entitlement for Disabled Child or Guardian Benefits Under Industrial Insurance - Washington

4.5 of 5 (73 votes)
  • Form F242-421-000 Declaration of Entitlement for Disabled Child or Guardian Benefits Under Industrial Insurance - Washington, Page 1
ADVERTISEMENT

Related Documents