Form F207-114-000 Transfer of Attending Provider Form for Self-insured Workers - Washington

What Is Form F207-114-000?

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 F207-114-000?
A: Form F207-114-000 is the Transfer of Attending Provider Form for Self-insured Workers in Washington.

Q: Who needs to use this form?
A: This form should be used by self-insured workers in Washington who need to transfer their attending provider.

Q: What is an attending provider?
A: An attending provider is a medical professional who is responsible for the care and treatment of a worker's injury or illness.

Q: Why would someone need to transfer their attending provider?
A: Someone may need to transfer their attending provider if they are not satisfied with the care or treatment they are receiving or if they need to change providers for another reason.

Q: Is there a deadline for submitting this form?
A: There is no specific deadline mentioned, but it is advisable to submit the form as soon as the need to transfer the attending provider arises.

Q: Are there any fees associated with submitting this form?
A: There are no fees associated with submitting Form F207-114-000.

Q: What happens after the form is submitted?
A: After the form is submitted, the self-insured employer or their claim administrator will review the request and notify the worker of the decision.

Q: Can the worker appeal the decision if their request to transfer the attending provider is denied?
A: Yes, the worker has the right to appeal the decision if their request to transfer the attending provider is denied.