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137-78-020  <<  137-78-030 >>   137-78-040

PDFWAC 137-78-030

Application process.

Employees who meet the eligibility requirements of WAC 137-78-020 and elect to apply for assault benefits shall submit a signed application for assault benefits, a properly completed report of accident/injury and a copy of his or her L&I Report of Industrial Injury or Occupational Disease form (F242-130-000), to his or her locally designated representative or human resource office within sixty working days of the occurrence of the assault or, if the application could not be reasonably submitted within that period, within sixty working days of the time when application could reasonably have been made. Applications shall be reviewed through the employee's chain of command. The department shall grant or deny the request for assault benefits within thirty working days after receipt of the completed application, but may extend that time to gather additional information. A completed application shall include information that the department of labor and industries has approved the employee's claim for benefits related to the assault.
[Statutory Authority: RCW 72.01.090. WSR 09-15-198, § 137-78-030, filed 7/22/09, effective 8/22/09; WSR 03-21-088, § 137-78-030, filed 10/17/03, effective 11/17/03. Statutory Authority: RCW 72.13.170. WSR 89-15-059 (Order 89-05), § 137-78-030, filed 7/19/89, effective 8/19/89.]
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