Directory information, not recipient confirmation. Fax numbers can change and differ by department, location, form, or plan. Confirm this destination directly with Washington State Department of Labor & Industries (L&I) before sending sensitive documents. FaxFlow is not affiliated with this organization.
Washington State Department of Labor & Industries (L&I) fax number
(360) 902-6690
Self-Insurance Section
Used for: Filing claims related to workplace injuries: ROA for L&I-insured patients and Providers Initial Report (PIR) for self-insured employers; fax to 360-902-6690 or 1-800-941-2976, or file online.
Fax destination details
- Department
- Self-Insurance Section
- Purpose
- Filing claims related to workplace injuries: ROA for L&I-insured patients and Providers Initial Report (PIR) for self-insured employers; fax to 360-902-6690 or 1-800-941-2976, or file online.
- Form
- ROA (Report of Industrial Injury or Occupational Disease) / PIR (Providers Initial Report) — ROA (Report of Industrial Injury or Occupational Disease) and PIR (Providers Initial Report)
- Address
- PO Box 44291, Olympia, WA 98504-4291
- Voice phone
- 360-902-6901
- Website
- Visit organization website
Before you send
- Confirm that this exact department handles your document or request.
- Check the organization website or call its main line for the current fax number.
- Include a cover sheet and any case, member, claim, or form reference required.
- Keep the delivery confirmation with your submission records.
Submit ROA via online filing or fax (2-day deadline to fax to 1-800-941-2976 or 360-902-6690). If the patient is self-insured, submit PIR (F207-028-000).
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