Forms & Publications
The following forms are available for your convenience in either Microsoft Word (doc) or portable document formats (pdf).
- Industrial Insurance Notice of Appeal (pdf)
- Firm Notice of Appeal (pdf)
- Crime Victim Notice of Appeal (pdf)
- WISHA Notice of Appeal (pdf)
- Notice of Appearance Form (doc)
- Notice of Intent to Withdraw (doc)
- Notice of Withdrawal - Superior Court Civil Rule (doc)
- Request for Dismissal of Appeal Form (doc)
Pamphlets
Filing a Workers' Compensation Appeal
Brochures
- Your Right to Be Heard - Industrial Insurance
- Gives an overall look at the appeal process at the BIIA, designed for the lay person.
- (English Version) Click here to download in pdf format. Remember to print back-to-back if your printer has that feature.
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- Your Right to Be Heard - WISHA
- Gives an overall look at the appeal process at the BIIA in Washington Industrial Safety and Health Act (WISHA) cases, designed for the lay person.
- Rules of Practice and Procedure Before the Board of Industrial Insurance Appeals of the State of Washington
- Lists the Rules and Regulations (RCW 51.52 and WAC 263-12) that govern the Board of Industrial Insurance Appeals. Click here to download in pdf format.
If you have questions regarding the publications call 360-753-9646 and ask for Publications.
Video - DVD
- The Appeal Process
- A 30-minute DVD designed to aid people who pursue a workers' compensation appeal before the Board of Industrial Insurance Appeals and who do not have the aid of an attorney. It discusses what happens after the appeal has been granted and the steps that the party can expect. This video is available in either English, captioned or in Spanish. You may request this by e-mail. Be sure to include your complete mailing address. mailto:Video@biia.wa.gov
To view these forms, you will need to have Microsoft Word® (or a Word viewer), or Adobe Acrobat® Reader installed on your computer. You can download either of these viewers from the following links:
Download Microsoft Word® Viewer
Download Adobe Acrobat Reader®
The Board of Industrial Insurance Appeals believes in non-discrimination and providing equal access in all areas of employment and service. Persons with disabilities who need assistance to receive the services of the Board, or need Board documents in an alternate format may call (360) 753-6823. Text telephone (TTY) and Telebraille users, please call the Board through the Washington State Telecommunications Relay Service: TTY 1-800-833-6388 and Telebraille 1-800-833-6385.