What Is an L&I Activity Prescription Form (APF)?

By Benjamin McCay, DC, CCSP

Published October 2, 2026

If you are treated for a work injury in Washington State, your medical provider may complete a form called an Activity Prescription Form, usually abbreviated APF. Despite the name, the APF is not a prescription for medication or treatment. It is one of the primary documents used to communicate what you are physically able to do while recovering from a work injury.

The APF tells L&I, your employer, and others involved in the claim whether you can perform your regular job, whether you can work with temporary restrictions, or whether you are temporarily unable to work. It also describes specific physical abilities and restrictions, documents objective medical findings, and summarizes the current treatment plan. This information can affect work duties, light-duty assignments, work hours, and wage-replacement benefits.

What Does an L&I APF Do?

The Activity Prescription Form provides a standardized way for your medical provider to communicate your current ability to work and what physical activities you can safely perform.

An APF can document whether you:

• Can return to your regular job without restrictions.
• Can perform modified or light-duty work.
• Can work only a limited number of hours.
• Are temporarily unable to perform any work.
• Have specific lifting, carrying, bending, reaching, sitting, standing, walking, or other physical limitations.
• Have experienced a change in what you are physically able to do since the previous evaluation.

The form also includes your diagnosis, measurable objective findings, treatment plan, and estimated dates for your current work status. This makes the APF considerably more useful than a simple doctor's note saying "light duty," because your employer needs enough information to determine what work you can actually perform safely.

Who Completes the Activity Prescription Form?

The APF is usually completed by your attending provider, meaning the medical provider primarily responsible for managing your work-injury care. Other qualified medical providers involved in the claim may also complete an APF in some circumstances.

The provider should base your restrictions on your medical condition, examination findings, physical abilities, and expected recovery rather than simply writing whatever restrictions are requested.

What Are the Different Work-Status Options on an APF?

The APF describes several different levels of work ability. You may be released to your regular job without restrictions, meaning your provider believes you can safely return to the same work you performed before the injury. Alternatively, you may be released to modified or light-duty work, meaning you can work but temporarily cannot safely perform all of your regular job duties. Your provider can also limit the number of hours you work, such as initially releasing you to four hours per day and gradually progressing toward a normal schedule.

With a more significant injury, your provider may determine that you are not released to any work, which means you are temporarily unable to work at all. These categories can change as you recover, and an updated APF may be needed whenever your ability to work or your physical restrictions change.

What Kind of Work Restrictions Can Be Written on an APF?

The APF is designed to describe what you are physically able to do, sometimes referred to as your functional capacity, rather than simply listing a diagnosis. Two people with the same diagnosis may have very different physical abilities. A lumbar strain, for example, does not automatically establish how much someone can lift, how long they can sit, or whether they can perform their regular job.

Depending on the injury, an APF may address activities such as lifting, carrying, pushing, pulling, bending, squatting, kneeling, reaching, sitting, standing, walking, climbing, or repetitive movements. Restrictions should be specific enough for your employer to determine whether suitable work is available.

For example, simply saying "light duty" provides relatively little useful information. Restrictions that address lifting, bending, prolonged positions, or other specific activities provide considerably more information about what type of work may actually be appropriate. The purpose is not simply to identify what you cannot do; a well-completed APF should also help identify what you can safely do while recovering.

Can I Do More Than My APF Allows?

An APF is not a court order, and the restrictions listed on it are not necessarily a precise measurement of the absolute maximum you are physically capable of doing. L&I describes the APF as a current snapshot of your abilities, and the form asks your provider to estimate what you can safely do.

That does not mean the restrictions can simply be ignored. For work purposes, your employer should not require you to perform duties beyond the limits established by your medical provider. You should not be required to lift more, work longer hours, or perform other work activities beyond your documented restrictions simply to see whether you can tolerate them.

At the same time, the APF is an estimate of your current abilities, not a permanent or absolute ceiling on your physical ability. Your abilities may improve between visits, and medical or rehabilitation care may involve reassessing or gradually progressing what you can safely tolerate. Evaluating whether your function has improved in a medical or rehabilitation setting is different from an employer requiring you to exceed your restrictions as part of your job. If your actual functional capacity changes, your attending provider can update the APF so that your documented restrictions better reflect your current abilities.

Do APF Restrictions Apply Only While I Am at Work?

No. L&I instructs providers that the abilities listed on the APF should represent what you can safely do all day, every day of the week, including activities outside of work. The restrictions should therefore represent your actual medical limitations rather than special limitations that apply only while you are at your workplace.

For example, if your provider determines that you should not lift more than a certain amount because of a healing injury, that limitation generally does not disappear when you leave work. Activities outside of work that are substantially inconsistent with your stated restrictions can also raise questions about whether the restrictions accurately represent your actual physical abilities.

Does L&I Require Objective Findings to Support Work Restrictions?

When you have not been released to full duty, L&I requires measurable objective medical findings to be documented on the APF. Objective findings are things your provider can observe or measure rather than symptoms that only you can report. Depending on the injury, examples may include measurable loss of motion, swelling, muscle atrophy, muscle spasm, neurological deficits, or relevant findings on an X-ray or MRI.

Pain, tenderness, and fatigue are considered subjective symptoms because they are experienced and reported by the patient rather than directly measured. This does not mean that pain is medically unimportant, but when a provider states that a work injury limits or prevents you from working, L&I expects objective medical findings to support that conclusion.

In some cases, a Functional Capacity Evaluation (FCE) may be used to more thoroughly evaluate what you are physically able to do. An FCE typically involves several hours of standardized testing of activities such as lifting, carrying, pushing, pulling, sitting, standing, walking, bending, and reaching. It can provide additional objective information when your functional abilities or work restrictions are unclear and can help clarify your physical abilities and inform your attending provider’s return-to-work recommendations or an updated APF.

Objective documentation becomes particularly important when your provider determines that you are temporarily unable to work and L&I or the organization administering a self-insured claim must decide whether time-loss compensation should be paid.

When Should an APF Be Completed or Updated?

An APF does not usually need to be completed at every medical visit. L&I recommends completing an APF with the initial injury report. For claims where you are unable to work because of the injury and may qualify for time-loss compensation, L&I recommends another APF within four weeks after the claim is established. If you are working with physical restrictions that must be followed in order to perform light or modified duty, L&I requires an APF within that four-week period.

More importantly, L&I instructs that an updated APF should be completed whenever there is a change in your medical or work status, physical abilities, or activity restrictions. This can include moving from regular work to light duty, changing lifting or activity restrictions, temporarily taking you off work, returning you to modified duty, or reducing or removing restrictions as your recovery progresses.

A change in work status can be brief. For example, if you are already working light duty but your accepted work injury significantly worsens and your attending provider determines that you are temporarily unable to work, an APF may document that short period off work and your subsequent return to modified duty. The change should reflect your provider's medical assessment and be supported by the clinical record rather than simply serving as a routine excuse for an absence.

L&I separately limits reimbursement for APFs billed under code 1073M. Providers may generally be reimbursed for up to six APFs during the first 60 days after the initial visit and up to four APFs per 60 days thereafter. This is a reimbursement limit, not a limit on when an APF may be completed. If your medical condition, work status, or restrictions genuinely change, another APF may still be appropriate even after the usual reimbursement limit has been reached.

Does an APF Put Me on Light Duty?

The APF does not itself create a light-duty job. Your medical provider establishes your medical restrictions, while your employer determines whether work is available that fits within those restrictions. If you cannot perform your regular job but can safely perform other work, the APF may release you to modified or light duty, and your employer can then determine whether temporary work is available within those restrictions.

In some claims, a vocational rehabilitation counselor (VRC) may help coordinate this process. The VRC can work with you, your employer, and your attending provider to identify possible light-duty or transitional work that fits your restrictions. The employer may prepare a written light-duty job description, or a credentialed vocational provider may prepare a more detailed job analysis describing the duties and physical demands of the proposed work. The job description or analysis is then sent to your attending provider for review and approval, either directly by the employer or with assistance from the VRC.

For example, a warehouse employee who temporarily cannot perform repetitive heavy lifting might be able to perform inventory work, administrative duties, equipment inspection, training, or another temporary assignment if those activities remain within the medical restrictions. Washington's L&I system encourages an appropriate return to work when medically reasonable, and L&I's Stay at Work program can reimburse eligible State Fund employers for some costs associated with providing temporary light-duty work.

Light duty should not simply mean sending you back to the same physical job and telling you to "take it easy." The actual duties must remain within your medical restrictions, and the attending provider must approve the proposed light-duty work when formal approval is required.

Does My Attending Provider Have to Approve a Light-Duty Job?

Yes. If your employer offers light-duty or transitional work, your attending provider must determine whether the proposed work is medically appropriate. Your employer should provide a written description of the proposed duties for your provider to review and should also provide you with a copy.

The description should contain enough information for your provider to compare the actual job demands with your medical restrictions, including relevant physical activities, work hours, and any modifications being offered. This is somewhat different from the APF itself: the APF describes your general physical abilities and restrictions, while a written job description or job analysis describes a particular job so your provider can determine whether that specific work fits within your restrictions.

Do I Have to Accept Light Duty?

You are not required to accept work that exceeds the restrictions established by your attending provider. However, if your employer provides a valid written light-duty or transitional job that your attending provider has approved and you choose not to accept it, you generally will no longer qualify for time-loss compensation based on being unable to perform your regular job.

You may still qualify for Loss of Earning Power (LEP) benefits. LEP is a wage-replacement benefit that may partially compensate you when your injury allows you to work but reduces your ability to earn your previous wages.

For this reason, a disagreement over a light-duty assignment should be addressed promptly rather than simply refusing to report to work. If you believe the proposed job actually requires activities outside your restrictions, provide the written job description to your attending provider and explain the particular duties that concern you. L&I also has a Light Duty Job Offer Complaint Resolution Office for workers who have questions or concerns about a proposed light-duty job.

What If Light Duty Makes My Injury Worse?

Returning to modified work does not end your right to continued medical care. If a light-duty assignment causes significant difficulty, the first question is whether the work actually complies with your medical restrictions and whether your condition or physical abilities have changed.

Even work that initially appeared appropriate may need to be reconsidered. If the light-duty work interferes with your recovery enough that your attending provider determines you should no longer continue performing it, your work status can be changed and time-loss compensation may again become appropriate. You should therefore communicate a significant change to your attending provider rather than simply continuing increasingly difficult work or independently stopping work without medical documentation. If your provider determines that your ability to work has changed, an updated APF may be appropriate.

How Does the APF Affect Time-Loss Benefits?

Time-loss compensation is partial wage replacement for an injured worker who is medically unable to work because of a work injury or occupational disease. An APF does not automatically qualify you for time-loss benefits, but it provides important medical documentation that L&I, or the organization administering a self-insured claim, can use when determining whether those benefits should be paid.

If your provider determines that you cannot work because of the accepted work injury, the medical record should document the period during which you cannot work and the medical findings supporting that decision. This is one reason an outdated or incomplete APF can create problems: if your medical records indicate one work status while your most recent APF says something different, your employer and the people managing your claim may receive conflicting information. Keeping the APF consistent with your current medical status helps reduce that confusion.

What If I Return to Work but Earn Less Money?

Returning to work does not necessarily mean that all wage-replacement benefits end. If you can return to work but earn less because of your work injury, you may qualify for Loss of Earning Power (LEP) benefits. LEP may apply when you return with fewer hours, earn a lower wage, or cannot perform other work you were doing when you were injured.

In general, the reduction in what you are able to earn must be more than 5 percent, and your medical provider must certify that the reduction is related to the work injury or occupational disease. LEP is different from time-loss compensation: time-loss generally applies when the work injury prevents you from working, while LEP applies in certain situations where you can work but the injury continues to reduce what you are able to earn.

What Should I Do With My Copy of the APF?

You should receive a copy of the completed APF so you can provide it to your employer when necessary. Read the form before leaving the medical office if possible, and make sure you understand your current work status and restrictions, particularly any lifting limits, limits on work hours, or restrictions affecting important parts of your job.

If something appears incorrect, discuss it with your provider. The APF should reflect your provider's medical opinion based on the current examination and available medical information. Do not assume that a verbal conversation automatically changes previously documented restrictions; if your ability to work or your physical restrictions have materially changed, an updated APF provides clear documentation for your employer and the people administering your claim.

What If My Employer Asks Me to Work Outside My Restrictions?

Your employer should provide work that remains within the medical restrictions established by your attending provider, and you are not required to accept work that exceeds those restrictions. If a particular task appears inconsistent with your APF, first compare what you are actually being asked to do with the written restriction. Sometimes the problem is simply a misunderstanding about what the job requires, while in other situations the written job description may not accurately reflect what you are actually being asked to do.

If there is a genuine conflict, communicate it promptly to your employer and attending provider. Your provider may need to clarify the restriction or review an updated job description. The appropriate solution is generally to clarify the work rather than repeatedly performing activities outside your medical restrictions or, at the other extreme, stopping work without discussing the situation with your provider.

Can a Chiropractor Complete My APF?

Yes. For an appropriate work-related musculoskeletal injury, a chiropractor may serve as your attending provider, meaning the provider primarily responsible for managing your work-injury care, and may complete your Activity Prescription Form.

This can include determining whether you can perform your regular job, establishing temporary physical restrictions, releasing you to appropriate modified duty, monitoring changes in what you are physically able to do, and reviewing proposed light-duty work. The same principle applies regardless of provider type: restrictions should be medically justified, supported by examination findings, and adjusted as you recover.

An APF should not simply be used to keep someone off work, nor should restrictions be removed simply because an employer wants an employee back at full duty. Its purpose is to provide an accurate description of what you can reasonably and safely do at that point in your recovery.

Why Does L&I Encourage an Early Return to Work?

The back of the APF includes several messages that L&I asks medical providers to discuss with injured workers. One of the main ideas is that safe activity is usually part of recovery, rather than something that should automatically be avoided until every symptom is gone.

L&I encourages workers to remain as active as they safely can and to gradually increase activity as recovery progresses. Some discomfort can occur when returning to activity after an injury and does not necessarily mean that the injury is being harmed or has worsened. At the same time, activity should remain appropriate for the injury and within reasonable medical limits. L&I also emphasizes early and safe return to work. Returning to appropriate regular or modified work can help maintain routine, function, and connection with the workplace. L&I notes that the longer an injured worker remains completely off work, the more difficult it can become to return to the original job and wages.

This does not mean that every injured worker should immediately return to full duty or that legitimate restrictions should be ignored. The goal is to remain as active and productive as is medically appropriate while the injury heals, using modified duty or temporary restrictions when necessary.

L&I Work Injury Care in Everett and Lynnwood

Advanced Chiropractic & Massage provides work injury treatment in Everett and Lynnwood and participates in the Washington L&I system. For appropriate musculoskeletal work injuries, care may include evaluation and treatment, APF completion, temporary work restrictions, coordination of light duty, imaging or specialty referral when indicated, and communication with L&I or the organization administering a self-insured claim.

For a broader explanation of Washington workers' compensation, including filing a claim, choosing an attending provider, time-loss benefits, light duty, IMEs, accepted conditions, and claim closure, see Washington L&I Work Injury Claims: What Injured Workers Need to Know.