Claims & Reporting - Injured Worker

Reporting: Injured Employee's Responsibilities

1. SEEK FIRST-AID or EMERGENCY MEDICAL ATTENTION IF NEEDED.

2. INFORM YOUR SUPERVISOR IMMEDIATELY.

3. COMPLETE AN EMPLOYEE Incident form - fillable

An employee incident may not require professional medical attention or Workers' Compensation benefits;
however, all employee incidents need to be recorded so facts of the injury, or near-miss, can be gathered
to prevent future incidents and reduce workplace hazards.

IF MEDICAL CARE IS NEEDED:

Contact NEWESD 101 Workers' Compensation Claims Department at (509) 789-3516 or (800) 531-4290 to file a formal Workers' Compensation claim and obtain a claim number.

1. What do I tell the Medical Provider?
    - Inform the medical provider that your injury is a work related incident.
    - Provide the medical provider with your claim number.
    - Instruct the medical provider to forward all information to:

              NE WA Workers' Compensation Cooperative (NE WA WC)
              NEWESD 101
              4202 S. Regal Street
              Spokane, WA 99223
              (509) 789-3516 - phone
              (509) 789-3780 - fax

    - Complete the Patient Section on the Physician's Initial Report (PIR) provided by the medical provider's office.
    - DO NOT file an L&I Stated Fund Report Form.
    - Obtain a note regarding your work status from your medical provider.
    - Schedule a return appointment.
   
2. What do I do after each medical visit?
    - Call NEWESD 101 Workers' Compensation Claims Department to report your work status.
    - Report your return to work status to your supervisor IMMEDIATELY.  
    - Give your supervisor and NEWESD 101 Workers' Compensation Claims Department a copy of your work status note.