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 State 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.