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 Report form

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.