Filing a Workers' Compensation Claim
Everything employees need to initiate a workers' compensation claim
Filing a claim can seem like an overwhelming task. Below is the best way to file and process your claim accurately and quickly.
For questions contact WorkersComp@kingcounty.gov.
You, your supervisor and your health care provider will need to complete the required forms and reports.
- The "Workplace Injury and Illness: A Guide for King County Employees, Supervisors and Doctors" packet, available from your supervisor, includes all the forms necessary to initiate a workers' compensation claim, including:
- "Work Related Illness or Injury Supervisor Report" form to be completed by you and your supervisor.
- "Self-Insurer Accident Report (SIF-2)" form, to be completed by you. Here is a sample form.
- "Activity Prescription" form, to be completed by your health care provider.
- "Provider's Initial Report" form, to be completed by you and your health care provider. Here is a sample form.
You, your supervisor and your health care provider will need to submit the completed forms to Safety and Claims. Please forward each form as it is completed. Do not delay reporting.
- Email: WorkersComp@kingcounty.gov
- Call: 206-477-3350
- Fax: 206-296-0514
- Mailing Address: 500 4th Avenue, Room 500, Seattle, WA 98104
To be eligible for workers' compensation, you must see a health care provider.
- Go to the emergency room or health care provider of your choice and tell the provider that you were injured at work and that King County is self-insured for workers' compensation.
- You and your provider need to complete a "Provider's Initial Report" form (within the "Workplace Injury and Illness: A Guide for King County Employees, Supervisors and Doctors" packet) for self-insured employers, which must be returned to the workers' compensation section of King County's Safety & Claims Management Division.
- If you need medical care after that first visit, you will need to see a provider in the Labor and Industries provider network.
If you can return to work with restrictions:
- You must notify your supervisor, human resources representative, or agency leave administrator of any work limitations by providing written notification from your health care provider that identified the restrictions.
- You and your supervisor discuss whether you may perform your job with or without restrictions.
- A coordinated effort will be made between Safety and Claims, you, your supervisor and your health care provider regarding restricted duties. There are occasions where Safety and Claims receives the restriction information directly from the health care provider or from you. In those circumstances, Safety and Claims will notify your agency.
If you can return to work without restrictions:
- Your health care provider may indicate on the "Activities Prescription" form or on a form appropriate to your division that you can return to work without restrictions. It is your responsibility to provide the form to your supervisor.
- Your supervisor is responsible for sending the form and reporting on your work status to Safety and Claims. If Safety and Claims receives the information directly from your health care provider, Safety and Claims will notify your agency.
Direct Deposit Documentation
You can now sign up for direct deposit of your workers’ compensation disability benefits.
- No cancelled check necessary to process
- Timely deposit of checks
- Money is available sooner, eliminates mailing time
- Reduced chance of losing checks or having check stolen
- No need to spend time visiting bank or ATM to deposit check
One hundred percent (100%) of your workers' compensation disability benefits will be deposited directly into the account you indicated on the Electronic Funds Transfer Authorization Agreement.