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Workers' compensation
Providing compensation claim services to employees in need.
Accident or fatality
Reporting a serious situation
We care about the safety and well-being of employees, and encourage them to seek medical assistance for a serious injury immediately. Employers are responsible for ensuring reports are made within eight hours of an incident, or within eight hours of learning about it.
A serious injury or fatality is one which results in a workplace death that happens within 30 days of an incident, a potentially fatal workplace injury, or an in-patient hospitalization related to the workplace that happens within 30 days of an incident.
Filing 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.
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Notify your supervisor
Notify your supervisor, typically in person, by email or telephone. Your supervisor will inform the appropriate human resources representative or leave administrator for your agency.
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Complete the forms within the Workers' Compensation Claim packet
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.
- Online version, only accessible on county computers
- Download or print the Work Related Illness or Injury Supervisor Report
- Self-Insurer Accident Report (SIF-2) form, to be completed by you. View 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. View a sample form.
- Work Related Illness or Injury Supervisor Report form to be completed by you and your supervisor.
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Report to safety and claims – Forward each form as it is completed
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
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Seek treatment
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.
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Notify your supervisor about your ability to return to work
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.
Disability Services, Safety and Health, and Workers' Compensation Claims contacts
Ensuring the health and safety of employees is our number one priority. Here are the contacts for Safety and Health, Workers' Compensation Claims, and Disability Services by department, as well as contacts for other various services and programs.
Employee Assistance Program
- Main EAP phone: 206-263-8733
- Email: HRDEAP@kingcounty.gov
Job accommodations due to injury or illness
Please contact Disability Services:
- Email: DisabilityServices@kingcounty.gov
- Phone: 206-263-9329
Or the Interim Disability Services Supervisor, Christina Davidson by phone at 206-477-3372.
Reassignment
Please contact the program directly:
- Email: RAP@kingcounty.gov
- Phone: 206-263-9329
Safety training classes
Contact Tammy Harris, Occupational Education and Training Program Administrator
- Phone: 206-477-3371
- Email: Tammy.Harris@kingcounty.gov
Supported Employment Program
Contact Christina Davidson, Program Manager
Phone: 206-477-3372
Eamil: Christina.Davidson@kingcounty.gov
Transitional Duty
Please contact the program directly:
- Email: TDA@kingcounty.gov
- Phone: 206-263-9329
By department
| Department | Contacts |
|---|---|
| Adult and Juvenile Detention |
Safety and Health Professional: John Stebbins, 206-477-2677 Workers' Compensation Claims Officer: Alaena Blouin, 206-477-3361 Disability Services Consultant:
|
| Assessments |
Safety and Health Professional: Chris Jacomme, 206-263-1024 Workers' Compensation Claims Officer: Jeff Norgaard, 206-477-3363 Disability Services Consultant: Dora Duong, 206-848-0255 |
| Community and Human Services |
Safety and Health Professional: Shawn Marino, 206-477-2678 Workers' Compensation Claims Officer: Teresa Fager, 206-477-3356 Disability Services Consultant: Dora Duong, 206-848-0255 |
| County Council |
Safety and Health Professional: Chris Jacomme, 206-263-1024 Workers' Compensation Claims Officer: Jeff Norgaard, 206-477-3363 Disability Services Consultant: Erin McPhee, 206-263-5728 |
| County Executive |
Safety and Health Professional: Chris Jacomme, 206-263-1024 Workers' Compensation Claims Officer: Autumn Musch, 206-477-3378 Disability Services Consultant: Erin McPhee, 206-263-5728 |
| District Court |
Safety and Health Professional: Dan Nwaelele, 206-477-3374 Workers' Compensation Claims Officer: Jeff Norgaard, 206-477-3363 Disability Services Consultant: Erin McPhee, 206-263-5728 |
| DES: Fleet, RALS, BRC |
Safety and Health Professional: Shawn Marino, 206-477-2678 Workers' Compensation Claims Officer: Autumn Musch, 206-477-3378 Disability Services Consultant: Dora Duong, 206-848-0255 |
| DES: Airport |
Safety and Health Professional: John Stebbins, 206-477-2677 Workers' Compensation Claims Officer: Autumn Musch, 206-477-3378 Disability Services Consultant: Dora Duong, 206-848-0255 |
| DES: OEM |
Safety and Health Professional: Tim Carter, 206-477-5010 Workers' Compensation Claims Officer: Autumn Musch, 206-477-3378 Disability Services Consultant: Dora Duong, 206-848-0255 |
| DES: FMD, CAO, OCR, OLR, Performance |
Safety and Health Professional: Chris Jacomme, 206-263-1024 Workers' Compensation Claims Officer: Teresa Fager, 206-477-3356 Disability Services Consultant: Dora Duong, 206-848-0255 |
| DES: FBOD, Risk |
Safety and Health Professional: Dan Nwaelele, 206-477-3374 Workers' Compensation Claims Officer: Autumn Musch, 206-477-3378 Disability Services Consultant: Dora Duong, 206-848-0255 |
| DHR |
Safety and Health Professional: Shawn Marino, 206-477-2678 Workers' Compensation Claims Officer: Autumn Musch, 206-477-3378 Disability Services Consultant: Nathan Kinker, 206-477-6993 |
| DNRP, Parks |
Parks Safety Program Manager: Nicholas Evans, 206-477-6862 Workers' Compensation Claims Officer: Autumn Musch, 206-477-3378 Disability Services Consultant: Aya Casem, 206-848-0259 |
| DNRP, Solid Waste |
Safety and Emergency Manager: Katie Jones, 206-477-3330 Workers' Compensation Claims Officer: Autumn Musch, 206-477-3378 Disability Services Consultant: Aya Casem, 206-848-0259 |
| DNRP, Wastewater Treatment |
Safety and Emergency Manager: Jim Faccone, 206-477-5379 Workers' Compensation Claims Officer: Autumn Musch, 206-477-3378 Disability Services Consultant: Aya Casem, 206-848-0259 |
| DNRP, Water and Land Resources |
Safety and Health Professional: Dan Nwaelele, 206-477-3374 Workers' Compensation Claims Officer: Autumn Musch, 206-477-3378 Disability Services Consultant: Aya Casem, 206-848-0259 |
| Elections |
Safety and Health Professional: Shawn Marino, 206-477-2678 Workers' Compensation Claims Officer Autumn Musch, 206-477-3378 Disability Services Consultant: Dora Duong, 206-848-0255 |
| Judicial Administration |
Safety and Health Professional: Chris Jacomme, 206-263-1024 Workers' Compensation Claims Officer: Jeff Norgaard, 206-477-3363 Disability Services Consultant: Nathan Kinker, 206-477-6993 |
| KCIT |
Safety and Health Professional: Dan Nwaelele, 206-477-3357 Workers' Compensation Claims Officer: Autumn Musch, 206-477-3378 Disability Services Consultant: Dora Duong, 206-848-0255 |
| Local Services, Permitting, and Environmental Review |
Safety and Health Professional: Dan Nwaelele, 206-477-3357 Workers' Compensation Claims Officer: Autumn Musch, 206-477-3378 Disability Services Consultant: Aya Casem, 206-848-0259 |
| Local Services, Roads |
Roads Safety Program Manager: Aaron Leftwich, 206-477-3374 Safety and Health Professional: Shawn Marino, 206-477-2678 Workers' Compensation Claims Officer: Autumn Musch, 206-477-3378 Disability Services Consultant: Aya Casem, 206-848-0259 |
| Metro Transit |
Division Director, Metro Safety and Security: Rebecca Frankhouser, 206-477-3976 Disability Services Consultant:
Workers' Compensation Claims Officer Operators and Rail:
Director’s Office, Sales & Customer Service, Budget & Financial Management: Latausha Carlyle, 206-263-9806 Marine, Vehicle Maintenance: Jade Pruitt, 206-263-8626 |
| Prosecuting Attorney |
Safety and Health Professional: Chris Jacomme, 206-263-1024 Workers' Compensation Claims Officer: Jeff Norgaard, 206-477-3363 Disability Services Consultant: Dora Duong, 206-848-0255 |
| Public Defense |
Safety and Health Professional: Dan Nwaelele, 206-477-3374 Workers' Compensation Claims Officer: Jeff Norgaard, 206-477-3363 Disability Services Consultant: Nathan Kinker, 206-477-6993 |
| Public Health |
Safety and Health Professional: John Stebbins, 206-477-2677 Workers' Compensation Claims Officer: Teresa Fager, 206-477-3356 Disability Services Consultant:
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| Sheriff's Office |
Safety and Health Professional: John Stebbins, 206-477-2677 Workers' Compensation Claims Officer: Jeff Norgaard, 206-477-3363 Disability Services Consultant: Aya Casem, 206-848-0259 |
| Superior Court |
Safety and Health Professional: Chris Jacomme, 206-263-1024 Workers' Compensation Claims Officer: Jeff Norgaard, 206-477-3363 Disability Services Consultant: Erin McPhee, 206-263-5728 |
| Hearing Loss |
Workers' Compensation Claims Officer: Alaena Blouin, 206-477-3361 |