Claims Kit
Washington
Forms
State Compliance Information
Reporting of Claim by Employer 51.28.010 (1) 51.28.025
An employer who has notice or knowledge of an injury or occupational disease of their employee and who has received treatment from a physician, or has been hospitalized, disabled from work, or who has died must immediately report this information to the Department.
A workplace fatality or in-patient hospitalization of any employee must be reported to L&I within 8 hours of the incident. Any non-hospitalized amputation or loss of an eye(s) must be reported within 24 hours of the incident. Note: This applies to all employers with workers working in Washington no matter what industry they work in and regardless of workers’ compensation coverage
Posting Requirements
Certificate of coverage required RCW 51.04.120
Employers are required to obtain a certificate of insurance coverage and post it conspicuously in their place of business. They must have a separate certificate of coverage in each business location they operate.
L&I will send three posters that inform employees of their rights and responsibilities as workers. They must be displayed where employees can see them
Poster (English and Spanish)
Self-Insured Poster (English and Spanish)
Penalties for Late Reporting RCW 51.28.025
An employer found to have engaged in claim suppression is subject to a penalty of at least $250, not to exceed $2,500, for each offense.
Physician Selection RCW 51.36.010
For the initial injury, a worker may see a provider of their choice.
Once the provider network is established in the worker's geographic area, an injured worker may receive care from a nonnetwork provider only for an initial office or emergency room visit.
Posters & Brochures
Documents Provided by CopperPoint
Portal User Help
Pharmacy First Fill - ENG/SPA
Change of Address
Witness Statement - ENG/SPA
Accident Report - ENG/SPA
Gramm-Leach-Bliley Act (GLBA) Privacy Notice
Return To Work
Return To Work Transitional Employment Offer Template - ENG/SPA
Return To Work Policy Guide
Injured Worker Guide
The worker's compensation system can be complicated, and each state has its own laws regarding workers' compensation.
The information contained in your state's guide provides a general guide for workers injured or made ill on the job.
This state-issued publication will assist you in navigating the workers' compensation system and serve as a resource for basic legal rights as well as steps to take to initiate workers' compensation benefits, deadlines and who to contact for additional assistance.
If you have questions about the workers' compensation process, this guide will provide the contact information for the regulatory agency for your state. In addition, many states have an ombudsman to oversee and assist all interested parties in the workers' compensation system.
Publications
Need help?
Phone: 800.231.1363
For Claim Reporting, please complete your First Notice of Loss and email to reportaclaim@copperpoint.com