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Washington Workers' Compensation Legal Library

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296-15-320 Reporting of injuries.

What elements must a self-insurer have in place to ensure the reporting of injuries? Every self-insurer must:
(1) Establish procedures to assist injured workers in reporting and filing claims.
(2) Immediately provide a Self-Insurer Accident Report (SIF-2) form F 207-002-000 to every worker who makes a request, or upon the self-insurer's first knowledge of the existence of an industrial injury or occupational disease, whichever occurs first. Only department provided SIF-2 forms may be used. Copies or reproductions are not acceptable.
(3) Establish procedures for ensuring the timely delivery of completed SIF-2s to the claims management entity.
(4) Designate individuals as resources to address employee questions. These resources must:
(a) Have sufficient knowledge to answer routine questions; and
(b) Have responsibility for seeking answers to more complex problems; and
(c) Have detailed knowledge of the self-insurer's claim filing process; and
(d) Be reasonably accessible to employees at every work location.
(5) Maintain a claims log of all workers' compensation claims filed.
(a) For each claim, the log must consist of only the following information:
(i) The complete first and last name of the injured worker (no initials or abbreviations).
(ii) The date of injury, or for an occupational disease, the date of manifestation.
(iii) The claim number found on the department's Self-Insurer Accident Report (SIF-2, form F 207-002-000).
(iv) The date the claim is closed.
(v) Whether the claim is a time loss claim or medical only.
(b) The self-insurer must designate the location of the official claims log.
(i) The self-insurer may maintain the log on its premises; or
(ii) The self-insurer may elect to have its third-party administrator maintain the claims log on its behalf. If this option is selected, there must be a written agreement between the self-insurer and the third-party administrator acknowledging that the official claims log is maintained by the third-party administrator.
The self-insurer must notify the department in writing of the location of their official claims log. If the option in (b)(ii) of this subsection is selected, a copy of the written agreement between the self-insurer and the third-party administrator must be provided to the department.
[Statutory Authority: RCW 51.04.020, 51.14.020, 51.32.190, 51.14.090, and 51.14.095. WSR 06-06-066, § 296-15-320, filed 2/28/06, effective 4/1/06.]

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