The Personnel Department manages claims for all on the job injuries of City of Seattle
employees. The City is self-insured and self-administered. For information, contact Workers'
Compensation at (206) 684-7855. You may also review the
Guide to Workers' Compensation for information.
What You Need to Do Immediately
Your supervisor should provide you with a packet that contains instructions on reporting your
claim. After reporting your injury or illness to your supervisor, follow these steps to make sure
your claim goes smoothly and all benefits due to you are paid on time:
- Complete the Self-Insurer Accident Report (SIF-2) form.
Return the form to you supervisor immediately. Keep the pink copy for your records. Your
claim number is printed in the upper right hand corner of the form. Your doctor will need to
know this number and you should also refer to it when calling about your claim.
- See your Health Care Provider.
When you see your health care provider, explain to your provider that you believe your injury or illness is work-related and that the City is self-insured. Please take the Activity Prescription Form (APF) with you to your visit. Also take any light duty job descriptions provided by your department. Request that your medical provider complete the forms and review the forms with your provider prior the end of your visit. This information will help us determine activities you are able to perform safely as you recover.
- Report to Work.
Give the completed Activity Prescription Form (APF) to your supervisor. If you
have been released to work with medical restrictions, your supervisor will identify duties
which are within your limits.
If your doctor says you are unable to report for work, inform your supervisor and turn in
your Activity Prescription Form (APF) immediately (no benefits can be paid
until this form is received).
- If you were involved in a vehicle accident.
Or if you were involved in another action that you believe was the fault of another
personwho was not an on-duty City employee at the timeyou also need
to fill out the Third Party Election Form and
return it to your supervisor.
You will receive a letter from your assigned claims specialist along with a booklet which
explains the City's workers' compensation claims process in more detail. Your claims specialist
will work closely with you to answer any questions and help make sure your recovery goes
smoothly. If you have any general concerns in the mean time, please call us at (206) 684-7855.