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Washington NOTICE TO EMPLOYEES Labor Law Poster

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  • Washington NOTICE TO EMPLOYEES Labor Law Poster

    Employer: This is your official industrial insurance poster.You are required by law to post this notice.
    If a job injury occurs...
    Your employer is insured through the Department of Labor and Industries’ workers’ compensation program. If you are injured on the job or develop an occupational disease, you are entitled to workers' compensation benefits.
    Benefits include:
    Medical care. Medical expenses arising from your workplace injury or disease will be paid by the workers' compensation benefits program.
    Disability income. If your injury or occupational disease prevents you from working, you may be eligible for benefits to partially replace your wages.
    Vocational assistance. Under certain
    conditions, you may be eligible for help in
    returning to work.
    Partial disability benefits. You may be eligible for a monetary award to compensate for the loss of body functions.
    Pensions. Injuries that permanently keep you from returning to work may qualify you for a disability pension.
    Death benefits for survivors. If a worker dies, the surviving spouse and/or dependents may receive a pension.
    What you should do...
    Report your injury. If you are injured, no matter how minor the injury seems, contact the person listed to the right.
    Get medical care. You have the right to go to any doctor qualified to treat your injury. Qualified
    doctors include: medical, osteopathic, chiropractic, naturopathic and podiatric physicians, dentists, optometrists and opthalmologists. Medical bills that arise from a workplace injury or occupational disease will be paid by the workers' compensation program.
    Tell your doctor that your injury or condition is work-related. Your doctor will complete a Report of Industrial Injury or Occupational Disease form and send it in. This is the first step in filing your industrial insurance claim.
    File your claim within set time frames. For an on-the-job injury, you must file a claim and Labor and Industries must receive it within one year after the date the injury occurred. For an
    occupational disease, you must file a claim and Labor and Industries must receive it within two years following the date you are advised by a doctor in writing that your condition is work-related.
    F242-191-909 [English, 09/2003]
    Report your injury to:


    (Your employer fills in this space.)
    Helpful phone numbers:


    Ambulance


    Police


    Fire
    IMPORTANT:

    NOTICE TO SELF-INSURED EMPLOYEES
    Your employer is self-insured. You are entitled to all of the benefi ts required by the State of Washington’s industrial insurance laws. These benefi ts include medical treatment and partial wage replacement if your work-related injury or illness requires you to miss work. Compliance with these laws is regulated by the Department of Labor and Industries.
    To report an injury...
    If you should become injured on the job or develop an occupational disease, immediately report your injury or condition to the person designated below:


    Name:


    Phone:
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