Workers Comp

Archdiocesan Guidelines for Reporting Workers’ Hours Guidelines used to calculate quarterly WC hours and payroll to compute premium due.	View
Investigation Report - Employee	View
Investigation Report - Supervisor	View
Steps in Filing a WC Claim - Employee	View
Steps in Filing a WC Claim - Supervisor	View
Sick Leave Usage for Time Loss Compensation If employee is going on Time Loss, please fill out this form and give to supervisor.	View
Provider's Initial Report (PIR) Employee should take with him/her to the medical provider at the first visit. If PIR is not taken, employee will need to let the doctor know the Archdiocese of Seattle is self-insured so that the doctor will know which forms to use.	View
Workers' Comp Nurse Line flyer	View

Labor & Industries - Job Safety and Health Law Poster Rev. 09/2015 Required Poster from WA State Dept. of Labor and Industries. Please post where employees can read	View
Labor & Industries - Your Rights as a Worker Poster Rev. 04/2019 Required Poster from WA State Dept. of Labor and Industries. Please post where employees can read	View
Labor & Industries - Notice to Employees - Injury, Self Insurance Poster Rev. 12/2012 Required Poster from WA State Dept. of Labor and Industries. Please post where employees can read	View

Workers' Compensation Card Give to employees at date of hire. Parish should have a supply - if needed, please contact Archdiocese WC Dept. 206 274-3120	View
Workers’ Compensation Filing Information Provide to employees within 30 days of hire	View
Labor & Industries - A Guide to Workers’ Compensation Benefits Publication from WA State Dept. of Labor and Industries	View