Highline Public Schools
15675 Ambaum Blvd. SW Burien, WA 98166

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Monday-Friday: 7:30 a.m. - 4:30 p.m.

Highline Public Schools
15675 Ambaum Blvd. SW Burien, WA 98166

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Workers Compensation

What is L&I or Workers Compensation? 

L&I stands for Labor and Industries (or Workers Compensation) and is an industrial insurance program that applies to all work-related injuries or illnesses. Highline Public Schools is a self-insured employer under the Washington State Workers' Compensation Law. Our industrial insurance administrator is Cannon Cochran Management Services Incorporated (CCMSI), located in Salem, OR.

What does Workers Compensation cover? 

  • If your injury is work related, Workers Compensation will pay all medical costs relating to that injury or illness, once the claim has been approved. 
  • If your physician states that you cannot work because of your work-related injury or work-related illness, you will be paid a percentage of your wages until your physician releases you to work. 

How do I know if I should file a claim?

If you were injured in the course of employment and sustained a work injury or occupational disease, you should file a claim.

  • A Work-related injury means that you were physically injured while you were performing work for your employer.
  • A work-related illness means that you obtained a disease or infection that arises naturally out of employment. 

How do I know if it is work-related illness? 

If you are not sure that an illness is work-related but you and your physician feel that it is, you can file a claim. In viewing your claim, medical evidence will need to substantiate that the disease exists and was caused because of your employment.

Is there a timeline in filing a claim? 

  • A work-related injury claim has to be filed within one year from the day upon which the injury occurred.
  • A work-related illness claim (occupational disease) must be filed within two years from the date of diagnoses. 

If I have a work-related injury or illness, how do I file a claim?

If you have a work-related injury or illness, you can get the necessary forms from your building office manager, secretary or from Human Resources at 206.631.3136. The required forms that are necessary to file a claim: 

  • Physician's Initial Report Form (PIR) - This form is to be completed by you and your physician. Your physician will retain this form and send it directly to CCMSI.
  • Self-Insurer Accident Report Form (SIF2) - This is the claim form itself. You need to fill out the "Employee" section as completely as you can and send it to the Human Resources within 24 hours of your injury. It is not necessary to have your supervisor's signature on this form as it is an option. This office will complete the "Employer" section and send it to CCMSI for processing. 

If your injury or illness is work-related, you will also need to complete: 

  • Highline Public Schools Employee Report of Incident - This form is to document the incident. This form requires your signature and your supervisor's signature. You need to complete this form for any work-related injury or illness whether a Workers Compensation claim is filed or not. 
  • Supervisors’ Investigation form - The supervisor will investigate the incident and report the root cause of the incident/injury.
  • Department of Labor Employee History form - This form documents your employment history for the previous 3 years.
  • Sick leave usage form - This form notifies Human Resources of how to use your sick leave balance. 

The Office Manager/Secretary at each location has the claim packets/incident reports with instructions on how to help the injured worker to complete the forms.

Once the forms are completed give them to the Office Manager/Secretary. They will confirm that all the information is attached and forward to Human Resources.