Washington Free Printable Workers Compensation Law Posters Washington Notice to Employees of Self-Insured Employers Poster

The Notice to Employees of Self-Insured Employers is a workers compensation law poster by the Washington Department Of Labor & Industries. This poster is mandatory for some employers, including employers in self-insured businesses.

This poster, written in English and Spanish, must be posted in a conspicuous place by all self-insured employers so that all employees can see it. This poster describes what to do if injured in the workplace, what benefits employees can get, and where to report injuries to.


WA All-In-One Labor Poster: Instead of printing out dozens of posters, employers can also purchase an all-in-one poster that covers both Washington and Federal poster requirements by clicking here .

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Notice to Employees	
It’s the law! 	Employers must post this notice where employees can read it. 	
(Revised Code of Washington 51.14.100)	
If a job injury occurs
Your employer is self-insured. You are entitled to all of the 
benefits required by the state of Washington’s workers’ 
compensation (industrial insurance) laws. These benefits 
include medical treatment and partial wage replacement 
if your work-related injury or disease requires you to miss 
work. Compliance with these laws is regulated by the 
Department of Labor & Industries (L&I).
What you should do
Report your injury.	 If you are injured, no matter how minor 	
the injury seems, contact the person listed on this poster.
Get medical care.	 The first time you see a doctor, you may 	
choose any health-care provider who is qualified to treat 
your injury. For ongoing care, you must be treated by a 
doctor in the L&I medical network. (Find network providers 
at 	www.Lni.wa.gov/FindADoc	 .)	
Qualified health-care providers include: medical, osteopathic, 
chiropractic, naturopathic and podiatric physicians; dentists; 
optometrists; ophthalmologists; physician assistants; and 
advanced registered nurse practitioners.
File your claim as soon as possible.	 For an on-the-job injury, 	
you must file a claim with your employer within one year 
after the day the injury occurred. For an occupational 
disease, you must file a claim within two years following 
the date you are advised by a health-care provider in 
writing that your condition is work related.	
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: 	 	
For additional information or help with a workers’ compensation issue you can contact 	
the Ombudsman for Self-Insured Injured Workers at 1-888-317-0493.	
Upon request, foreign language support and 
formats for persons with disabilities are available. 
Call 1-800-547-8367. TDD users, call 360-902-5797. 
L&I is an equal opportunity employer.	
About required workplace posters 
Go to 	www.Lni.wa.gov/RequiredPosters	 	
to learn more about workplace posters from 	
L&I and other government agencies.	
Self-Insurance Section
Depar tment of Labor & Industries
P.O. Box 4 4 89 0
Olympia WA  9 85 0 4 -4 89 0	
On the web: 	www.Lni.wa.gov	PUBLICATION F 207-0 37-9 0 9  [12-2012]

Aviso a los empleados	
¡Es la ley! 	Los empleadores deben colocar este aviso en un lugar donde puedan leerlo los empleados. 	
(Código Revisado de Washington 51.14.100)	
Si ocurre una lesión en el trabajo
Su empleador está autoasegurado. Usted tiene derecho 
a todos los beneficios requeridos por las leyes de 
compensación para los trabajadores (seguro industrial) 
del estado de Washington. Estos beneficios incluyen 
tratamiento médico y sustitución parcial de su salario si no 
puede trabajar como resultado de su lesión o enfermedad. 
El cumplimiento de estas leyes está regulado por el 
Departamento de Labor & Industrias (L&I).
Lo que usted debe hacer
Reporte su lesión.	 Si usted se lesiona, aún cuando la lesión 	
parezca ser minima, comuníquese con la persona indicada 
en este cartel.
Obtenga atención médica.	 La primera vez que usted visite 	
a un doctor, usted puede escoger a cualquier proveedor de 
cuidado de la salud que esté calificado para tratar su lesión. 
Para cuidado continuo, usted debe recibir tratamiento 
de un doctor de la red de proveedores médicos de L&I.  
(Encuentre proveedores de la red en 	www.Lni.wa.gov/	
Spanish/ClaimsIns/Claims/FindaDoc	 .)	
Los proveedores de cuidado de la salud calificados 
incluyen: médicos generales, osteópatas, quiroprácticos, 
médicos de naturopatía y podiatría, dentistas, 
optometristas, oftalmólogos, asistentes de doctor y 
enfermeras registradas de práctica avanzada. 	
Presente su reclamo lo más pronto posible.	 Para una lesión 	
en el lugar de trabajo, usted tiene que presentar un reclamo 
con su empleador dentro de un año a partir de la fecha en 
que ocurrió la lesión.  Para una enfermedad ocupacional, 
usted tiene que presentar un reclamo dentro de dos años 
después de la fecha en la que un proveedor de cuidado de 
la salud le haya notificado por escrito que su condición está 
relacionada con su trabajo.	
Para reportar una lesión:
Si sufre una lesión en el trabajo o se 
le presenta una enfermedad ocupacional, 
repór telo inmediatamente a la persona 
indicada abajo:
Nombre: 	 	
Teléfono: 	 	
Para información adicional o ayuda con un asunto relacionado con la compensación 
para los trabajadores, se puede comunicar con el Ombudsman (defensor) de la sección 	
de trabajadores lesionados autoasegurados al 1-888-317-0493.	
A petición del cliente, hay ayuda disponible para personas que 
hablan otros idiomas y otros formatos alternos de comunicación 
para personas con discapacidades. Llame al 1-80 0-547-8367. 
Usuarios de dispositivos de telecomunicaciones para sordos 
(TDD, por su sigla en inglés) llamen al 360-9 02-5797. L&I es un 
empleador con igualdad de oportunidades.	
Información sobre los carteles requeridos 	
en el lugar de trabajo	
Vaya a 	www.Lni.wa.gov/IPUB/101- 054-999.asp	 	
para aprender más sobre los carteles del lugar de 
trabajo de L&I y de otras agencias gubernamentales.	
Self-Insurance Section
Depar tment of Labor & Industries
P.O. Box 4 4 89 0
Olympia WA  9 85 0 4 -4 89 0	
En Internet: 	www.Lni.wa.gov	PUBLICACIÓN F 207-0 37-9 0 9  [12-2012]

Other Washington Labor Law Posters 5 PDFS

There are an additional three optional and mandatory Washington labor law posters that may be relevant to your business. Be sure to also print all relevant state labor law posters, as well as all mandatory federal labor law posters.

Poster Name Poster Type
Mandatory Notice to Employees of Workers' Compensation in the State of Washington Workers Compensation Law
Mandatory Job Safety and Health Law in the State of Washington Job Safety Law
Mandatory Your Rights as a Worker in Washington State General Labor Law Poster
Mandatory Domestic Violence Leave Factsheet General Labor Law Poster
Mandatory Notice to Employees of Self-Insured Employers Workers Compensation Law

View all 4 Washington labor law posters


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** This Document Provided By LaborPosters.org **
Source: http://www.laborposters.org/washington/364-notice-to-employees-of-self-insurance-poster.htm