Your initial report may have generated an email that included a claim number, if you indicated that you intended to seek medical attention.  If you did not receive this email or now wish to seek medical attention and need a claim number, or if you have other questions about your claim and medical follow up, please call the Puget Sound Workers Compensation Trust Claim Inquiry line at: (425) 917-7638

Everett Public Schools is self-insured and uses a third party administrator, Puget Sound Workers Compensation Trust, to manage our claims.

If you seek medical treatment related to your work injury, you will need the physician to provide you with an Activity Prescription Form (APF). This form will dictate whether you are able to return to work fully, with restrictions, or if you cannot return to work.

If your APF has any physical restrictions on it the Benefits team will need to confirm with your building that they can be accommodated prior to your return to work.

Each time you seek medical treatment from your physician you will need to provide the APF to the benefits office within 1 day of your visit. This form helps us to track your lost time and ensure you receive the proper district pay and any time loss benefits from PSWCT. 

If you are out of work for more than three days related to this injury, we will need a time loss form completed by you in order to make sure you are paid correctly.

Be sure to enter your time off into Frontline Absence Management. For doctor's visits, please enter the absence time as sick time. If you are restricted from working by your medical provider due to the injury, please enter your absence time as L&I Disability. Unreported absences will need to be submitted to your supervisor on an Absence Verification form as soon as possible if you were unable to submit your time in Frontline.

Each time you seek care related to your injury, you will need the physician to provide you with an Activity Prescription Form (APF) and provide this to the benefits office within one (1) day of your visit. The working restrictions typically have a time frame associated with the restriction. Once the restriction deadline has passed, the district can presume that you can return to work in your full capacity. If you feel continued restrictions are needed, you need to discuss this with your physician and provide another APF with any ongoing restrictions. Be sure to keep track of the dates of restrictions and schedule ongoing appointments as needed.

While you are away from work and L&I is paying you, the district needs to know how you would like to be paid from us.

A Time Loss form is required to let us know your wishes. You will receive this form, uniquely updated with your information, from the benefits office. 

You have three choices you will designate on the form to determine any pay you receive while on leave.

• you want ONLY the amount that workman’s compensation will pay you,
• you want the district to use part of your accrued leave balances to make up the difference while you are out of work,
• or, you want to use a FULL day of leave in addition to what L&I is paying you.

Students needing medical attention should be referred to the school nurse. Additionally, you should report the accident/injury to your supervisor. Supervisors have a separate communication follow up requirement with the student/parent involved in the incident.