We typically receive workers’ compensation claims via an injured worker completing our online SIF-2 form.

However, sometimes we are first notified of a workers’ compensation claim when we receive a document from the injured worker’s medical provider called the Provider’s Initial Report (PIR).

We are required to open a claim using the information on this form within 3 business days of receiving a PIR, even if the injured worker has not yet completed the SIF-2 online. While it is our practice to attempt to get in touch with the worker to have them file a claim, sometimes they are not responsive, even after we have made multiple attempts to contact them by phone.

The PIR form does not contain all the information we need to open a claim and does not provide the worker with a claim number for billing purposes. This is an area where we need help from our school district counterparts to enable the worker to file a claim in a timely manner.

If the worker has not filed a claim after 3 business days, we will need to file a dummy claim. This is a claim completed with basic information by one of our claims specialists to get the claim set up in our system. To file a dummy claim we require the worker’s email address, job title, and job location. We may also need other information from you if the PIR is missing information such as the worker’s Social Security Number, date of birth, or mailing address.

It is important that you respond to requests for this type of information within 24 hours, so that we can ensure your injured workers’ claims are filed within the required timeframe. Not doing so can result in penalties being assessed by LNI.

We appreciate your assistance. Please reach out to us if you have any questions by emailing pswct@psesd.org or calling (425) 917-7638.