Report an Incident

Not all incidents become claims, but employees can file a claim up to one year after the incident. Documenting the string of events that lead to the incident while the information is fresh in your mind will increase understanding for all if it should evolve into a claim.

You can report an incident online or, if you were provided an incident packet, you can email or fax a completed incident report to ERNwest.

All claims are unique.

If you haven’t filled out an incident report or need more information, please call your ERNwest claims manager so they are aware and can guide you through the process. If you don’t know your claims manager, please fill out our Find Your Claims Manager form.

When should I call Labor and Industries?

Contact L&I when there is a death, probable death or in-patient hospitalization. Download our Serious or Fatal Injury Packet to guide you through best practices and requirements following the initial emergency response.

NOTE: Employers must report the death or in-patient hospitalization of any employee to L&I (within 8 hours) and any non-hospitalized amputation or loss of eye (within 24 hours) due to an on-the-job injury by calling 1-800-423-7233.

Claim re-opening?

If you have any indication that a claim might be re-opened, please call your ERNwest claims manager.

These are just some of the questions your ERNwest team can help you answer.

  • What if my employee was injured on the job and did not return to work?
  • What do I do if my employee has restrictions?
  • What if the witness statement does not match the incident report, or there are red flags on the claim?
  • Why should I avoid having Labor and Industries pay Time Loss?
  • What if my employee sustained a work-related injury that did not allow them to come back to their job immediately?
  • What is a reasonable time to expect them back and what do I do?
  • When should I utillize KOS (Kept on Salary)? Is it always beneficial to do so?

Submit an Incident Report

Get in touch with your claims representative quickly by completing the form below.

Injured Worker's Information


Incident Information

MM slash DD slash YYYY
Employer questions claim/injury?
Required off site medical attention?
Admitted to hospital?

Submitter's Information

Name of person submitting form(Required)
This field is for validation purposes and should be left unchanged.

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