4.050 - On-Duty Illness or Injury

Effective Date: 9/18/2013


This policy applies to all employees who report or investigate a work-related illness or injury.

1. Employees Report a Work-Related Illness or Injury to a Sergeant/Supervisor

Sergeants/supervisors will investigate reported or observed job-related illness or injury to an employee under their command.

See 4.050-PRO-1 Reporting and Investigating Job-Related Illness or Injury

For additional information: City Workers’ Compensation Link

Sergeants/supervisors may refer to the Supervisor’s Resource Guide for additional information.

2. Sergeants/Supervisors Complete Electronic Timesheets for Employees Off Work Due to On-Duty Injury/Illness

Sergeants/supervisors will record the employee earning regular pay for the remainder of the day that they were injured. 

Sergeants/supervisors will mark the timesheet “WD” for time the employee is absent from work due to their on-duty injury/illness. 

If timeloss is not approved by workers comp the WD hours will be converted to sick hours using the employees available time balances.

3. Eligible Employees May Buy Back Retirement Service Credit for Absences Resulting From On-Duty Illness/Injury

Employees may buy back service credit after they return to regular paid status or separate from employment.

LEOFF II members may contact DRS (Department of Retirement Systems) at (360) 464-7000 or toll free at 1 (800) 547-6657; pressing “0” to speak with a live representative.  Sworn employees may view the Department of Retirement Systems policy from this link:  http://www.drs.wa.gov/

Civilian employees may contact SCRS (Seattle City Employees’ Retirement System) at (206) 386-1293.  Non-sworn employees may view the Seattle City Employees’ Retirement System policy from this link:  www.seattle.gov/retirement/

4.050-PRO-1 Reporting and Investigating Job-Related Illness or Injury


1. Requests a sergeant/supervisor respond to the injured/ill employee’s location.


2. Investigates the circumstances surrounding the injury or illness.

3. Completes an Investigating Supervisor's Report of Employee's Industrial Injury (form 2.22)

a. Sends the original to the Employment Services lieutenant.

b. Provides the employee with a copy.

4. If the employee requires time off work, completes a Medical Absence Report (form 2.11).

5. If medical treatment is required for a LEOFF 2 or civilian employee, completes a Self Insurer Accident Report (SIF-2).

  • Ensures the “employee” portion of the SIF-2 is completed by the injured employee.

6. Gives the employee a copy of the SIF-2

7. Gives the LEOFF 2 or civilian employee an electronic or paper copy of, “A Guide to Workers' Compensation Benefits” and, “Help for Injured Workers of Self-Insured Businesses.

8. Provides a Washington State Insurer Activity Prescription Form (APF) to the employee.

Note:  A health care provider must complete this form when an employee is treated for a duty-related illness or injury.

9. Makes a copy of the completed SIF-2 for unit records.

10. Delivers the completed SIF-2 form and the APF, if available, to the Employment Services Lieutenant within 24 hours of the incident.