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An Employee’s Guide To Understanding Labor and Industries Washington State Rules

labor and industries washington state rulesWrapping your head around all the Labor and Industries Washington state rules can send you into a frenzy.

There’s an official document by the Department of Labor and Industries (L&I), but it’s a 40-page, jargon-heavy read.

If you want a quick and easy guide to the main rules, read this Employee’s guide below. You’ll have a broad understanding of most rules to obtain worker’s compensation — and if you need additional help, speak with one of our lawyers.

Who can get workers’ compensation from L&I?

Anyone that sustains an injury or contracts an illness from their workplace can apply for worker’s compensation (Washington Labor and Industries claim). That includes physical injuries, occupational diseases like certain cancers or leukemia, and mental health issues (depression, anxiety, burnout, and other mental illnesses also count).

In other words, if you sustain any injury at the workplace which requires medical treatment (and usually time off work), you can claim worker’s compensation to cover medical expenses and possible wage losses.

How to file for workers’ compensation?

For workers in Washington state, you can file your claim via Labor and Industries online, by phone at (877) 561-3453 or with a doctor.

If you decide to file yourself with the L&I, you’ll need to hand in reports, forms, and requested medical assessments.

Any doctor in Washington can file an L&I claim and if you trust your personal doctor, this can be the best approach. They’ll fill in all the paperwork for you to avoid any mistakes.

Once your claim has been filed, your claim will be assigned to an L&I case manager. You may also be required to undergo an independent medical examination (IME) which consists of an “interview” with a doctor chosen by L&I.

They’ll ask you questions about your injury and assess what compensation you deserve (we’ll discuss IMEs later in this guide).

After your claim is reviewed, you’ll see what compensation you earned. It is possible to appeal if you believe the compensation isn’t adequate.

Worker’s compensation with self-insured employers

Keep in mind what we detailed above is for employers that pay premiums into L&I. Some companies in Washington outsource their workers’ compensation to insurance firms instead. These are known as self-insured employers.

These insurance firms have a different approach. The start of the process (a doctor’s assessment and completing forms and documents ) are very similar, but the approval process with an insurance firm has less transparency.

Insurance firms will do their best to make sure you don’t get compensation — and if you do, that it’s the lowest amount possible.

That’s why you need to be alert with self-insured employers (never go to a doctor they recommend) and hire a lawyer to make sure the insurance firm isn’t underpaying you.

What benefits can I receive from L&I?

The amount of workers’ compensation you receive depends on the rating L&I gives to your injury.

Many workers are unaware of this, but L&I has a rating system for injuries from least  severe to most severe. Depending on the rating, compensation can change in the 6-figures.

And this assessment is mostly done on the category of your injury and the IME (if you had one). That’s why it’s important to check the diagnosis the IME doctor makes and if it’s different from your personal doctor’s, you should appeal.

Here are the 3 benefits you can receive:

  • Lifetime pension: if you have an injury that makes it impossible for you to return to work, you can earn a monthly pension from L&I for the rest of your life
  • Structured settlement: a lump sum paid by L&I for medical expenses and wage losses
  • Permanent Partial Disability (PPD): one-time payment for a disability you got from work, but which still allows you to perform your duties

Learn more about workers’ comp settlements here.

Do employees pay L&I?

No. L&I is funded with premiums paid by companies based in Washington State — the employees don’t need to contribute a dime.

Premiums paid by employers depend on their industry and the hours worked by their staff.

In the case of self-insured employers, instead of paying premiums to L&I, they pay fees to insurance companies and it works more like an “outsourcing contract” rather than a tax.

How does the IME work?

Even if you have already been diagnosed by a doctor, L&I may require that you go to an independent medical examiner of their own to assess your injury.

This assessment consists of a 30-minute interview, in which the L&I doctor will ask about the circumstances and severity of your injury. This is the time to be crystal clear and describe in detail how you got injured.

Keep in mind the doctor can write down in the report anything you say. So even a muddled thought or phrases such as “Hmm, I guess so” can be used against you. Be objective and discrete — don’t answer questions that aren’t about the injury.

This 30-minute interview will be the basis for L&I to determine what compensation you deserve. That’s why it’s crucial you prepare with a lawyer for the IME and you should record the conversation or bring a relative or friend with you to the appointment.

You have full rights to a recording and if you ever need to appeal, this recording can back it up.

Should I hire a lawyer for my workers’ compensation claim?

Filing for worker’s compensation with L&I is a stressful, time-consuming process and can be a major headache when you should be focused on healing from your injuries.

This is especially true with self-insured employers; while L&I can be tricky, at least it has more guidelines to follow to provide you with fair compensation.

Meanwhile, self-insured employers hire insurance companies that have a vested interest in making you ditch the claim so they can keep the money. They’ll create many obstacles to wear you down and make you give up.

A worker’s compensation lawyer has plenty of experience already on these setbacks and knows how to navigate to get your claim approved. It’s their 9 – 5 job and they’ll perform it professionally while you rest.

Get in touch with our lawyers with over 15 years of experience in L&I!

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