Denied L&I Claims in Washington State

How to Challenge a Denied Workers’ Comp Claim

If your workers’ comp claim is denied in Washington, you may file a protest or appeal.

• Protest: A protest is a written request asking L&I to reconsider its decision. This is often the first step and allows you to submit additional evidence, such as updated medical records or witness statements. In some cases, a strong protest can result in a reversal without further legal action.

• Appeal: If the denial is not resolved through a protest, or if you choose to proceed directly, you can file an appeal with the Board of Industrial Insurance Appeals (BIIA). This is a more formal legal process that may involve hearings, evidence, and testimony before a judge.

Both options require careful documentation and strict adherence to deadlines.

How to Protest a Vocational Determination

If you disagree with a vocational determination on your claim, you may submit the Vocational Dispute Form with your concerns. The dispute form is not required but may prove to be a useful tool.

You may appeal in writing to:

The Washington State Department of Labor and Industries
Vocational Dispute Resolution Office (VDRO)
P.O. Box 44880
Olympia, WA 98504-4880

Your dispute must be sent within 15 calendar days of receipt of a notification letter. The 15-day deadline may be extended by VDRO if good cause is shown. It’s best to dispute on time. If you miss this deadline, you can try reconsideration or appeal, which have 60-day deadlines.

Are Time-Loss Benefits Affected During the Vocational Dispute Period?

L&I will not pay time-loss benefits during the VDRO review process or if the vocational determination finds the injured worker employable.

Can You Reopen a Denied Workers’ Compensation Claim?

If your workplace injury or occupational disease worsens, you and your doctor may apply to reopen your L&I claim. There must be medical evidence from an L&I-approved provider stating that after your claim closed, the condition caused by the original workplace injury worsened and needs more medical attention. Once you have this evidence, you should reach out to an experienced Seattle L&I attorney.

The amount of time that you have to reopen your Washington state L&I claim depends on the benefits you are seeking.

• For medical treatment only, you may apply at any time.
• For both wage replacement benefits and medical treatment, apply within 7 years of the date your claim was first closed (10 years for eye injuries).
  • If your claim has been closed for more than 7 years, you may apply for medical benefits. However, only the L&I Director may grant additional disability benefits such as wage replacement or disability awards for these claims.

Strengthening Your Case After a Denial

To improve your chances of overturning a denied L&I claim, it’s important to gather strong supporting evidence, including:

• Detailed medical records and provider opinions
• Independent Medical Examinations (IMEs)
• Witness statements or incident reports
• Employment and wage documentation

Even valid claims can be denied when documentation is incomplete or unclear, which is why building a well-supported case is essential.