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What Is an L&I Claim?
Medical Treatment and Independent Medical Exams (IMEs)
Wage Replacement and Vocational Benefits
Claim Closure and Permanent Disability Decisions
What If Your Claim Is Denied?
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What Is a Washington State L&I Claim?

A Washington State L&I claim is a workers’ compensation claim handled by the Department of Labor & Industries (L&I). It provides benefits to employees who suffer a workplace injury or occupational disease, regardless of fault. L&I claims may be handled directly by the state or by a self‑insured employer, depending on where you work.

Available L&I benefits may include medical treatment, time‑loss (wage replacement), loss‑of‑earning‑power benefits, vocational rehabilitation, permanent disability awards, and survivor benefits.

L&I Claim Review and Approval

After your claim is filed, L&I or the self‑insured employer reviews medical records and may request additional documentation. If the claim is approved, L&I will issue a written order explaining what benefits are available.

At this stage, many workers begin receiving medical coverage and time‑loss benefits. However, approval does not guarantee that all benefits will be fairly paid. Disputes often arise later regarding work restrictions, IMEs, and disability ratings.

Medical Treatment and Independent Medical Exams (IMEs)

Medical treatment continues while your claim is open, but L&I may require you to attend an Independent Medical Exam (IME). IMEs play a major role in determining whether your condition is work‑related, whether additional treatment is allowed, and whether you have reached maximum medical improvement.

Because IME opinions often conflict with treating doctors, they frequently impact benefit reductions and claim closure decisions.

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Wage Replacement and Vocational Benefits

If you are unable to work due to your injury, you may qualify for time‑loss or loss‑of‑earning‑power benefits. If you cannot return to your job permanently, L&I must evaluate vocational options, including retraining or job placement services.

Many claims stall or are prematurely closed during this phase, which is why understanding the next steps is critical.

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Claim Closure and Permanent Disability Decisions

Eventually, L&I moves toward claim closure, often after an IME finds you reached maximum medical improvement and a doctor releases you to work. Before closing a claim, L&I must decide whether you qualify for a Permanent Partial Disability (PPD) award or other long‑term benefits.

Claim closure can have lasting financial consequences. For a full breakdown, see our Washington State L&I claim closure page.

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What If Your Claim Is Denied?

Denied claims are common and often disputed successfully. If your L&I claim is denied, reduced, or closed too early, you may protest or appeal the decision within strict deadlines. Appeals may go through L&I or the Board of Industrial Insurance Appeals (BIIA).

  • 60 days to appeal a claim decision or a payment decision
  • 20 days for providers to appeal a billing decision that reduces the amount paid, or demands repayment
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HOW IT WORKS

How to File an L&I Claim

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How to File an L&I Claim in Washington State

In order to receive benefits from L&I there are two very important things that you must do right away, even before a claim is filed:

  • Get medical help.
  • Tell your employer.

If you are injured at work, you have three options to file a Washington state L&I claim:

Note that if you work with a self-insured employer (SIE), you must file your claim with them. Contact your employer’s human resources department for help.

To file an L&I claim in Washington state, you must provide the following:

  • The location where the injury occurred
  • Contact information for any witnesses to the injury
  • Employer information
  • Wage information
  • If you have already seen a doctor:
    • Your doctor’s first and last name
    • The hospital or clinic where you received treatment

If you are eligible for time-loss benefits and no further information is needed, L&I or your self-insured employer will send the first benefit check within 7 days of receiving the report. If your doctor is one of the many healthcare providers that do not handle workers’ compensation claim cases, you can find an L&I-approved doctor on the L&I website. If your L&I claim is approved, the State will cover the initial visit even if it wasn’t with one of their approved doctors.

L&I or your self-insured employer must receive your Report of Accident within 1 year of your injury date to file a claim. occupational disease claims must be received within two years of the date that your doctor notified you in writing that your injury is work-related.

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How Employment Law and Washington State L&I Claims Work Together

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Your Washington State L&I Claim Is Worth More If You Also Have an Employment Claim

A significant number of Washington state L&I claims often involve additional legal claims such as employment or third-party claims. Many people file their claims without seeking representation from an experienced local Seattle L&I attorney and thus never discover that, in addition to their Washington state L&I claim, they may be missing out on the ability to file an employment claim or a third-party claim. Pursuing additional legal action with the help of an experienced Seattle workers’ compensation and L&I attorney has the potential to significantly increase a claim’s overall compensation. At Emery | Reddy, our experienced Attorneys practice both Employment and Labor Law and Workers’ Compensation Law, which means we will investigate all aspects of your claim to make sure you aren’t missing out on any potential benefits.

What Is an Employment Claim?

Many injured workers find that their employer has taken, or plans to take, adverse action against them because they filed an L&I claim or they are out of work. You can file a lawsuit against your employer for several reasons, including retaliation, wrongful termination, discrimination, or unpaid wages. An L&I attorney who is experienced in both L&I — Workers’ Compensation Law and Employment and Labor Law can help you with your Washington state L&I claim while simultaneously filing a federal or state law claim for the violation of workers’ rights by your employer.

What Is a Third-Party Claim?

A third-party claim is one in which someone other than your employer or co-worker is responsible for your injury. If you have been injured on the job due to someone else’s actions or negligence, you may be entitled to additional compensation through a third-party claim, which combines your Washington state L&I claim with a personal injury claim using the same facts.

Unlike workers’ compensation payments, there is no limit to the amount of compensation an injured worker may seek in third-party damages. Third-party claims are private matters and are typically litigated directly with the Washington State Superior Court.

Who Is at Fault for a Workplace Injury?

L&I is a no-fault system, ensuring compensation for any industrial disease. However, if a third party is involved in causing your illness, you may be able to pursue legal action against them for additional compensation under third-party claims.

How Do I Know If I Have a Strong Washington State L&I Claim?

If you have a Washington state L&I claim or wonder if you should contact an experienced Washington workers’ compensation attorney, ask yourself the following:

  • Have I been denied the medical benefits to which I am legally entitled?
  • Has L&I asked me to undergo an Independent Medical Exam (IME)?
  • Do I have questions about the Washington state L&I claim process?

If any of the above apply to you, Emery | Reddy may be able to help.

Navigating a Washington state L&I claim can be difficult and very time-consuming, especially when you’re ill or injured. You want to focus on healing and make sure your bills are paid, but if you don’t file things properly or on time, your health, home, and job could be in jeopardy. Many individuals miss out on much-needed L&I benefits because they don’t understand what to do or how to get the most compensation for their injuries. If you are experiencing any challenges in your case, a Seattle workers’ compensation and L&I attorney can assist you. By contacting Emery | Reddy as soon as possible after you’ve been injured, we can help you avoid the common pitfalls of filing and navigating an L&I claim. Our local Washington L&I attorneys are here for you every step of the way.

When to Speak With a Washington L&I Attorney

If you are concerned that your L&I claim has been undervalued, closed too early, or denied important benefits, speaking with a workers’ compensation attorney can help clarify your options. Emery | Reddy represents injured workers throughout Washington State in L&I claims involving benefit disputes, PPD ratings, vocational issues, settlements, and disability pensions.

Call today for a Free Case Review. No fee unless we recover for you.

Want More Information?

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Claim Value

To determine the value of your L&I claim, you first need to understand the different types of L&I awards offered in Washington state.

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L&I FAQ

The Labor and Industries claim process is anything but straightforward. Find out the answers to your L&I — workers’ comp questions today.

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Self-Insured Employer Claims

Self-insured employers account for one-third of workers’ compensation in Washington state. Find out more about how to handle SIEs.

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