Emery | Reddy PLLC’s Seattle L&I attorneys have decades of combined experience in handling L&I claims and are here to guide you through the process. Here’s how the workers’ comp claim process works in Washington State.

What Is An L&I Claim?

The Washington Department of Labor and Industries (L&I) is an agency that handles workers’ compensation claims (referred to as L&I claims). Some of the benefits available through L&I include:

• Medical costs
• Ongoing medical coverage including surgery costs
• Lost back wages
• Permanent partial disability (PPD) award
• An L&I pension

How To Start The L&I Workers’ Comp Claim Process

Navigating an L&I claim can be extremely complex and time-consuming, even when you’re not the injured or sick party. Follow the steps below to ensure that your L&I claim is closed quickly and in your best interests.

Get Prompt Medical Attention And Notify Your Employer

In order to receive medical 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.

L&I, or your self-insured employer, can approve your claim if your doctor certifies that you were the victim of a workplace injury, or if you have an occupational illness. If your L&I claim is approved, you may be eligible for medical benefits.

Promptly alerting your employer of the injury will allow enough time for them to understand the situation and respond quickly upon receiving your L&I claim paperwork. They can then begin work on your workers’ comp claim.

Be Wary Of Employers’ Behavior With An L&I Claim

L&I offers incentives to employers that have no claims, or “medical-only” claims. This is done with good intent L&I wants employers to create a workplace that is free from injury, accident, or risk of illness. However, these employers receive a “claim-free” discount from L&I, meaning that it is in the employers’ best financial interest to make sure that there are no L&I claims.

In some cases, bad employers may twist this advantage to discourage workers from filing an L&I claim at all, even when one is fully warranted. These employers will often make an argument that an injury is less severe than the employee claims. They will also manufacture jobs for the claimant to do while they recover so that the employee cannot claim that they lost hours.

In each of these cases, the employer is skating around L&I law, and what they are doing might be legal but is often unethical. This is a situation in which you would want to have an experienced L&I attorney on your side.

How To File An L&I Claim In Washington State

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

• File by phone at 877.561.3453.
• File online through the L&I website’s File Fast tool.
• File at your doctor’s office.

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
• Names and birth dates of your dependents

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, and no further information is needed, L&I or your self-insured employer sends the first benefit check within 14 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. When your L&I claim is approved, L&I will cover the initial visit even if it wasn’t with one of their approved doctors.

Statute Of Limitations For Work Injuries And Occupational Illness In L&I Claims

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 illness claims must be received within two years from the date that your doctor notifies you in writing that your injury is indeed work-related.

How To File A Self-Insured Employer Claim In Washington State

If you work for a self-insured employer, you must file your claim directly with them. Contact your employer’s personnel department for help.

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 illness claims must be received within two years from the date that your doctor notifies you in writing that your injury is indeed work-related.

How To Choose A Workers’ Compensation-Friendly Doctor

Medical benefits will be available to you for as long as your claim is open, even if you have returned to work. Your first visit to a doctor for a workplace injury is covered by L&I, even if your claim is not approved. If you need medical care after the first visit, you will need to see an approved provider in the L&I network.

Complete An Independent Medical Exam (IME)

An IME is a medical evaluation requested by L&I or a self-insured employer to review your medical history and the details of your accident to establish findings, opinions, and conclusions about your physical condition. IMEs are conducted by approved L&I providers.

The purpose of an IME is to help the insurance company determine the reality and extent of your injury. The L&I doctor’s findings are then used to deny or award benefits for your workers’ compensation claim to help you recover and pay for treatment. Here are our tips on how to beat an IME exam and see past IME doctor tricks.

L&I Claim Status

If your L&I claim is approved you will receive a written order from L&I explaining your benefits. You have the right to a variety of L&I benefits to help pay for medical treatment costs and replace lost wages during the recovery period.

Getting Your L&I Benefits

Workers’ compensation benefits will cover your medical bills and treatments. If you are eligible for additional benefits, the Seattle L&I attorneys at Emery | Reddy will help you proceed with seeking wage replacement, return-to-work help, pensions, or disability compensation if necessary—things that L&I won’t offer you unless you fight for it. Remember, they will often do as little as possible to get you back into the workforce.

Closing The L&I Claim

An L&I claim closes when an L&I-approved provider certifies the following:

• The worker is at maximum medical improvement (MMI).
• The worker has been released to work.

What If Your Claim Is Denied?

You, your employer, and your doctor all have the right to protest any decision made about your workers’ compensation claim. L&I must receive a written protest within 60 calendar days of the date the decision was received (15 days for decisions about vocational benefits) or the decision will become final.

You may also appeal directly to the Board of Industrial Insurance Appeals (BIIA). The decision becomes final if your written appeal is not received within the following legal time limits from the date you received the decision:

• 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

Reopen A Claim

If your workplace injury or occupational disease worsens, you and your doctor may apply to reopen your 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. The amount of time that you have to reopen your 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.

Your L&I Claim Is Worth More If You Also Have An Employment Law Claim

A significant number of L&I workers’ compensation claims often involve additional legal claims such as employment law or third-party claims. Many people file their claims without seeking representation from an L&I attorney and thus never discover that in addition to their L&I claim, they may be missing out on the ability to file an employment law claim or a third-party claim. Pursuing additional legal action with the help of an experienced labor and industries lawyer has the potential to significantly increase a claim’s overall compensation.

What Is An Employment Law 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, disability discrimination, or unpaid wages. An L&I attorney who is experienced in both L&I workers’ compensation law and employment law can help you with your 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 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.

Who Is At Fault For A Workplace Injury?

L&I is a no-fault system, ensuring compensation for any workplace injury. However, if a third party is involved in causing the injury, 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 Case?

The bottom line is that anyone who isn’t familiar with L&I claims should seek the input of experienced L&I attorneys who are.

After years of helping injured workers, Emery | Reddy has recovered hundreds of millions for our clients. Our team of L&I attorneys is experienced in litigating and L&I claims, injury law claims, and employment violations. We understand how to leverage each claim in state (or federal) court and before the Board of Industrial Insurance Appeals to maximize the value of all of your claims.

Emery | Reddy Can Help You With Your L&I Claim

Emery | Reddy is the only law firm in Washington State that is equipped to provide comprehensive representation on your case from every angle. Our Seattle L&I attorneys thoroughly assess every case to determine if our clients have additional claims, and at times this can extend far beyond the underlying workers’ compensation claim.

If you have been injured in the workplace call Emery | Reddy today to speak with our legal team for a free case review. Please remember to have your L&I claim number readily available.

Want More Information?

Claim Value

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

L&I FAQ

The L&I workers’ compensation process is anything but straightforward. Find out the answers to your L&I workers’ comp questions today.

Self-Insured Employer Claims

Self-insured employers account for one-third of workers’ compensation in Washington State, and they provide benefits directly to injured workers.

Meet The Team

The L&I attorneys at Emery | Reddy are passionate about helping workers with L&I claims and employment law issues. We Help Workers®: it’s our motto and it’s what drives us every day.

We know how L&I and big companies think, and we understand the tactics they use. Our labor and industries attorneys use that knowledge coupled with over two decades of experience to help our clients get access to the L&I benefits to which they are legally entitled and hold employers accountable when they break the law.

If you’re struggling with an L&I claim, injury, or legal issue at work, please call us and see how Emery | Reddy can help you today.