L&I and Workers' Compensation Claims Process

Emery | Reddy PLLC’s Seattle workers’ compensation 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’ compensation claim process works in Washington state.

What Is An L&I Claim?

The Washington State Department of Labor and Industries (L&I) is a system that covers workers who are hurt on the job and can provide them with medical care, disability, rehab, pensions, time-loss compensation, and more.

The process that follows L&I claim status is this:

• A worker is injured.
• The worker sees a doctor (referred to as L&I medical treatment).
• The worker files a claim with L&I.
• The worker completes their medical care.
• The injured worker receives a disability rating through an Independent Medical Exam (IME).
• L&I claim is closed.

How To Start The Workers’ Compensation Claims Process

Navigating an L&I claim can be extremely complex and time-consuming, even when you’re not the injured or sick party.

Get Prompt Medical Attention

If you are injured at work and require medical treatment, visit the emergency room or a healthcare provider right away. Be sure to inform the physician that you sustained the injury on the job.

How to Choose a Workers’ Compensation-Friendly Doctor

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 Department of Labor and Industries website.

Did you visit a doctor or emergency room not covered by L&I when you were first injured? Not to worry—if your L&I claim is approved, L&I will cover the initial visit even if it wasn’t with one of their approved doctors.

Notify Your Employer About The Injury

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 begin work on your workers’ compensation claim process.

When To Contact An L&I Attorney

You have the right to have an attorney represent you in an L&I claim case, though it is not required by law. It is wise, however, to have someone in your corner who knows their way around the difficult and convoluted procedures of L&I claims and workers’ compensation claims.

Whether or not you need an L&I attorney depends on the case. If the case is simple, with plenty of witnesses and well-substantiated doctors’ notes, you might be okay to go through your L&I claim on your own. On the other hand, if there is any doubt, getting a dedicated L&I attorney can save you a world of headaches (and quite possibly get you a much larger payout than you may have been able to secure on your own).

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 (such as sitting in a room and watching safety videos all day) 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. These are some L&I situations in which you would want to get an L&I attorney involved.

File A Workers’ Compensation Claim

Employees who are injured on the job can file an L&I claim online, by phone at 877.561.3453, or at their doctor’s office. This will begin the workers’ compensation claim process.

L&I Paperwork

The injury L&I claim officially goes on file when the doctor submits the workers’ compensation paperwork to L&I. Paperwork varies depending on the type of claim. An attorney will determine the nature of your claim, process the appropriate forms, and keep records of all paperwork. Any correspondence, phone calls, or other negotiations with L&I or your self-insured employer will also be the responsibility of your lawyer.

Important L&I Claim Deadlines And Statute Of Limitations

In Washington state, your workers’ compensation claim must be submitted within one year of your injury date. This time frame might be extended if your claim involves a lengthy diagnosis process for an occupational disease; you have two years from the date of your doctor’s diagnosis, to file your claim.

How To Handle Roadblocks Or Unexpected L&I Claim Complications

The best way to prevent any complications is to hire an experienced workers’ comp attorney at the start of the workers’ comp claim process. We will manage all the details of filing your workers’ compensation claim, including any paperwork from your doctor. As an advocate for your best interests, your lawyer will see to it that your physician submits reports within the required timeframes, and will check the status of your claim by following up to make sure that L&I processes your claim in a timely manner. To avoid any mix-ups that could delay your L&I claim, a lawyer can also assist you in the event that any of your personal information changes.

L&I Claim Approval

Once your L&I claim has been approved, you will receive a written order from L&I explaining your benefits.

Getting Your L&I Benefits

Workers’ compensation benefits will cover your medical bills and treatments. If you are eligible for additional benefits, the L&I attorneys at Emery | Reddy, PLLC will help you proceed with seeking wage replacement, return-to-work help, pensions, or disability compensation if necessary.

Handling Rejected L&I Claims

If your workers’ compensation claim is rejected for any reason, it is in your best interest to enlist the help of an experienced L&I attorney to protest and appeal your denied injury claim. You may protest any L&I decision within 60 days of the date of the decision by writing a letter to your claim manager. If you disagree with the decision regarding your protest, you may appeal to the Board of Industrial Insurance Appeals.

Returning To Work

If your workers’ compensation claim is rejected for any reason, it is in your best interest to enlist the help of an experienced L&I attorney to protest and appeal your denied injury claim. You may protest any L&I decision within 60 days of the date of the decision by writing a letter to your claim manager. If you disagree with the decision regarding your protest, you may appeal to the Board of Industrial Insurance Appeals.

Closing The L&I Claim

An L&I claim closes when a physician certifies that further treatment will not improve a worker’s condition, when L&I does not have documentation that the employee requires further treatment, or when treatment is successful and complete.

Protest Or Appeal A Closed L&I Claim

In some cases, a worker, doctor, or employer may disagree with the L&I decision to close or reject a claim and any of these parties may protest or appeal the L&I ruling. Our attorneys will manage the appeals process to ensure that any ruling is in your best interest as a worker.

How To Win An L&I Claim Case

It takes tenacity, intelligence, and experience to win the maximum benefits and monetary award that you are entitled to under Washington state law. You need an experienced litigator in your corner. Our L&I attorneys come from a background in insurance defense litigation, complex and multi-party litigation, criminal prosecution, and federal plaintiff’s litigation. The courtroom is where we shine. You won’t find another firm in Washington state that is better at representing injured workers for their L&I claims.

Call Emery | Reddy, PLLC today for your free case review. Please remember to have your L&I claim number readily available.