L&I Settlement Amounts
Sometimes the cost to heal a work-related injury or illness far exceeds the standard benefits. Sometimes the injured worker can never return to work or the same line of work. In these cases, L&I may choose to settle with the injured worker or provide them with a pension.
L&I settlement amounts vary widely and typically fall into three categories:
- Pensions: these are typically lifetime monthly payments for a person who cannot return to work.
- Permanent Partial Disability (PPD): lump sum payments for a person who can return to work.
- Settlements: Washington law allows for Claim Resolution Settlement Agreements (CSRA) and structured settlements. Both options allow a person to settle and close an L&I claim for a lump sum payment.
Below you’ll find a breakdown of each of these categories to help you obtain a deeper perspective on how L&I settlement amounts are calculated and how they can vary in real-life situations.
How L&I Settlements In Washington State Work
In Washington, the money awarded to a claimant is determined by numerous factors, such as the date the injury occurred, the severity of the injury, and the steps the injured worker takes to receive the compensation they need.
The first thing injured workers must do is see a doctor who will help them fill out a “Report of Accident” (ROA) form. You will also need to use an L&I-approved provider.
After receiving your medical examination, be sure to file your L&I claim within one year for an injury and within two years for an occupational disease. Once the claim is filed, keep tabs on its status. An L&I attorney can be enormously helpful in this process.
While waiting for your claim settlement, be sure to secure time-loss compensation, which makes up for the wages lost while you cannot work. It is also important to adhere to your doctor’s recommendations during this time.
In time, the Washington Department of Labor & Industries will review your claim to determine your settlement. An L&I attorney can ensure you receive a favorable outcome commensurate with your injury or illness.
When Will My L&I Settlement Amount Be Paid?
L&I settlements are paid out once the claim is closed, though the total settlement amount awarded upon claim closure depends on the size of the settlement.
How Will My Payment Be Made?
Small L&I settlement amounts are paid out via check if the settlement award amount is less than three times the state’s average monthly wage on the day the claimant was injured. Settlements larger than that amount are typically paid in monthly installments according to the claimant’s monthly time-loss compensation.
A lifetime L&I pension (also known as Permanent Total Disability Pension) is a monthly lifetime annuity payment based on the amount of the injured worker’s wage at the time of injury and the number of their dependents. You may be entitled to a pension if you meet the following criteria:
- You sustained a workplace injury that is permanent and totally disabling.
- You are unable to ever return to work.
When it comes to L&I settlement amounts, negotiating this type of payout is quite involved, and the most difficult to obtain. It’s strongly advised that you work with an experienced L&I attorney if you were injured on the job and you’re permanently disabled to the point where you cannot return to work.
Who Is Qualified To Receive An L&I Pension Settlement?
People who cannot return to work in their lifetime due to injury can greatly benefit from L&I pensions. However, qualifying for a pension L&I settlement in Washington state is not an easy task. In fact, few L&I settlements are paid out via pensions.
There are no definitive qualifications to receive an L&I pension. Rather, the qualifications are based on judgments made by people, including claims managers, doctors, employers, and vocational counselors involved in the claim. In order to receive a successful outcome, those seeking L&I pensions need to be well-versed in the process from the beginning. Seeking help from experienced L&I attorneys can ensure you receive the pension benefits you deserve.
Examples of Successful L&I Pension Settlements
All labor and industries injury settlements are different, and there is no cookie-cutter example of a claim that results in a pension. However, several elements can contribute to both successful and unsuccessful pension claims.
- Successful case: A 62-year-old sawmill worker with a high school education develops a back injury and mental illness as a result of heavy physical labor on the job. After a medical examination, a doctor says that the worker cannot return to the workforce.
- Unsuccessful case: A 37-year-old office worker with a college degree develops anxiety and lower back pain resulting from a high-stress job. This person has held several different jobs in the past. After a medical examination, a doctor says that the worker could return to the workforce in a different line of work.
A structured settlement, also known as a Claims Resolution Settlement Agreement (CRSA), is a lump sum amount paid in regular installments or one large installment that is intended to permanently settle a workers’ compensation claim for a serious injury. L&I uses structured settlements in place of pensions to avoid pension payments or when a worker is not eligible for a pension.
The amount of workers’ compensation structured settlement varies widely and depends on a number of important factors, such as:
- The age of the injured worker (50+)
- The type and severity of the injury
- The length of time the claim has been open (180+ days)
- Inability to participate in vocational rehabilitation
- The threat of litigation if both sides cannot agree on the amount of the settlement
- The reputation of the attorney leading the negotiation
- The likelihood of the claimant prevailing
- The opportunity for the claimant to pursue a pension if a settlement is not reached
Having the right structured settlement lawyer at your side can affect L&I settlement amounts and the time it takes to successfully negotiate a resolution. This is one of the many situations where working with our firm is beneficial for an injured client. Our reputation precedes us, and we understand the process, know how to leverage your legal rights, and will litigate your claim to increase the overall settlement amount, if necessary.
Structured Settlement Benefits
The main benefit of a structured settlement is that it allows you to negotiate your lump sum based on your needs and the severity of your injuries. As of 2021, Washington state allows claimants the option of a single lump sum payment rather than multiple lump sum payments distributed over time. This means that claimants have a better chance at quick financial resolutions.
Who Qualifies For A Structured Settlement?
Generally, a worker qualifies for an L&I structured settlement if they are injured at work, are 50 years of age or older, and have an L&I claim that is six months old. An L&I claim would qualify for a structured settlement if it is not qualified for a pension.
Permanent Partial Disability (PPD)
This is a one-time payment to compensate an injured worker for a work injury that isn’t permanently disabling. The Permanent Partial Disability settlement payment is typically based on the type and severity of the injury. There are additional factors that often determine whether L&I will accept a PPD claim and the total amount that L&I is willing to pay, including:
- The level of support from the injured worker’s physician
- Whether an independent medical examination (IME) agrees or disagrees with the physician’s opinion
- The type of injury
- The severity of the injury, also known as the “rating”
How Much Will PPD Pay?
The amount that L&I will agree to pay for a PPD varies widely depending on what it considers to be the correct rating. For example, for a dorso-lumbar injury, there is a 15x difference between a category 2 and a category 8 PPD rating. This means that a claimant with a category 8 injury of this type would receive approximately $150,000 more than one with a category 2 rating (based on the 2020-21 L&I PPD Schedule). L&I often undervalues claims by using an independent medical examination report to support a lower category rating. If you disagree with the IME report or L&I decision, contact an L&I attorney immediately.
Who Qualifies for PPD?
An injured worker qualifies for PPD if they are able to return to work, according to a medical professional. If you can return to work but still have lasting injuries or illnesses that require financial compensation, you may be eligible for PPD.
Can I Reopen a Claim Once It’s Settled?
If you are experiencing further issues due to injury or illness, you can apply to reopen your L&I claim even after it has been closed. You can receive full benefits if you reopen your claim seven years after it has been settled.
What Can I Do If I’m Unhappy With My L&I Claim Settlement?
If you feel that you deserve a higher L&I settlement amount, you have options. You have 60 days to protest or appeal the settlement decision once it’s made. An L&I attorney can help you navigate the appeals process to ensure that you receive the settlement amount that’s right for you.
Don’t Go It Alone
Trying to navigate the complexities of settlements can be overwhelming and confusing, especially when you’re injured or ill. Receiving a favorable settlement amount requires knowledge of the process, access to quality medical information, and help from expert attorneys.
The L&I attorneys at Emery | Reddy, PLLC have decades of combined experience fighting for the rights of injured workers. We have successfully obtained and negotiated structured settlements for many of our clients. While it can be a complex and time-intensive process, it’s a process we intimately understand. We find that having an experienced workers’ compensation attorney involved early in the settlement process is the key to increasing the total amount of these awards.
We will analyze your situation and give you the information you need instead of what you may want or hope to hear. When it comes to L&I settlement amounts, it all starts with that first step toward financial recovery. Call Emery | Reddy today for your free case review. Please remember to have your L&I claim number readily available.