In Washington state, employers need to pay a premium to the Washington State Department of Labor and Industries (L&I) each month or have a self-insured policy establishing a fund that is then used to pay out self-insurance workers’ compensation claims as they arise.
Self-insured employers (SIEs) account for one-third of workers’ compensation in Washington state, and they provide benefits directly to injured workers.
Self-insurance is less common than L&I insurance, but it’s popular among larger corporations. Self-insured policies allow the company to save money, so these employers must be able to pass certification requirements from L&I to prove that they can take on the risk of covering self-insurance workers’ compensation claims.
This also means these employers hire third-party firms — instead of using L&I — to evaluate workers’ compensation claims, which can cause endless headaches for injured workers. While L&I will oversee the entire claim process and ensure your employer follows the rules and regulations, it is wise to seek the assistance of an attorney who is experienced in facing the challenges posed by self-insurers and their adjustors.
Self-Insured Employer Claims vs. L&I Claims
Self-insured employers will do everything in their power to deny your compensation. If you disagree with their decision, you have the right to report your problem directly to L&I and to appeal it. The best way to protest or appeal a decision is by contacting an experienced L&I — workers’ compensation lawyer to help you get in touch with the Department of Labor and Industries. L&I oversees all workers’ compensation claims and ensures self-insured companies abide by the necessary rules to protect their employees.
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 human resources 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.
Common Reasons for Self-Insured Employer Claims
The most common reason for self-insured employer claims is work injuries. Employers are required to provide a safe work environment, and employees have the right to receive compensation if they are injured at work. Even if the company is self-insured, it is still subject to state and federal laws.
How to Protest or Appeal Your Self-Insured Employer Claim
You have the right to protest any decision made about your claim. Your self-insured employer 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 becomes final.
Penalties for Unreasonable Delay in Benefit Payments
Self-insured employers are required to pay self-insurance workers’ compensation benefits on time. If they do not, they can be penalized $1,000 or 25% of the amount due (whichever amount is greater).
Delayed benefits that are subject to penalty include time-loss, loss of earning power (LEP), medical benefits, and permanent partial disability (PPD) awards.
How to Make a Penalty Request
A penalty request is made by sending a written request to Labor and Industries. Some penalties are payable to the injured worker, and some are payable to L&I.
Emery | Reddy Can Help You with Your Self-Insured Employer Claim
We find that claims against self-insured employers often require the most attention. A third-party Claim Administrator’s job is to save the self-insured employer money, often by minimizing your award and fighting your workers’ comp claim.
Self-insured employers hire Claims Managers who are skilled at denying claims. From the moment a Claims Manager is hired, they become focused on one goal: to deny your claim at all costs. Once the claim is denied, it takes experience and persistence to get L&I to reverse the initial denial. Hiring an experienced Labor and Industries attorney is crucial to ensure that you receive the L&I benefits to which you are entitled.
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 for a Free Case Review with an experienced Intake Specialist to learn more about how we may be able help you.
Want More Information?
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Meet the Team
The L&I Attorneys at Emery | Reddy, PLLC are passionate about helping workers with L&I claims and Employment Law issues. We Help Workers®. It’s our motto and 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 three 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, call us for a Free Case Review with an experienced Intake Specialist to learn more about how Emery | Reddy may be able to help you today.
“Tim and Patrick are the best in the business. They genuinely care about helping workers get every penny you deserve. Amazing staff, too!”
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