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Self-Insured Employer Claims

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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 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 Versus 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. The best way to protest or appeal 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.

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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.

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).

How to Make a Penalty Request

A penalty request is made by sending a written request to L&I. Some penalties are payable to the injured worker, and some are payable to L&I.

How Do I Know If I Have A Strong L&I Claim?

If you have an L&I claim or wonder if you have an injury case, ask yourself the following:

  • Have you been denied the medical care benefits to which you are legally entitled?
  • Has L&I asked you to undergo an Independent Medical Exam (IME)?
  • Do you have questions about the L&I claim process that you don’t understand?

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

Navigating an 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 labor and industries 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 an L&I claim. Our Seattle L&I attorneys are here for you every step of the way.

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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, PLLC is the only law firm in Washington State that is equipped to provide comprehensive representation on your case from every angle. We 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 settlement you first need to understand the different types of worker’s compensation offered in Washington State.

L&I FAQ

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

Contact

When faced with difficult self-insurance workers’ compensation claims or a violation of your legal rights at work, you want an experienced and skilled attorney in your corner.

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.

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Timothy W. Emery

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Patrick B. Reddy

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Karolina S. Arthur

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Paul Cipriani, Jr.

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