The Washington State Department of Labor and Industries (L&I) states that third-party claims are fault-based, therefore the injured worker must prove the negligence of the third party. Unlike workers’ compensation payments, there is no limit to the amount of compensation an injured worker may seek in third-party damages.
Third-party injuries in the workplace are the result of accidents caused by someone other than your employer or co-worker. 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. Third-party claims combine your L&I claim with your personal injury claim using the same facts.
Third-party claims are not a matter of choice. The nature of your injury and the facts of your case are what determine if you should pursue the third-party claim, not your personal preference. Since L&I paid out for your L&I claim, they will be suing the third party for the damage they caused. L&I must be reimbursed from any recovery.
Examples Of Third-Party Accidents And Personal Injury Claims
According to L&I, third-party accidents and personal injury claims may include:
- A motor vehicle collision caused by another driver
- A property owner who failed to properly maintain the building where you were working when you were hurt
- A worksite general contractor, if you were employed by a subcontractor
- The manufacturer of the defective device that injured you
- The owner of an animal that bit you
You are entitled to workers’ compensation benefits, regardless of who caused the workplace injury. L&I must be reimbursed from any recovery.
Can You File Both An L&I Claim And A Third-Party Claim?
L&I claims and third-party claims often go together, and injured workers often need to file both. An L&I claim will be filed with your doctor at your first medical visit regarding the injury. At a later date, if they suspect your case qualifies for a third-party claim, L&I will send you a Third-Party Election Form. Either you or your L&I lawyer will need to fill out this form and send it back within 60 days of receiving it.
Your third-party claim will pursue the money that L&I was unable to pay, allowing you to get money back for your pain and suffering, lost wages, and medical expenses, and even replace future earnings you may have lost if the injury has left you with less earning potential than before.
Both L&I and third-party claims can result in a cash award, but the payment from L&I is limited. By actively pursuing both an L&I claim and a third-party claim, you can ensure that you are fully and adequately compensated for your injury.
An L&I Claim And A Third Party Claim Affect Each Other
- Third-party claims combine your L&I claim with your personal injury claim using the same facts.
- A third-party settlement will affect ongoing and future L&I benefits because L&I must be reimbursed from any recovery.
- L&I orders directly affect your third-party claim.
- A third-party claim can create a deficiency and ruin your L&I claim.
- A bad order or unfavorable Independent Medical Exam (IME) can hurt your third-party claim.
- An L&I claim can be limited or even denied by L&I or the self-insured employer thereby severely affecting the third-party recovery.
How To File An L&I Claim In Washington State
To receive 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
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
Note that if you work with a self-insured employer, you must file your claim directly with them. Contact your employer’s personnel department for help.
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 will send 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. 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.
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 of the date that your doctor notified you in writing that your injury is work-related.
Third-Party Claim Statute Of Limitations (SOL)
The third-party SOL in Washington State is 3 years in most cases. You must settle your claim or file a lawsuit before those 3 years run out.
Third Party Election Form
If your workplace injury is the result of an accident caused by someone other than your employer or co-worker, you may be entitled to additional compensation through a third-party claim. If you indicate on your Report of Accident that a third party may have caused the injury, L&I will send you a Third Party Election Form to complete.
L&I Claim Value
L&I awards are paid out once the claim is closed, though the total award amount awarded upon claim closure depends on the size of the award. L&I award amounts vary widely and typically fall into three categories:
- 1. L&I Disability Pensions: a life-long benefit awarded to injured workers who will never be able to return to any gainful employment due to a severe or life-threatening injury.
- 2. Permanent Partial Disability (PPD) awards: a one-time sum paid to injured workers when their L&I claim is closed. The worker can re-enter the workforce following a PPD award.
- 3. Claim Resolution Settlement Agreement (CRSA): an L&I settlement option where all parties agree to close an injury claim for a specified amount. When agreeing to this settlement type, the injured worker exchanges all future benefits, except medical, for the payment.
In Washington State factors that determine a settlement amount include the date the injury occurred and the severity of the injury.
How Do I File A Third-Party Claim?
There are two main steps that you must follow to file your third-party claim:
Step 1: Consult With An L&I Lawyer Before Talking To Insurance Companies
Insurance companies are experts at minimizing their liability costs, sometimes at the expense of the victim. Let an L&I third-party claim attorney advise you against making a statement that the insurance company can later use against you.
Step 2: Complete An L&I Third Party Election Form
L&I will send you a Third Party Election Form. If you do not indicate your preferred course of action on the L&I form, your case could be automatically assigned to L&I, which would mean the loss of your right to pursue third-party compensation with your own L&I third-party attorney. Failure to return the L&I Third Party Election Form could also cost you your rights.
The L&I Third Party Election Form has three options. Be sure to talk to your L&I attorney to determine the best course of action for you:
Option A: You DO Want To Take Legal Action Against The Third Party Yourself, With Your Own L&I Third-Party Attorney
Selecting Option A on the third-party election form indicates your desire to work with an L&I attorney to seek damages for your injury. Your L&I third-party attorney will help you complete the form, notify L&I when the lawsuit has been filed, and handle case details and updates on your behalf.
If you receive a financial settlement through action with your L&I third-party attorney:
- You or your L&I attorney must report the amount of any award to L&I. After receiving a third-party settlement, you are responsible for repaying any L&I benefits you may have received. However, your attorney can assist you in negotiating the refund amount for which you are responsible.
- Once reaching a third-party settlement, funds are distributed, according to Washington State mandate, between you, your L&I attorney, and reimbursement to L&I.
Option B: You DO NOT Want To Take Legal Action Yourself, But Will Give This Right To L&I
Option B indicates that you do not wish to take legal action yourself, but instead want L&I to take legal action against the third party on your behalf. However, they may decline to do so. We highly recommend consulting an experienced L&I attorney bound by law to act in your best interests rather than entrusting L&I with your case.
Washington State law allocates funds differently for settlements reached through L&I. If you receive any portion of the recovered funds, there is a significant chance that you will receive less compensation than you would with your own L&I attorney.
Option C: No Third Party Is Responsible
Choosing Option C means you do not feel that your work injury was caused by a third party. We advise that all injured workers consult third-party attorneys before making any judgments regarding the nature of their accident. Third-party liability is difficult to determine without comprehensive legal training. An experienced L&I attorney will fight aggressively for your best interests to earn you the maximum possible settlement.
Third-Party Claim Value
The value of your third-party claim can be calculated by completing L&I’s interactive Third Party Recovery Worksheet. You can either use set figures, or you may make an estimate. You can also request the L&I Third Party section to do the calculation for you.
What Options Are Available For Temporary Workers?
Employees who work for a temporary staffing agency are not employed by the onsite company. For that reason, temporary employees who are injured at work will have the standard two claims:
- An L&I claim against their employer, the temporary staffing agency
- A third-party claim against any negligent parties who work for the onsite employer
Protective Regulations In Washington State Third-Party Claims
In Washington State, employers are required to provide a safe workplace free from hazardous conditions that may cause injury to their employees as indicated by the following:
Washington Industrial Safety And Health Act
In 1973, the legislature passed the Washington Industrial Safety and Health Act (WISHA) see Revised Code of Washington (chapter 49.17 RCW). WISHA requires employers to provide safe and healthful workplaces for all employees. It gives L&I/DOSH the responsibility to establish and enforce workplace safety and health rules. These rules are the Washington Administrative Code (WAC).
Occupational Safety And Health Act (OSHA)
The Occupational Health & Safety Administration (OSHA) works to provide safe working environments and enforces health and safety regulations in workplaces across the U.S. Every American employer, worker, and manufacturer is required to observe OSHA rules. Affected workers deserve compensation, but are often unaware that OSHA violations led to their injury. An experienced attorney will work with industry experts to determine this and more.
Closing Your L&I Claim
Your L&I claim closes when a physician certifies that further treatment will not improve your condition, meaning that you have met maximum medical improvement (MMI), and you have returned to work or that L&I has determined that you are fit to return to work.
What Happens After Your L&I Claim Is Closed?
- If you do not protest or appeal, after 60 days the closing order becomes final.
- If you protest or appeal, then the closing order is held in abeyance.
How Do I Know If I Have A Case?
The bottom line is that anyone who isn’t familiar with L&I claims in Washington State should seek the input of experienced L&I attorneys who do.
After years of helping injured workers, Emery | Reddy has recovered millions for our clients. Our team of L&I attorneys is experienced in litigating 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, PLLC 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.
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