If you’ve been injured at work and have an accepted L&I workers’ compensation claim, you have the right to a variety of L&I benefits to help pay for treatment costs and replace lost wages during your recovery period. Call Emery | Reddy, PLLC today to speak to an experienced Intake Specialist and to learn about how we may be able to help you with your claim.
What Are Washington State L&I Benefits?
The Washington State Department of Labor and Industries (L&I) has a range of workers’ compensation benefits at its disposal that serve as a vital safety net, ensuring that employees are supported in the event of work-related injuries or illnesses. From medical coverage to financial assistance during periods of disability, these benefits provide essential support for workers and their families.
The first step to receiving your L&I benefits is to file your claim, completing the process as follows:
How to File an L&I Claim in Washington State
In order 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 with them.
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
- 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 7 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 2 years from the date that your doctor notifies you in writing that your injury is work-related.
Medical Benefits
L&I, or your self-insured employer (SIE), can approve your claim if your doctor certifies that you were the victim of a workplace injury or have an occupational illness. If your claim is approved, you may be eligible for medical benefits.
Medical benefits will be available to you for as long as your claim is open, even if you have returned to work. Your first visit to a doctor for a workplace injury is covered by L&I, even if your claim is not approved. If you need medical care after the first visit, you will need to see an approved provider in the L&I network.
Sometimes, workers who feel they have fully recovered will later find that they still need additional medical care for the same, ongoing injury. If your claim was closed prematurely and you need further compensation, our Seattle L&I Attorneys can work to reopen your case and ensure that any additional medical bills will be covered, including L&I disability benefits.
Time-Loss
Time-loss is partial wage replacement for an L&I claim and is paid every two weeks while you are not working due to a job injury or an occupational illness. See RCW 51.08.178 and 51.32.090 for additional details. In such cases, L&I will reimburse you for lost time with benefits between 60-75% of the worker’s earnings prior to the injury or illness up to a maximum cap. The IRS considers time-loss compensation to be a disability benefit, not earned income, so income tax laws do not apply.
How Do I Qualify for Time-Loss?
- Your L&I claim must be open and allowed.
- A doctor must certify that you are not released to work without restrictions.
- Verify with L&I that you are not currently working. You can do this by filling out a Work Status Form and submitting it to L&I.
- If you have been released to light or modified-duty, there must be no opportunities where your workplace injury occurred.
- You must not have received a vocational decision indicating that you are able to work.
Time Loss Calculator
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*Time loss is subject to a maximum set by L&I and adjusted annually. This calculation is as of 2022. Call Emery Reddy to discuss your specific case.
What Activities Are Prohibited While Receiving Time-Loss?
- You may not work while on time-loss.
- You should not post anything on your social media accounts that may contradict the validity of your L&I claim.
- Most importantly, do not miss your medical appointments. Follow your doctor’s advice about activities, including sports and recreational activities.
Each time-loss compensation case is different depending on details like marital status and claimed dependents. Our Seattle L&I Attorneys will guide you through these complex regulations, which include regular doctor certification of your health condition so that you earn maximum compensation for lost wages due to your workplace injury.
HOW IT WORKS
Watch This Video to Learn More about Time-Loss and Disability
Loss of Earning Power (LEP) Benefits
An injured worker can return to their job and be entitled to LEP benefits with a doctor’s medical clearance.
How Do I Qualify for LEP Benefits?
Your loss of earnings must be greater than 5% of wages at the time of injury. Some situations that may qualify include:
- Returning to work for less pay.
- Returning to work at your regular wage, but at reduced hours.
Your doctor must certify that your loss of earning power is due to your work-related injury or occupational illness. If your doctor approves a written light-duty or transitional job and you choose not to accept the work, you are not entitled to LEP or time-loss compensation.
What Are Examples of Light-Duty Jobs?
Light-duty or transitional work can be:
- Working shorter hours.
- Performing some of your original duties part-time, then gradually increasing back to your full-time work responsibilities.
- Performing different duties with lighter physical demands as you transition back to your regular job.
- Adjusting your job or worksite to meet your physical limitations by providing accommodations like tools, equipment, or the appliances that you need to perform your job as expected by your employer.
- Starting a new job with a new employer and losing more than 5% of your earnings.
Concerns about returning to work — and the possible impact on your L&I claim — are normal, but don’t let these concerns stop you from talking to your employer. You can continue to receive L&I benefits for your claim until you’ve reached maximum medical improvement (MMI).
Permanent Partial Disability (PPD) Awards
You may be rated for a PPD award before L&I closes your claim if you have completed treatment and are able to work but have suffered a permanent loss of function, and a qualified doctor provides L&I with a PPD rating. Time-loss and medical benefits will end after receiving your disability award unless the L&I claim is reopened.
How Do I Qualify for a PPD Award?
Washington state law broadly defines permanent partial disability (PPD) as a physical or mental impairment arising from an injury that is fixed, lasting, and stable, and can’t be improved with further medical treatment, also referred to as having reached maximum medical improvement (MMI).
How Are L&I PPD Awards Paid?
PPD awards are based on the type of injury and the level of severity of the injury, measured by a category rating. In general, the higher the rating, the bigger the payout. An experienced L&I lawyer and the right doctor are usually the winning combination to unlocking the maximum amount of L&I benefits to which you are entitled.
L&I PPD Awards Are Paid When Your L&I Claim Is Closed
- Small awards: If the award amount is less than three times the state’s average monthly wage at the date of injury, L&I or the self-insured employer (SIE) will send out a check for that amount at the time of claim closure.
- Larger awards: If the award exceeds more than three times the state’s average monthly wage at the date of injury, L&I or the SIE makes a down payment. The balance of the award is paid once a month in installments equal to the worker’s monthly time-loss compensation (at the time of closure).
Permanent Partial Disability Settlement Calculator
The permanent partial disability settlement calculator is the L&I Disability Awards Charts, and it is calculated as part of the claim closing process. Your final award amount is determined by converting the rating received from your Independent Medical Exam (IME) to settlement dollars. Use the Permanent Partial Disability Award Charts from the Washington State Department of Labor & Industries to see the dollar figures.
HOW IT WORKS
Watch This Video to Learn More about Permanent Partial Disability (PPD) Awards
L&I Disability Pensions
An L&I disability pension is a special category of pension only awarded to the most severely injured workers. If you are eligible for an L&I disability pension, you will receive a non-taxable payment every month for the rest of your life.
Under Washington state law (WAC 296-14-150), gainful employment is defined as a regular occupation for income, salary, or wages. If your doctor or vocational counselor says that you cannot ever work again because of a job-related injury or illness, you may be eligible for an L&I disability pension.
How Do I Qualify for a Washington State L&I Disability Pension?
You may receive L&I benefits in the form of a monthly disability pension if you are certified as permanently and totally disabled, and:
- The medical and vocational evidence finds that your injury prevents you from becoming gainfully employed, or
- You have lost or lose the use of both legs, both arms, an arm and a leg, or your vision. These are administrative pensions and operate differently than traditional pensions.
Under Washington state law (WAC 296-14-150), gainful employment is defined as a regular occupation for income, salary, or wages. If your doctor or vocational counselor says that you cannot ever work again because of a job-related injury or illness, you may be eligible for an L&I disability pension.
How Are L&I Disability Pensions Paid?
An L&I disability pension is a payment received once monthly for the rest of your life. The monthly dollar amount is roughly equal to your combined twice monthly time-loss payment.
L&I disability pensions are hotly contested, and less than 2% of all L&I claims end up settled in this manner. Because these claims are expensive to fund, it’s sometimes cheaper for the state or self-insured employer (SIE) to fight a claim rather than just pay it. In other words, your claim is valuable, and you should expect to fight hard for it.
HOW IT WORKS
Watch This Video to Learn More About L&I Disability Pensions
Claim Resolution Settlement Agreement (CRSA)
A CRSA is 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.
Self-insured employers (SIEs) are more likely to use CRSAs. The most common reason for this is to save money and will, unfortunately, make it more difficult for you to get your compensation. The SIE will do everything in their power to deny it. However, they still need to follow L&I’s rules for self-insured companies. If you disagree with their decision, you have the right to appeal. Contact an experienced Labor and Industries lawyer for help as soon as possible to help with the process.
How Do I Qualify for a CRSA?
You must meet certain criteria to receive a CRSA from the Washington State Department of L&I. Among these criteria are the following:
- You must be over the age of 50.
- Your claim must be allowed and at least 180 days old.
How Are Claim Resolution Settlement Agreements Paid?
CRSAs are awarded in one lump sum when your L&I claim is closed.
Vocational Rehabilitation
Vocational rehabilitation is an L&I benefit available to injured workers who are unable to return to their existing profession. The following services are included in vocational rehabilitation training:
- Vocational recovery
- Ability-to-work assessment
- Plan development or work relating to prior job experience, education, or other transferable skills
- Plan implementation (vocational training)
- Counseling
- Job placement
L&I cannot close your claim until you either return to work or your doctor has deemed that you are able to return to work. See RCW 51.32.095.
HOW IT WORKS
Watch This Video to Learn More about Vocational Rehabilitation
How Do I Qualify for Vocational Rehabilitation?
In order to qualify for vocational rehabilitation, you must be unable to return to work in the same or modified position. You must also have no sufficient transferable skills that allow you to gainfully return to the workforce. L&I determines if you qualify for vocational rehabilitation during the ability-to-work assessment. The final report to L&I includes the following:
- Your age, education, and work experience
- Your transferable skills
- Preexisting physical and mental conditions and their effect on your employability
- Physical and mental conditions caused by your injury or occupational illness and their effect on your employability
- Your wage at the time of injury
- Your work pattern
- Significant barriers to your employment
- Surveys of potential jobs (referred to as labor market surveys)
- Complete work history, explaining any gaps in employment and any licenses or training that you may have had in addition to your formal education
It is strongly advised that you talk to a Labor and Industries attorney before you start working with a Vocational Rehabilitation Counselor (VRC). VRCs and L&I Claims Managers are skilled at finding ways to argue you can return to the workforce in some other job — even if it’s a job you’ve never performed.
HOW IT WORKS
Watch This Video to Learn More about How Employment Law and L&I Claims Work Together
Your L&I Claim Is Worth More If You Also Have an Employment Claim
A significant number of L&I — workers’ compensation claims often involve additional legal claims such as employment or third-party claims. Many people file their claims without seeking representation from an L&I attorney and thus never discover that, in addition to their L&I claim, they may be missing out on the ability to file an employment claim or a third-party claim. Pursuing additional legal action with the help of an experienced Labor and Industries attorney has the potential to significantly increase a claim’s overall compensation. At Emery | Reddy, our experienced Attorneys practice both Employment and Workers’ Compensation Law, which means we will investigate all aspects of your claim to make sure you aren’t missing out on any potential benefits.
What Is an Employment Claim?
Many injured workers find that their employer has taken, or plans to take, adverse action against them because they filed an L&I claim or they are out of work. You can file a lawsuit against your employer for several reasons, including retaliation, wrongful termination, disability discrimination, or unpaid wages. An L&I attorney who is experienced in both L&I — Workers’ Compensation Law and Employment Law can help you with your L&I claim while simultaneously filing a federal or state law claim for the violation of workers’ rights by your employer.
What Is a Third-Party Claim?
A third-party claim is one in which someone other than your employer or co-worker is responsible for your injury. 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, which combines your L&I claim with a personal injury claim using the same facts.
Unlike workers’ compensation payments, there is no limit to the amount of compensation an injured worker may seek in third-party damages. Third-party claims are private matters and are typically litigated directly with the Washington State Superior Court.
Who Is at Fault For a Workplace Injury?
L&I is a no-fault system, ensuring compensation for any workplace injury. However, if a third party is involved in causing the injury, you may be able to pursue legal action against them for additional compensation under third-party claims.
How Do I Know If I Have a Strong L&I Claim?
If you have an L&I claim or wonder if you need the assistance of an experienced L&I — workers’ compensation attorney, ask yourself the following:
- Have I been denied the medical care benefits to which I am legally entitled?
- Has L&I asked me to undergo an Independent Medical Exam (IME)?
- Do I have questions about the L&I claim process?
If any of the above apply to you, Emery | Reddy may be able to help.
Navigating a workers’ compensation 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 and navigating an L&I claim. Our Seattle L&I Attorneys are here for you every step of the way.
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?
To determine the value of your L&I (workers’ compensation) settlement you first need to understand the different types of L&I settlements offered in Washington state.
The L&I workers’ compensation process is anything but straightforward. Find out the answers to your L&I workers’ comp questions today.
During the course of your workers’ comp claim, you may be required to complete an Independent Medical Exam (IME) conducted by a doctor other than your primary provider.
WE FIGHT FOR YOU
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 the Emery | Reddy team has helped me with an employment matter…and I must say, I can't say enough how grateful and happy I am with the service I have received. They were detail-oriented, attentive, on time with communication, and very knowledgeable. Highly, highly recommend!”
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