L&I Medical Care and Benefits
If you’ve been injured at work and have an open L&I Claim for Workers’ Compensation, you have a right to L&I Medical Care.
As long as your treatment is deemed proper and necessary, you are able to choose your own doctor from the network of the medical providers and have any medical bills paid for that relate to your job injury or disease. This includes payment to medical providers in the L&I network for healthcare and treatments that are directly related to the on-the-job injury. L&I Medical care typically ends when a workers’ comp claimant reaches maximum medical improvement (MMI) or when the claim closes.
It’s important to secure a good and supportive doctor. When necessary, your doctor can also refer you to specialists. Your claim may require the support of a specialist who is preauthorized by L&I or your self-insured employer. Your doctor or the specialist may prescribe diagnostic tests and or procedures, and these will need to be authorized by L&I or your self-insured employer. Approved doctors are paid directly by L&I or the self-insured employer at your doctor’s discounted rate. Your doctor is not allowed to bill you the difference between the regular rate and the discounted rate.
The L&I Medical Care benefit does not include health care for any other medical conditions unrelated to the workplace injury, medical care not covered by Workers’ Compensation, or treatment from providers who are not part of L&I’s provider network (other than the initial emergency room visits).
If L&I or your self-insured employer denies the medical care or procedures that you require, you should contact an experienced workers’ compensation attorney. A good L&I attorney, like the Seattle workers’ comp attorneys at Emery Reddy, will provide you a free consultation and tell you how to secure treatment that doesn’t require out-of-pocket payments or private insurance.
If you have a third-party claim, you should consider filing a workers’ comp claim immediately, in order to obtain L&I medical care. L&I medical care is usually the best option when compared to using your own private insurance or fighting with your insurance company (if you have PIP), or the other party’s insurance company.
If you have difficulty getting approval from L&I or your self-insured employer for a medical test or procedure, please contact the workers’ comp attorneys at Emery Reddy, or another trusted L&I law firm. Once a denial occurs, it can be difficult to persuade L&I or the self-insured employer that the requested treatment or procedure is in fact necessary. Any good L&I attorney will offer free advice and give you some options, so don’t hesitate to seek counsel.