Did you receive an unfavorable decision from the Washington State Department of Labor & Industries (L&I)? If so, you may be feeling stressed out or overwhelmed. Please know that you have the right to protest the order in writing and, if necessary, file an appeal with the Board of Industrial Insurance Appeals. In this article, our Seattle workers’ comp attorneys provide a more comprehensive overview of the most important things you should know about protesting or appealing an L&I decision in Washington.
Understanding Your L&I Order
L&I is a Washington State government agency that is charged with administering Washington State workers’ compensation claims. When L&I makes a determination on a workers’ comp case, you are notified through a written document called an order. Depending on the decision, your L&I order may be called a Notice of Decision, Order and Notice, Payment Order, or simply Order. When you get an L&I order, you should:
- Read the order;
- Take the time to understand what it means to you and your claim; and
- Review and note any protest or appeal deadline listed on it.
Unfortunately, L&I does not always come to correct decisions. You have the right to protest an adverse workers’ compensation order, but you must do so within the 60 days of L&I’s order or within whatever time limit is specified on the order or letter. If you have any questions or concerns about the L&I order, an experienced Washington workers’ comp lawyer can help.
Denial Letters
There are also times when L&I will send a letter which denies treatment such as surgery, physical therapy, or medications. Carefully read all letters you received on your claim. You may have the same protest or appeal rights to the decision in the letter even if it doesn’t contain statutory deadline language.
Protesting an L&I Decision Starts with a Written Protest
If you received an unfavorable order from L&I, you can file a written protest with the Department of Labor & Industries or your self-insured employer. A phone call to your claim manager saying you are unhappy with an order is not sufficient. The protest can be mailed or you can file the protest through L&I’s Claim and Account Center. The reconsideration process is L&I’s internal appeals procedure. In order to file a valid protest to an L&I order, you must do the following:
- Within the time limits explained on the order or letter, write a letter to your claim manager explaining why you are protesting the decision. State in your protest the date you received the order or letter;
- If L&I closed your claim, denied surgery, or denied a medical condition, provide information from your physician or health care provider explaining why you and your provider disagree with L&I’s decision; and
- Submit your workers’ comp claim through the online Claim & Account Center or send a written protest to the address listed on the order or letter.
Each protest is unique and written based on the issue addressed in the order or letter and the medical support for your position. The written protest should clearly explain why you believe L&I made the wrong decision. You can usually benefit from providing supplemental documents, records, and evidence as part of your L&I protest.
Know the Deadline: There is a strict 60-day deadline to protest an unfavorable Labor & Industries order by filing a written protest. Any protest must be sent in writing. If you fail to place your written protest in the mail or file it through L&I’s Claim and Account Center within 60 days from the date you received the order, the unfavorable order will become final and binding on you and your claim.
You Can Appeal the Denial of Your L&I Claim to the Board of Industrial Insurance Appeals
An alternative to submitting a protest directly to L&I is to appeal an adverse decision to the state of Washington Board of Industrial Insurance Appeals (BIIA). The BIIA is a state government agency that is entirely independent from L&I. It has the authority to hear workers’ compensation appeals. If your claim or protest was denied by L&I, you can appeal the denial order to the BIIA. The same deadlines apply for your appeal – 60 days from the date you receive an unfavorable order from L&I or other time limit specified in a denial letter. An appeal must comply with the requirements of RCW 51.52.070. To bring an L&I appeal in Washington, you must include the following information:
- Your name and claim number;
- The exact date of the L&I order being appealed and when you received the order;
- A list of every issue in the L&I decision being appealed;
- The reasons why you disagree with the decision; and
- Any supporting evidence or information to justify the appeal.
To successfully appeal an L&I denial, you must present a strong, well-supported case. The appeals process is complex and you should probably not go through the workers’ comp appeals process on your own. An experienced Washington workers’ comp lawyer can help you put together the case you need to fight for the full and fair benefits you are entitled to under the law.
Know the Deadline: As with a protest, there is a 60-day deadline to file an appeal with the Board of Industrial Insurance Appeals. If you fail to submit a BIIA appeal within 60 days, then your case may be dismissed before you can present any evidence.
You Can Start with a Protest or Appeal
It is usually best for you to challenge an adverse L&I decision by protesting it to L&I’s claim manager. The protest reconsideration process at L&I is typically faster and more cost-effective than an appeal. However, you have the right to file an appeal directly with the Board of Industrial Insurance Appeals without first protesting the decision. If you go straight to the BIIA, the Board will notify L&I and provide the agency with an opportunity to reassume jurisdiction and review its initial determination.
Schedule a Free, Confidential Consultation with a Workers’ Comp Lawyer in Washington
At The Walthew Law Firm, our Washington workers’ comp attorneys are passionate and dedicated advocates for injured workers and their families. If you have any questions about how to protest an unfavorable L&I decision, we are more than ready to help. Contact our law firm now for a no-cost, no-obligation initial consultation. With office locations in Seattle and Everett, we are well-positioned to help workers throughout Western Washington, including in King County, Snohomish County, Kitsap County, Pierce County, and Skagit County, protest or appeal their unfavorable L&I decisions.