You were certain your workers’ compensation claim would be granted, but the Washington State Department of Labor & Industries (L&I) denied some or all of it. Now you’re stressed out, overwhelmed, and worried about the future. Fortunately, you have the right to protest or appeal the decision.
While there’s no guarantee L&I will reverse their denial, this guide outlines how to file a protest or appeal, what information to include, and what to do if the decisions don’t go your way.
Understanding Your L&I Order
The Department of Labor and Industries administers Washington State workers’ compensation claims for injured workers. Once L&I makes a decision about your workers’ comp case, they’ll send you a written notification, also known as an order. Depending on the decision, your order may be called:
- Notice of Decision
- Order and Notice
- Payment Order
- Order
No matter what L&I decides, injured workers have the right to protest or appeal it. However, you must do so in writing within 60 calendar days (15 days if the order is about vocational benefits) of the decision date.
How to Protest Your L&I Decision
In most cases, filing a protest is the best first step. Because it’s a less formal process, it’s typically faster and more cost-effective than an appeal. You’ll file the written protest directly with your L&I claims manager or self-insured employer and ask them to reconsider the initial decision.
To be clear, you must submit a written protest to L&I. Calling your claims manager to protest is not sufficient.
What to Include in a Written Protest
Your written protest must include:
- Your workers’ comp claim number
- The date you received L&I’s order
- A letter to your claim manager explaining why you believe L&I made the wrong decision
- Information and records from your attending medical provider explaining why you and they disagree with L&I’s decision
You can submit the protest through L&I’s online Claim and Account center or mail it to the address listed on your order.
Assuming you meet the 60-day deadline and include all of the required information, L&I will review and reconsider your workers’ compensation claim. However, L&I has no official deadline or timeline for issuing a decision. It may take 30 days, 60 days, or even longer.
Possible Protest Outcomes
Your protest can end in one of four decisions:
- No change. L&I affirms its original decision, and it remains in force. The Department will send you a new order, which restarts your 60-day clock to file an appeal.
- Partial change. If L&I reviews your protest and partly agrees with you, they’ll send you a new order that replaces the old one. You could receive a benefit adjustment (like new time-loss dates) or agree your workplace injury caused some of your medical conditions.
- Complete change. In some cases, L&I reverses its decision, agreeing that the original one was incorrect. In this case, you’ll receive an entirely new order.
- New or additional orders. Occasionally, a protest leads to a related but different action. For example, if you submit new medical evidence, the order may be amended to take that into account. If you disagree with the new or additional order, you have the right to appeal it.
It’s important to note that L&I may pause your protest review, usually to request things like medical records or information from your employer. This is quite common and doesn’t impact the review.
How to Appeal Your L&I Decision
The appeals process is more formal. Instead of going to your claim manager, you’re taking your appeal directly to the Board of Industrial Insurance Appeals (BIIA), an independent agency that resolves workers’ compensation disputes. Unlike the informal nature of a protest, the appeals process may include mediation sessions or a formal hearing where both sides can present evidence and testimony.
It’s your right to skip a protest and go straight to the appeals process. If you do, BIIA will notify L&I you’ve moved directly to an appeal and give the Department the opportunity to take your claim back and review its initial decision.
You also have the right to appeal directly to BIIA if your written protest doesn’t change L&I’s decision.
What to Include in a Written Appeal
Like your protest, your written appeal must be submitted to the Board of Industrial Insurance Appeals within 60 days from the date you received the order. It must include:
- Your name and address
- Your employer’s name and address
- Your claim number
- Your date of injury
- The date of the L&I order you are appealing (it’s a good idea to attach a copy of the order with the appeal)
- A list of every issue you’re appealing
- Why you disagree with L&I’s decision
- Supporting evidence or information
Once the Board of Industrial Insurance has your written appeal, it will notify L&I about your appeal, and L&I has 60 days to respond. Labor and Industries can:
- Send their claim record to BIIA
- Reverse their original decision
- Notify BIIA they are reconsidering the decision
During that same 60-day period, the Board of Industrial Insurance Appeals must also decide if your appeal is granted or denied. All this step means is that the Board of Industrial Insurance Appeals has decided whether or not it has the right to hear your case. If your appeal is denied (jurisdictional denial), BIIA has decided it cannot hear your appeal, and L&I’s decision stands.
The Board generally issues jurisdictional denials because:
- Your claim wasn’t filed within the 60-day window
- Labor and Industries’ order isn’t final, meaning you’re trying to appeal something that’s being reviewed or decided on
- You’re appealing something that isn’t covered by workers’ compensation (like wrongful termination)
However, if the Board decides it has jurisdiction, there are no deadlines or timelines for the Board to issue a decision. It may take months before your case is decided.
Possible Outcomes
An appeal can end one of four ways:
- Reversal. If L&I agreed to review its original decision, it may reverse or even change the order. If you disagree with the change, though, you still have the right to appeal it.
- Settlement or resolution. You may come to a settlement or other agreement before mediation or other hearings, in which case, your appeal is dismissed.
- Decision. If all the other options are exhausted, your appeal may go to a hearing before an industrial appeals judge. That person will make a decision that can affirm, reverse, or modify L&I’s original order.
- Review. In the event of a hearing and ruling, either party can ask the BIIA to review it, and the board may adopt, modify, or reverse that decision.
If you’re still dissatisfied with the outcome, you have the right to appeal the BIIA’s final decision to Washington Superior Court.
Work With Walthew Law Firm
At any step of the protest and appeals process — including formally challenging the decision in Superior Court — you have the right to represent yourself. However, ensuring you meet the deadlines, including all the information L&I or BIIA wants, and gathering the necessary medical evidence that supports your claim is complex and time-consuming.
The experienced, compassionate team of workers’ compensation attorneys at Walthew Law Firm knows how stressful an unfavorable decision from L&I can be and understands how to navigate a complicated and sometimes unfair system. Let us put their 90 years of legal expertise to work for you.
Contact us today for a free, no-obligation consultation. We’ll learn more about your case, discuss your options, and help you get the compensation you’re entitled to.