The overwhelming majority of employees in Washington State are entitled to no-fault workers’ compensation benefits. Getting through the claims process is challenging enough, but doing it perfectly is nearly impossible. In the haze of recovering from an injury and an unstable financial situation, many injured workers make common mistakes that can damage their ability to get the full benefits they’re entitled to.
15 Common L&l Claims Mistakes
These are the 15 most common mistakes workers make when filing a workers’ compensation claim with the Washington State Department of Labor and Industries (L&I) and how to avoid them.
Mistake #1: Waiting Too Long to Report Your Injuries
If you’re injured on the job, your first priority should be getting medical treatment. When you do, make sure you tell the doctor the injury happened at work and make sure they file a Report of Accident (ROA) with L&I on your behalf. Then you should report your injury to your supervisor and HR as soon as possible.
These reports to L&I and your employer are important. In Washington State, injured workers must report their work injury claim or occupational illness in writing. They have one year from the date of injury or two years from the date a doctor notifies them they have an occupational disease. Failing to report your injury in this timeframe could mean your L&I claim is denied.
Mistake #2: Using Your Employer’s Doctor
Your employer can suggest a doctor, but you don’t have to use them. You have the right to choose which doctor to see, and that choice matters.
A doctor with an existing and ongoing relationship with your employer may not be as neutral as you hope. When it comes time to assess your ability to return to work, the severity of your injuries, or whether your benefits should continue, ask yourself who the doctor is really looking out for.
Stick with a provider you know and trust, or you can choose a primary care provider from L&I’s network of approved providers throughout Washington State.
Mistake #3: Downplaying the Severity of Your Injuries
Your doctor’s notes and records are the foundation of your entire claim. If you downplay the severity of your injuries, pain and suffering, or extent of your impairment, that becomes the official record. Your employer or L&I could use these records against you and claim your injuries aren’t that severe, that you weren’t injured at all, or claim you weren’t injured on the job.
>>MORE: Have more questions about L&I? Read all of our L&I FAQs and get the answers.
Mistake #4: Saying Too Much About Your Case
As soon as you notify your supervisor of a work-related injury or occupational disease, assume they’re keeping an eye on you. They may monitor your social media, watch you on your days off to see what you’re doing, or talk to your coworkers about what you’re telling them about your injury.
Don’t post photos about your weekend activities, and don’t update your coworkers about your condition. Follow your employer’s policies while you’re on leave and keep the specifics of your injury and recovery between you, your doctor, and your immediate family.
Mistake #5: Not Including All Your Income
Labor and Industries uses a specific formula to calculate your time-loss compensation benefits. In short, L&I will pay you between 60% and 75% of your gross pre-injury wages, which is adjusted when you have dependents.
Time-loss calculations include your base pay, bonuses, and overtime, but they also include fringe benefits like medical, dental, and vision insurance. Because it’s up to you to report that information as part of your L&I claim, make sure you don’t leave anything out; otherwise, you may not receive all the compensation you’re entitled to. And if you work multiple jobs, make sure to include all the income from those jobs too to ensure you aren’t leaving any money on the table that you’re legally entitled to.
Mistake #6: Not Understanding What a Self-Insured Employer Is
While plenty of employers use Washington State L&I to manage their workers’ compensation claims, some prefer to handle them directly to save money. These are called self-insured employers, and if you work for one, you need to understand what that means for you.
When your employer or their third-party administration is managing your claim, they have a financial incentive to save money by paying you as little as possible or denying your injury claim, particularly if you suffered a complex or extensive — and therefore expensive — injury. While L&I claims managers are neutral, the same may not be true when the workers’ compensation claims are funded by self-insured employers. It’s not uncommon for injured workers to receive lowball offers, delay tactics, and denials.
Mistake #7: Returning to Work Too Soon
The pressure to return to work is real. Financial pressure from outstanding bills and pressure from your supervisor to “get back to it” can cloud your judgment and make you think it’s OK to return to work when, in reality, it’s much too soon.
Beyond the fact that injured workers need time to heal, your employer or your L&I claims manager can use that as evidence against you and claim your injury isn’t a severe injury. Let your doctor determine when you’re ready to return to work, not your boss and not your financial situation.
Mistake #8: Misunderstanding the Independent Medical Exam (and What It Means)
Sometimes, L&I or the insurance company may request that you undergo an independent medical exam (IME). Despite the word “independent,” the doctor examining you is there to evaluate your condition, and their report can be used to cut off your benefits.
While you can refuse the independent medical exam, doing so can hurt your L&I claim. So, go to your independent medical exam prepared. Describe your symptoms fully and completely. Don’t exaggerate, but don’t downplay your symptoms if you happen to be feeling well that day. You also have the right to bring someone to the IME with you and record the session. And if the report inaccurately describes your condition or makes your injury sound less severe than it really is, you have the right to challenge it.
Mistake #9: Not Reporting Your Mental Health Injuries
When people think of a work injury, they usually think of broken bones and bad backs. But Washington State workers’ compensation also covers mental health conditions that result from a workplace injury or accident, like PTSD, depression, and anxiety.
If you’re struggling emotionally after your workplace accident, you should report that to your doctor. It’s not a weakness. It’s part of your injury, and you may be entitled to medical care and compensation for it.
>>MORE: Learn more about the ins and outs of workers’ compensation.
Mistake #10: Misunderstanding the Impact of Impairment Ratings
Once you’ve reached maximum medical improvement, meaning your condition is stable, your L&I claim will likely receive an impairment rating. An impairment rating assigns a dollar value to how your injury has permanently impacted you. In serious cases, this may include a permanent partial disability determination, which is used to calculate a one-time case award.
Impairment ratings are assigned using the guidelines outlined in WAC 296-20-200 as well as American Medical Association (AMA) standards. While a doctor or other attending provider assigns the rating, they aren’t always applied correctly. You may be assigned a low rating that doesn’t accurately reflect the impact of your injury or illness. But you don’t have to accept the rating. You can challenge it, but it must be done quickly. Once a settlement is final, it’s difficult to reopen your case because of your impairment rating.
Mistake #11: Refusing Valid Light-Duty Work
Your employer has the right to offer you light-duty work while you recover: temporary, modified, or alternative work that’s within the bounds of the restrictions your doctor has in place. Light-duty work could include working shorter hours, performing different tasks, or other accommodations. For example, if your job requires you to stand for eight hours a day, light-duty work could consist of you working six hours a day while sitting.
As a rule, you should not refuse valid light-duty work because it could jeopardize your time-loss benefits in Washington State. But “valid” means work that doesn’t exceed your restrictions, cause pain, or isn’t properly accommodated. If you’re worried about the light-duty responsibilities, talk to your doctor and get their opinion in writing.
Mistake #12: Settling Too Soon
The thought of taking the initial settlement offer sounds tempting, but it’s often one of the biggest (and most easily avoided) mistakes. The insurance companies and self-insured employers know you’re likely under financial pressure, and early settlement offers take advantage of that.
However, the full extent of your injuries often isn’t clear in the days and weeks immediately following your accident. An injury that seems minor and manageable right now may require extensive medical care a year or two later — an additional medical expense that you may not be able to pay for if you settle too soon.
Mistake #13: Overlooking Third-Party Claims
Your L&I claim covers your employer’s liability. But your employer may not be the only party responsible for your injuries.
You can pursue a third-party claim in addition to your L&I claim. These personal injury lawsuits allow you to recover compensation from a third party in addition to workers’ compensation. For example, if you were injured due to defective equipment or a contractor on a job site, you may have an additional third-party claim.
Mistake #14: Waiting Too Long to Protest or Appeal Your L&I Claim
Even if you do everything right, your L&I claim may still be denied. You still have options, but you have to move quickly.
In Washington State, you have 60 calendar days to file a written protest or appeal a decision. Miss that window, and you may lose the right to challenge your case — permanently.
Mistake #15: Not Keeping Consistent Records
While your doctor keeps official records, keeping a dated personal journal that logs your symptoms, pain levels, mobility, and ability to do basic tasks (to name a few) is critical.
If your claim is disputed, that paper trail becomes a credible account of your pain and suffering against their claim. The other side is keeping records, so you should, too.
Contact Our Experienced Workers’ Compensation Attorneys
Finally, here’s a bonus mistake some people make with their L&I claim: not hiring an experienced workers’ compensation attorney.
You’re not required to hire a lawyer. But if you were seriously injured, denied benefits, you suspect your self-insured employer is trying to lowball you, or your claim was flat-out denied by your claims manager, talk to an experienced workers’ compensation attorney as soon as possible for professional support and guidance throughout the Washington State L&I claim process.
For over 90 years, the team of skilled, experienced workers’ compensation lawyers has advocated for the rights of injured workers throughout Western Washington State. We can provide you with the compassion and legal expertise you need while protecting your rights and fighting for the maximum compensation you deserve.
Contact us today for a free, no-obligation consultation and learn more about your options.