Washington State Frequently Asked L&I Questions

Labor & Industries: Frequently Asked Questions (FAQs)

Unfortunately, many hardworking people get hurt on the job. The National Safety Council (NSC) estimates that 4.6 million Americans are injured at work every year. While some of these injuries are relatively minor, many others are serious—even completely debilitating. An accident can cause significant disruption to your life and could keep you off the job for weeks, months, or even permanently. Injured workers are entitled to the maximum available compensation to support themselves and their loved ones.

At The Walthew Law Firm, our Washington workers’ compensation attorneys have extensive experience advocating for the best interests and legal rights of injured workers. We want to make sure that people understand their rights and responsibilities under state law. Here, our legal team has put together answers to some common questions people have about L&I claims. If you have any specific questions about your legal options, please do not hesitate to contact our L&I lawyers for a free and strictly confidential initial consultation.

What is L&I?

The Washington State Department of Labor & Industries (L&I) is a state governmental agency that regulates and enforces industrial insurance benefits to workers who are injured on the job, crime victims’ compensation, work-place safety, wage and hour issues, and leave benefits. Primarily, L&I is responsible for administering the Washington State workers’ compensation insurance program. The agency is headquartered in Tumwater, and it has satellite offices in nearly twenty cities and towns across the state.

Am I Covered By L&I Insurance?

The vast majority of workers in Washington State are covered by the state’s mandatory no-fault workers’ compensation insurance system. Employers are required to provide L&I coverage to most employees—including part-time workers and temporary workers.

Under Washington State law (RCW 51.08.180), the term ‘worker’ is defined broadly. Almost everyone who is engaged in employment is a worker for the purposes of state law. For example, you should be covered by L&I insurance even if you are an undocumented immigrant or paid in cash wages; however, there can be challenges in proving coverage in such cases.

There are some limited exceptions to coverage. You can find some of these exceptions outlined in RCW 51.12.020. Maritime workers such as dock workers or ship builders, federal employees, and railroad workers are some examples of workers not covered under Washington State L&I. If you have any specific questions about your coverage, contact an experienced Washington State L&I lawyer for assistance.

What Do I Need to Do to File an L&I Claim?

Following an on-the-job injury, injured workers need to take immediate action to protect themselves and their legal rights. If the injury occurred while working for a large self-insured employer, report the injury to your supervisor and ask for form SIF-2, which is the Report of Accident. File that document with your employer and see your doctor who will complete the Providers Initial Report. For all other on-the-job injuries, see your medical provider as soon as possible and fill out the Report of Accident at the provider’s office or online. While filing an initial L&I claim is relatively straightforward, there are many common mistakes that you need to avoid. Here is a brief overview of the process of filing a Washington workers’ compensation claim:

1. Report your accident to your supervisor.
2. Seek immediate medical attention. All injuries should be evaluated by a medical provider.
3. Complete the Report of Accident (ROA) form. As indicated above, you can get this form from your doctor and/or your employer.

Are There Any Deadlines for Filing an L&I Report of Accident?

Yes. There are strict deadlines for filing an L&I claim. First, you should report your injury or occupational disease to your supervisor as soon as possible. Second, get medical attention right away. Failure to seek medical care can also undermine your ability to recover full and fair L&I benefits. Here are the deadlines for filing an L&I claim:

• Industrial Injury Claims: You must file your industrial injury claim with L&I or your self-insured employer within one year of the date of the accident.
• Occupational Disease Claims: You must file your occupational disease claim within two years from when your doctor tells you, in writing, that you have a work-related condition.

With most industrial injury claims, there is rarely a dispute over the date of the accident. With occupational disease claims, the onset or manifestation of the illness or condition is not always so clear. It is best to file an occupational disease claim as soon as you have symptoms of your work-related condition and have seen your doctor. If your doctor informs you in writing that your condition is probably linked to your employment, the two-year clock has started to run.

What Workers’ Compensation Benefits Can I Get in Washington?

If you were hurt on the job and your L&I claim is approved, you are entitled to benefits. These benefits provide a much-needed financial lifeline to injured workers and their families. Here is an overview of the benefits that may be available:

• Medical Coverage: In Washington, L&I coverage pays for all medical care that is deemed “proper and necessary.” Among other things, this may include emergency medical treatment, hospital bills, diagnostic studies, health care provider visits, costs of medications, and occupational and physical therapy. Medical care should be covered until your condition has stabilized, and, based on the opinion of a medical provider, no further physical or mental health recovery is expected. Unfortunately, L&I may deny certain types of treatment.
• Time Loss Compensation: If you miss time from work as a result of your disabling condition, time loss compensation is paid as compensation for lost wages. Time loss is calculated as a portion of your average weekly wages. The benefit is typically between 60 percent and 75 percent of a worker’s wages from all employment and is based on marital status and number of children. State law sets the minimum and maximum time loss rates.
• Loss of Earning Power (LEP) Benefits: One of the most underutilized types of workers’ compensation benefits, Loss of Earning Power (LEP) benefits compensate workers who can only return to part-time work or are forced to take a lower-paying position upon their return to the workplace. If you have questions about LEP benefits, contact an experienced Washington loss of earning power attorney for help.
• Vocational Services and Travel Reimbursement: Injured workers may be entitled to vocational retraining services and travel reimbursement. These are important benefits, and they should be accounted for in any claim. L&I also provides coverage for some of the incidental costs related to items damaged during an injury, limited to prescription eyeglasses, boots, clothing, and personal protective equipment.
• Permanent Partial Disability (PPD) Benefits: PPD benefits are paid to claimants who have a permanent impairment related to their work injury. If you reached maximum medical improvement and the disability or impairment remains, then PPD benefits should be paid by L&I. PPD benefits are paid based on a predetermined schedule set forth by Washington law and must be rated by a doctor.
• Structured Settlements: If you have an accepted workers’ compensation claim and are over the age of 50, you can resolve your claim with a structured settlement. The settlement resolves all issues on a claim with structured payments agreed to by all parties—the worker, the employer, and L&I or the self-insured employer. It is best to work with a qualified workers’ compensation attorney before entering into such a settlement as there are risks involved.
• Pension Benefits: In Washington, total disability pension benefits may be available for injured workers who can never reasonably return to the workforce. L&I considers your age, education, work history, prior injuries or disabling conditions, and the effects of an industrial injury to determine if a worker can return to gainful employment. If you cannot work at any job because of your injuries, an experienced workers’ compensation lawyer can help you make a claim for lifetime pension benefits. These benefits supplement other forms of financial support, such as Social Security Disability and Retirement benefits.
• Work-Related Death Benefits: The loss of a family member is heartbreaking and devastating. While nothing can make things right, L&I provides death benefits to help support spouses, children, and others who are financially dependent on the deceased worker. Death benefits may include immediate burial and funeral coverage, immediate payments, and widow or dependent pension benefits. An attorney can help your family navigate this system and obtain the maximum L&I death benefits.

How are PPD Benefits Determined in Washington?

Many serious injuries qualify for a final benefit payment at the closure of a workers’ compensation claim. These payments are called Permanent Partial Disability awards or PPD awards. As explained by the Department of Labor & Industries, you may be paid PPD if:

1. Your medical treatment is finished, and you are, hopefully, able to return to the workforce, but you have a permanent impairment; and
2. You have been given a PPD rating by a doctor.

The key thing to know is that your disability rating will control your award. In other words, there is a pre-set PPD “schedule” that will determine how much an injured worker is entitled to receive. That schedule of payments is based on your date of injury or manifestation and not the date the PPD rating is done. It is crucial that your PPD rating accurately represents the severity of your injury. If your PPD rating is improperly low, then you will be denied the full and fair workers’ compensation payment you deserve.