Do I Have the Right to Choose My Own Physician?
Yes. Under workers’ compensation laws, injured workers are permitted to choose their own physician. You need a doctor who you can trust to provide reliable care. However, that provider must be on L&I’s approved provider list. Labor & Industries has put together a searchable network of medical providers. If you are not sure where to find a doctor, this database is helpful. For treatment outside of Washington State, providers must have an L&I provider number in order to treat injured workers. If you need help finding a doctor, an experienced workers’ compensation attorney may be able to assist you in finding a qualified and trustworthy provider near you.
L&I is Requesting an Independent Medical Evaluation (IME). What Does that Mean?
The term Independent Medical Evaluation is a bit of a misnomer. It is a medical evaluation requested by L&I or a self-insured employer. Claims managers typically want a second doctor to assess your medical condition: usually to determine entitlement to time loss benefits or need for medical treatment. These medical evaluations are requested and paid for by L&I or the self-insured employer, and they choose the doctors who will conduct the examination.
If L&I or an employer schedules an IME, you should cooperate even though it could be a sign that the claims manager is seeking to deny or stop benefits on your claim. Failure to attend the examination, except for “good cause,” could result in the suspension of your claim and termination of monetary benefits. You may want to consult with a workers’ compensation lawyer before your independent medical evaluation.
Is there a Difference Between an Injury Claim and an Occupational Disease Claim?
Yes, there are some notable differences. In Washington State, an injury is defined as a “sudden and tangible happening of a traumatic nature.” The term industrial injury refers to something that happened at a specific point in time. In contrast, an occupational disease is defined as a “condition that develops gradually because of the work performed.” An occupational disease could be anything from a repetitive stress injury such as carpal tunnel syndrome to a lung disease caused by breathing in toxins in the workplace.
For a number of different reasons, occupational disease claims are complex. There are often questions about how the condition can be linked to the workplace. To qualify for L&I benefits for an occupational disease, a worker must prove that the condition arose “naturally and proximately” out of employment. For more information on occupational diseases and L&I benefits, contact a Washington workers’ compensation lawyer.
I Disagree With an L&I Decision. What Can I Do?
The L&I claims managers are not perfect. The agency sometimes makes mistakes and comes to incorrect decisions. If you believe that L&I got something wrong in your case, you have the right to protest or appeal the adverse order or determinative letter, such as a vocational determination. However, you only have a limited amount of time to do so. If you fail to take action, an adverse workers’ compensation decision will become final. L&I orders give workers 60 days to file a written protest or appeal.
To challenge an L&I decision, an injured worker must file a protest. You must submit an L&I protest in writing, and you must do so before the deadline expires. You can submit supplemental documents, records, and information to support your protest. The Department will issue a subsequent order, which if unfavorable, can be appealed to the Board of Industrial Insurance Appeals. Again, you have 60 days to file your appeal with the Board of Industrial Insurance Appeals.
An experienced workers’ compensation lawyer will help you build a compelling and strong protest or appeal.
My L&I Claim Was Already Closed. Can I Reopen It?
Yes. Under Washington State law, claimants can reopen an L&I claim within seven years of the date of first closure to receive monetary benefits such as time loss, PPD, or pension. You can apply to reopen a claim at any time, but after seven years, it is at L&I’s Director’s discretion whether or not benefits other than medical will be paid.
Additionally, you cannot reopen your L&I claim simply because you disagreed with the initial closure. To successfully reopen a workers’ compensation claim in Washington State, a doctor must say that your condition has objectively worsened since the date of closure.
If you have any questions or concerns about reopening an L&I claim, contact an experienced Washington workers’ compensation lawyer for help. An attorney will explain your options for getting additional financial support.
How Does My L&I Claim Affect My Right to File a Third-Party Liability Lawsuit?
As a general rule, an L&I claim is an injured worker’s exclusive legal remedy. It is a no-fault insurance, which means if your accident was caused by your own fault, your coworker’s, or your employer’s negligence, you would be entitled to receive benefits. It also means you cannot sue your coworker or employer. However, you retain the right to file a personal injury claim against any other party that caused your accident through recklessness or carelessness. For example, if you were injured on the job because of the negligence of a property owner, you can hold them accountable through a personal injury lawsuit. These types of claims are called third-party liability claims.
To clarify, your L&I claim and your third-party liability claim are two separate legal cases. If you were injured on the job in Washington, you should file a workers’ compensation claim. If your injuries were caused by a negligent third party, then you should also file a claim against the negligent third party. Through a third-party claim, you may be eligible for additional financial support, including compensation for your pain and suffering.
Should I Hire a Workers’ Compensation Attorney for My L&I Claim?
All workers in Washington have a right to hire an attorney to assist with their L&I claim. In some cases, injured workers can effectively handle their own claim. However, if you run into any problems or have any questions, you should speak to a professional. Here are three signs that indicate that you need to consult with a workers’ compensation attorney:
- You or your loved one suffered a severe injury;
- You have run into problems with your employer or L&I; and
- Your workers’ compensation claim was rejected, or your benefits denied.
If you are unsure whether or not you need to hire a workers’ compensation attorney, we encourage you to reach out to our law firm for a free and confidential initial consultation. During a consultation, our workers’ compensation attorneys can review your case, answer your questions, and help you take action to maximize your L&I benefits.
Call Our Washington State Workers’ Compensation Lawyers for Help
At The Walthew Law Firm, our Washington workers’ compensation attorneys have the skills and legal experience to assist you with all types of L&I claims. With more than eight decades handling work injury claims, we are more than ready to protect your rights. To set up a no-cost, no-commitment review of your case, please contact us today. From our legal offices in Seattle and Everett, we represent injured workers throughout the entire region, including in Bellevue, Redmond, Tacoma, Olympia, Kent, Puyallup, Federal Way, Issaquah, and Lakewood.