These words are important. Learn the lingo and you can talk with the players.
Understanding the precise meaning of common L&I words will help you control the outcome of your case. Some of the definitions are obvious, some are not.
Time loss compensation is money paid every two weeks to partially replace lost wages. It is paid if your doctor certifies your inability to work. The time loss rate is 60% of wages, more with spouse, children, and lost health care benefits. It is tax free. How to get a fair time loss rate.
PPD is a money settlement paid when your case closes. You must be able to return to some work to get PPD. Dollar amount is determined by medical report and L&I rules, the amount can be as little as zero. PPD includes physical and mental impairment but does not include loss of income nor pain and suffering. How to get a fair PPD settlement.
A pension is the rough equivalent of your time loss for the rest of your life. To qualify for a pension you must be unable to return to work. Pensions can be worth a lot of money. They are not easy to get. You can get permanent partial disability or a pension, not both. To learn more see Pensions.
Vocational training also known as vocational rehabilitation, is a benefit some workers receive, if it is determined that they are not employable and would benefit from vocational services. See Vocational Rehabilitation for details.
An order is a written determination by L&I or SI that affects your legal rights. Orders are issued for many purposes, to include opening or closing claims, setting wage rate, accepting or denying benefits, etc. The time period between the date the order is communicated to you and the time you must act is often 60 days. This is the time you have to protest or appeal in writing that order. If you do not timely protest or appeal, then the order becomes final - and cannot be changed.
A protest is a written disagreement with a protestable order. Must be sent to L&I within 60 days of when the order was communicated to you. This written protest must specify that you disagree with the order and are requesting action inconsistant with the decision.
An Appeal is a written disagreement with a protestable or appealable order. Must be sent to the Board of Industrial Insurance within 60 days of when the order was communicated to you. This written appeal should comply with the requirement of RCW 51.52.070.
The SOL is a time limit imposed by statute, within which time you must act, or lose your right to take action. The decision or order you disagree with should specify the time within which you must disagree.
The Department of Labor & Industries. A Washington State agency in charge of worker’s compensation claims, crime victim claims, WISHA, wage and hour claims, and worker safety. L&I manages state fund claims and oversees self insured claims. 73% of L&I claims are state fund.
Employers with sufficient assets can self insure. They manage the claims themselves or with the help of a service company. Employers self insure to save money; they save that money by not paying it to injured workers. If you have a self insured claim and a serious injury, you are already at a disadvantage. 27% of all L&I claims are self insured.
The independent medical exam generally takes the form of a brief physical exam and a long report produced by a doctor who sees you one time for the purpose of assessing your claim and answering questions. Independent medical examiners range from truly independent to totally biased. A fair IME is used to obtain a second opinion and properly manage your claim. This biased IME is used to close your claim or deny a medical condition. IME's don't just happen, they are set up by claims manangers. And make no mistake about his: these claims managers know what they ae doing. They want a particular result and they get these IME doctors to help them do it. The totally biased IME doctors are willing to say whatever they think the people paying them want them to say. Be careful of independent medical exams. These examiners are answering the claims manager's questions designed to get opinions that either deny medical care or close your case. Most independent medical examiners are not there to help you. When somebody orders an independent medical exam in your case, watch out.