Sharpe Law Firm

http://www.sharpelawfirm.org/washington-state-workers-comp-landi/frequently-asked-li-questions-faq.shtml

FREQUENTLY ASKED L&I QUESTIONS (FAQ)

The majority of the cases handled in our office are Washington State Workers' Compensation claims.  We deal directly with the Department of Labor and Industries, self-insured employers and their agents, vocational counselors...

The majority of the cases handled in our office are Washington State Workers' Compensation claims.  We deal directly with the Department of Labor and Industries, self-insured employers and their agents, vocational counselors, doctors, and anyone else who may be necessary to help your case move to a successful conclusion.

For answers to our FREQUENTLY ASKED QUESTIONS, please follow the links below.

The information provided above is meant for reference only. Information provided on this website is not intended as legal advice. If you have specific legal concerns, you should consult a lawyer.

How do I know if I have workers' compensation coverage?

Most workers that are employed in the state of Washington have mandatory workers' compensation coverage.  If you have been injured while on the job, the best way to find out if you are covered is to file a claim with the Department of Labor & Industries.  If you are denied coverage, you may want to speak with an attorney, as you may have coverage even if your  employer does not provide it. See also WASHINGTON STATE WORKERS' COMPENSATION (L&I).

How do I file a claim?

To file a claim, you must see a doctor and complete a Labor & Industries accident report form.  For state fund cases, most doctors have this form in their office. For self-insured employers, your employer should have the form you need.  Complete your part of the form, then give it to the doctor's office to complete their part of the form, and send it to Labor & Industries.  It is also smart to report your injury to your employer as soon as possible. For additional information see STARTING AN L&I CLAIM.

What benefits does Labor & Industries provide to injured workers?

Labor and Industries can provide benefits such as medical coverage, time loss payments, permanent partial disability awards, vocational services, pensions, death payments, travel reimbursement, loss of earning power payments, and more.  To find out more, see L&I BENEFITS.

Can I choose any doctor I want?

You may choose your own physician and have the medical bills for treatment and diagnostic testing paid for, if it is related to your job injury or occupational disease, and if the treatment you receive is likely to improve your condition.  For more information, see the section on MEDICAL CARE.

Does workers' compensation pay for my lost wages?

Workers' Compensation coverage will pay for 60 to 75 percent of what your wages were at the time of injury.  This amount is limited and cannot exceed the state maximum rate.  You should receive a check every two weeks, as long as you are properly certified as unable to work by your attending physician. For more information, see HOW DO I GET A FAIR TIME LOSS RATE?

When my claim closes, am I entitled to a monetary settlement?

As an injured worker, you have a right to receive a monetary award if you have a permanent partial disability that is an objectively measurable impairment that exists at the time of your claim closure.  The amount of the award is dependent upon the extent of the disability and the date of injury.  Claim closure will usually occur shortly after the doctor has completed treatment. For more information, see HOW TO GET A FAIR PERMANENT PARTIAL DISABILITY (PPD) SETTLEMENT.

Can I have an attorney represent me for a workers' compensation claim?

In workers' compensation, you have a right to legal counsel. If you have any questions regarding workers' compensation law, or your rights, you may want to consult an attorney.  You may choose any attorney you wish, and you have a right to have the fees that your attorney charges reviewed to ensure that they are reasonable. For more nformation see LAWYERS.

Is there a statute of limitations that applies to workers' compensation claims?

Yes. The statute of limitations is a time deadline, and you must file an original claim for benefits within that time deadline or you will lose your right to benefits.  In the state of Washington, a job injury has a statute of limitations of one year from the date of the injury.  Occupational disease claims have at least a two year statute of limitations, from the date that the doctor has informed the worker in writing that they have a job-related disability.

What is a third party claim?

A third party claim exists if, while on the job, you are injured intentionally by anyone, or if you are injured negligently by someone who is not your employer or co-worker.  When this occurs, you can demand payment for the losses that they have caused you and, if necessary, sue them.  For more information, see THIRD PARTY CLAIMS.

Can I get job retraining if my injury does not allow me to return to my old job?

Limited vocational assistance is sometimes available to injured workers whose injury continues to totally restrict their ability to work.  For more information, see VOCATIONAL REHABILITATION.

What is the difference between an injury and an occupational disease?

A job injury is basically defined as a sudden and traumatic outside event producing an immediate result to the worker.  An occupational disease is a medical condition or disease that has developed slowly, over time, resulting from exposure or a continuous condition on the job.  An example of a job injury is falling off a ladder and breaking an arm.  An example of an occupational disease is loss of hearing due to working around noisy equipment. For more information see INJURY or OCCUPATIONAL DISEASE.

What is an IME?

An IME is an independent medical examination that is requested by the state or self-insured employer.  The stated purpose of these are to obtain an expert opinion regarding medical conditions.  In reality, IME's are often used to cut off benefits and close claims.  Labor & Industries or the self-insured employer has the power to schedule and insist on your attendance at a reasonable number of IME's. If an IME is scheduled for you, you might want to consider consulting an attorney. For more see ELEVEN THINGS THAT CAN RUIN YOUR CLAIM.

Can I reopen my Labor & Industries claim once it is closed?

Labor & Industries claims can be reopened for full benefits any time within seven years of  the date of initial closure, and for medical benefits anytime, as long as you can show objective worsening of your accepted condition.

Do I have to pay taxes on my L&I payments?

Mostly good news here. Federal Tax Regulation 1-104-1(b) states that workers' compensation benefits for personal injuries or sickness incurred in the course of employment are excludable from gross income (not taxable). There is a possible exception for mental health injuries if they are not the result of a personal injury. Talk to your tax advisor if this applies to you.

Also, there is an unjustice in the reverse offset years (age 62-65), for some persons getting both social security disability and either workers' compensation time loss or pension payments. The L&I benefits which offset the taxable Social Security benefits are treated as though they are a taxable Social Security benefit. Social Security will send a statement to the injured worker and to the IRS. Depending on the remainder of household income, income taxes may be due on these Social Security Benefits even though they are never received. 28 U.S.C. § 86(d)(3).  US Tax Court Flores v. Commisioner. Talk to your tax advisor if this applies to you.

 

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