Understanding the precise meaning of L&I jargon will help you understand what's happening and control the outcome of your case. A few of the more important definitions are listed below.

For additional information about the people you will deal with in the Workers' Compensation system, see THE PLAYERS.

Appeal
An Appeal is a written disagreement with a protestable or appealable order. Must be sent in writing to the Board of Industrial Insurance Appeals within 60 days of when the order was communicated to you. This written appeal should comply with the requirements of RCW 51.52.070. Miss your 60 day deadline and the order becomes Res Judicata. If you appeal in time then you will start into the Board of Industrial Insurance Appeals process.

Independent Medical Examination (IME)
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. If they want a particular result, then 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. The claims managers ask questions of the IME doctors, designed to get opinions that either deny medical care, find that you're employable, 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. See IME.

Labor & Industries (L&I)
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.

Order
An order is a written determination by L&I or the self-insured employer 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. 60 days is the amount of 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. See definition of "Res Judicata" in this section.

Pension 
A pension is the rough equivalent of your time loss for the rest of your life. A pension is also known as Permanent Total Disability. 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.

Permanent Partial Disability (PPD)
PPD is a money settlement paid when your case closes. You must be able to return to some work to get PPD. The dollar amount is determined by medical report and L&I's rules; the amount you receive can be substantial or 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.

Protest (Request for Reconsideration)
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. Miss your 60 day deadline and the order becomes Res Judicata. If you protest in time, then you get to present more evidence and you should get another decision.

Res Judicata
A principle of finality; that is once a matter is decided then it cannot be decided again. This principle applies to L&I orders. When an L&I order is issued, it is not final because you have 60 days to protest or appeal. If you do nothing then 60 days after that order is communicated to you it becomes final and res judicata and cannot be changed.

L&I orders should, and almost always do, contain this language:

"THIS ORDER BECOMES FINAL 60 DAYS FROM THE DATE IT IS COMMUNICATED TO YOU UNLESS YOU DO ONE OF THE FOLLOWING: FILE A WRITTEN REQUEST FOR RECONSIDERATION WITH THE DEPARTMENT OR FILE A WRITTEN APPEAL WITH THE BOARD OF INDUSTRIAL INSURANCE APPEALS. IF YOU FILE FOR RECONSIDERATION, YOU SHOULD INCLUDE REASONS YOU BELIEVE THIS DECISION IS WRONG AND SEND IT TO: DEPARTMENT OF LABOR AND INDUSTRIES, PO BOX 44291, OLYMPIA, WA 98504-4291. WE WILL REVIEW YOUR REQUEST AND ISSUE A NEW ORDER. IF YOU FILE AN APPEAL, SEND IT TO: BOARD OF INDUSTRIAL INSURANCE APPEALS, PO BOX 42401, OLYMPIA WA 98504-2401 OR SUBMIT IT ON AN ELECTRONIC FORM FOUND AT HTTP://WWW.BIIA.WA.GOV/."

This language means what it says. Put another way, if you miss your 60 day deadline to protest or appeal then the order becomes final and binding.

Self Insured Employer
Self Insured (SI) 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.

Statue of Limitations (SOL)
The SOL is a time limit imposed by law, within which time you must act, or lose your right to take action. In L&I cases, it generally refers to the time you have to file a claim.

• Injury statute of limitations. You have one year from your injury date to when you must file an L&I claim, see Statute of Limitations.
• Occupational Disease Statute of Limitations. You have two years from the date your occupational disease manifests itself until you must file a claim. See Statute of Limitations for important details.

Time Loss Compensation (Temporary Total Disability – TTD)
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. See also HOW TO GET A FAIR TIME LOSS RATE.

Vocational Training (Voc)
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.

Voluntary Retirement
Voluntary retirement is a determination by L&I that you had given up being a worker, at the time you applied for benefits.

The precise definition is at WAC 296-14-100:

1. What is voluntarily retirement? The worker is considered voluntarily retired if both of the following conditions are met:
   (a) The worker is not receiving income, salary or wages from any gainful employment; and
   (b) The worker has provided no evidence to show a bonafide attempt to return to work after retirement.
   Time loss compensation is not paid to workers who voluntarily retired from the work force.
   (c) Payment of union dues or medical or life insurance premiums does not constitute attachment to the work force.
2. When is a worker determined not to be voluntarily retired? A worker is not voluntarily retired when the industrial injury or occupational disease is a proximate cause for the retirement.
3. A final order declaring "voluntary retirement' means no time loss RCW 51.32.090 (8), and no pension benefits RCW 51.32.060 (6). A worker who has been found to be voluntarily retired must challenge that finding by protest or appeal or they will be precluded from receiving money benefits.

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