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L&I is short for the Washington State Department of Labor & Industries. It is a quasi insurance system covering persons hurt on the job. Benefits include medical care, time loss compensation, permanent partial disability, vocational rehabilitation, pensions, and other payments. You paid a premium for these benefits. Insist on getting yours. L&I manages state fund cases and presides over self insured cases.
Most workers are covered by L&I Insurance. You may have L&I insurance even if you think you don’t. Coverage is mandatory, and your employer is required to pay for it, either before or after you are injured.
There are two types of Washington State L&I insurance. The Department of Labor & Industries (L&I) is in charge of worker’s compensation in Washington State. Most L&I cases are state fund cases, handled by L&I claims managers. Some cases are self insured, handled by agents of the employer.
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.
For sure there is a deadline to file a claim. It is called the Statute of Limitations. There are two such statutes, one for injury and another for an occupational disease. For an injury you have one year from your injury date to file an L&I claim. For an occupational disease you have two years or longer, from the manifestation of your occupational disease, to file an l&I claim.
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.
You may choose your own physician, from a limited pool of doctors, and have the medical bills for treatment and diagnostic testing paid for. The treatment you receive should be likely to improve your condition and the conditions treated need to be related to your job injury or occupational disease For more information, see MEDICAL CARE.
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?
As an injured worker, you have a right to receive a monetary award if you have a permanent partial disability which 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 and L&I says you can work. For more information, see HOW TO GET A FAIR PERMANENT PARTIAL DISABILITY (PPD) SETTLEMENT. See also: CLAIMS RESOLUTION STRUCTURED SETTLEMENT AGREEMENTS.
In workers’ compensation, you have a right but not an obligation to have 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 information see LAWYERS.
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.
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.
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 and a more formal definition see INJURY or OCCUPATIONAL DISEASE.
An IME is an independent medical examination. An IME is requested by the state or self-insured employer for the stated purpose of obtaining an expert opinion regarding medical conditions. In reality, IME’s are performed by hack doctors and 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. See: ELEVEN THINGS THAT CAN RUIN YOUR CLAIM. See also: IME.
Labor & Industries claims (except CRSSA’s) can be reopened for full benefits any time within seven years of the date of first final closure, and for medical benefits anytime, as long as you can show objective worsening of your accepted condition. See REOPENING.
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.