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Penalties to the Self Insured Employer

Self Insured Employers Must Follow the Law

Some employers are self-insured and manage their own workers compensation claims.

They choose to self insure because they wish to save money. Some self insurers will try to save money by not paying it to you. Don’t let them do this to you. Stand up for your rights and insist the self insurer treat you fairly. If they will not treat you fairly than request a penalty.

Penalties and the amount of the penalty for refusing to pay or delaying benefits are authorized by RCW 51.48.017. This law assesses a penalty of the greater of $500 or 25% of the amount due. Payment is to the injured worker.

Penalties are for Unreasonable Delay Paying Benefits

These self-insured employers are required to pay workers compensation benefits on time. If the self insured employer delays benefits they can be penalized.

The department of Labor and Industries will consider assessing a penalty for unreasonable delay of benefits under the guidelines of WAC 296-15-266.

Delayed benefits subject to penalty include time loss, loss of earning power, coverage of medical conditions, payment of medical bills, authorization of emergency medical care and permanent partial disability.

It is Difficult to Get L&I to Order a Penalty.

Unfortunately in their administrative regulations, L&I allows the Self Insured employers to get away with delayed payment if there is any legal or medical doubt that payment is due. Said another way, if the self insured gets a bogus IME it is difficult to get a penalty. This isn’t right. The opinion of the attending doctor should prevail. See: Clark County v McManus

Penalties which can be assessed against Self Insured employers for certain prescribed conduct:

Some penalties are payable to the injured worker, others to L&I.

Unreasonable delay: RCW 51.48.017; WAC 296-15-266
Failure to comply with a CRSSA: RCW 51.04.063
Failure to conspicuously post required information: RCW 51.14.100(1)
Failure to keep and or furnish compensation records: RCW 51.14.110
Failure to timely provide the claims file: RCW51.14.120(1); WAC 296-15-420(7)
Failure to timely notify L&I: RCW 51.14.120(2); WAC 296-15-480; WAC 296-15-420(1)
Failure to submit a medical report of closure: RCW 51.14.120(3)
Failure to timely act on a filed claim: RCW 51.14.130; WAC 296-15-350
Failure to keep and allow inspection of payroll records: RCW 51.48.040
Failure to follow L&I rules RCW 51.48.08

How to Make a Penalty Request

A penalty request is made by sending a written request to Labor and Industries. The director of L&I is required to issue an order within 30 days of your request. Some penalties are payable to the injured worker and some are payable to L&I.

Frequently asked questions about self insured penalties and more insight about how a court, the Board of Industrial Insurance Appeals, looks at penalties see : Penalties (RCW 51.48.17)