11 Things That Can Ruin Your L&I Workers Compensation Claim

Ruining an L&I claim is easy. L&I does this every day. But you don’t have to fall into their trap. Learn from the injured workers who have come before you and keep your L&I claim on track and healthy. Don’t let L&I ruin your claim. Here are 11 things to pay special attention to. 

If you’re feeling overwhelmed or uncertain, we’re here to help. Schedule a free case consultation and take the first step towards protecting your rights.

1. Independent Medical Exams (IME) Ruin More Claims Than Any Other L&I Trick 

The independent medical exam is a report produced by a doctor who sees you once to assess your claim and answer questions. 

That sounds innocent enough, but it is not. Be careful of independent medical exams. 

Most of them are set up by claims managers whose interests are different than yours. These claims managers are looking for opinions that deny medical care, close your case, and give you less settlement than you deserve. Many IME doctors are happy to oblige them. 

When somebody orders an independent medical exam in your case, watch out and do your research on IMEs.  

2. If Your Employer is Self-Insured, Watch Out!

Employers self-insure to save money. The way they save money is to avoid paying it to injured workers. Their tactics include:

  • Suppressing claims
  • Harassing injured workers
  • Not paying benefits
  • Slashing benefits
  • Delaying benefits
  • Withholding file information
  • Doing unfair surveillance films

If your employer is self-insured, you are at a disadvantage and need to learn how to deal with self-insured employers.

3. Not Doing Enough to Get Yourself a Pension Could Ruin Your Claim and Your Financial Situation for the Rest of Your Life 

If you will never work again because of your injury, you may qualify for an L&I pension. 

Many people qualify, but few are chosen. Getting a pension requires tenacity, an understanding of the system, persistence, a helpful vocational counselor, a savvy attending physician, the ability to articulate your position, faith, a smart attorney, and the reserve to wait them out while they try and starve you. 

Is it worth the effort? A typical PPD settlement can be worth between $2,000 and $20,000. Many pensions are worth over $500,000. It is worth the effort! 

Find out if you qualify for a pension and do enough to get one. 

4. Letting a Vocational Rehabilitation Counselor (VRC) Decide Your Working Future is a Mistake 

You wouldn’t go into a restaurant and let someone else decide what you eat. 

Likewise, you shouldn’t let some counselor decide your working future without your input. 

Get involved. Know the vocational rules. Help design your vocational plan. Get L&I vocational training and get a good job. 

5. Getting On the Wrong Side of a Claims Manager

Claims managers have a lot of power over your claim. 

Some of them are good people; others not so much. Bad claims managers will drive you crazy. All claims managers are overworked. Make it easy for them to help you.

  • Don’t be rude or mean or get on their bad side. It’s best to treat each other politely, with dignity and respect. 
  • Don’t assume it’s their job to help you. It’s not. 
  • Do cooperate as required, but be smart about it. 
  • Do give them information that will help your case. 

6. Missing a Deadline Can Ruin a Claim 

Don’t miss an important deadline, or it will ruin your day and your claim. 

  • You must protest or appeal every adverse order within 60 days.
  • You must dispute vocational determinations within 15 days
  • You must file your injury claims within one year of the injury.
  • You should file occupational disease cases within two years

Also, don’t fail to understand the scope and impact of an order

For example, when a wage order sets your wages, it often fails to include some essential items such as overtime, bonuses, a second job, lost health care benefits, etc. 

If you don’t protest or appeal, the wage order becomes final, and you will be stuck with this low wage rate for many years.

7. Comparing Your Case to Someone Else’s Case is Stinkin’ Thinking 

Comparing your case to anybody else’s and thinking you will get similar results is a mistake. 

You probably have different injuries, different doctors, different claims, different claims managers, different reactions, and different needs. 

You will get different results. What you get will often result from your injuries and how much work you put into your case, and it will have little to do with somebody else’s case.

8. Not Getting Good Legal Advice Soon Enough

Not being smart about legal advice can ruin your claim. 

L&I Claim consultations are free. You do not have to hire a lawyer for a free claim consultation. Just schedule a call. Don’t hire a lawyer if you don’t need one. Do hire a lawyer if you do need one.

Talk to a lawyer if your case has big problems or you need help figuring out what to do. 

Most workers’ compensation lawyers offer a free legal consultation so you can learn about your claim and figure out whether a lawyer is important for your case. 

Do this early enough in your case to give the lawyer, if you do hire one, a chance to help you make smart moves. Lawyers are better at thinking and planning ahead than cleaning up a mess you made because you waited too long. 

If you need an initial legal consultation to assess where you are at and what you can do, contact us and we’ll give you one – for free. 

9. Choosing the Wrong Doctor

Choosing the wrong doctor can ruin your claim. Some doctors care and can really help. Some don’t. 

Let’s take the hypothetical example of Unlucky Joe and Smart Jerry. 

Unlucky Joe has a back injury and sees a doctor his employer recommended. That doctor starts a claim, tells Unlucky Joe he’ll get better soon, gives him some drugs, and sends him back to work too soon. Unlucky Joe re-injures his back. That doctor’s report is later used to close the claim and cut off Unlucky Joe’s benefits. 

Smart Jerry knew enough to choose his own doctor, and he got a good one. That doctor recognized there might be a problem and ordered diagnostic tests to include an MRI. The MRI showed a major back problem. That doctor helped Smart Jerry keep his claim open and get the specialized medical care he needed to get a good result in his workers’ compensation case. 

Unlucky Joe and Smart Jerry could have had precisely the same injury, but their choice of doctors made all the difference. 

Find out how to get medical treatment for a Washington State L&I claim and choose a doctor who will help your claim, not ruin it. 

10. Not Understanding or Recognizing Depression and How it Can Ruin Your Claim 

If you have a severe injury and are out of work, out of money, unable to function as you would like to, and are in the dark about your rights, then you are probably depressed. 

Most people don’t want to know that they are depressed and won’t admit it even if they do know. Depression has a lot of symptoms. Among them is a tendency to sit around and do little or nothing about your problems. 

Unrecognized and untreated depression can ruin your case because you sit around feeling sorry for yourself while they stick it to you. 

Get it together, educate yourself on L&I PPD settlements, and get the money you deserve. 

11. Doing Nothing to Help Yourself Can Ruin Your Claim 

The Department of Labor & Industries or the self-insured employer has an army working to process and close your claim. 

In most cases, they are trying to pay as little as possible.

You may get very little if you do little to help your case. Stand up, speak up, and increase your chances of getting a good result. Action cures fear. Contact us for a free strategy session if you need help figuring out what to do. We’ll tell you what your choices are and what you should do.

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Chris Sharpe

Meet Chris Sharpe

Christopher Sharpe is the go to attorney for injured persons. His law firm is helpful, honest, and knowledgeable about workers' compensation and personal injury law in the State of Washington. Chris has been helping injured Washington State workers for over 40 years. He has built a successful law practice by thoroughly educating, honestly helping, and successfully representing workers throughout Washington State.

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