Can’t work? Get L&I to pay time loss.
To get time loss you need all of the following:
You can go about your daily activities within the limits and restrictions outlined by your doctor. You should be receiving medical treatment and attending medical appointments while on time loss. Use this time to focus on your recovery.
The Department of Labor and Industries makes the time loss payment to injured workers on State Fund Claims.
If you work for a Self Insured employer, your employer pays your time loss. The self insured employer may have a Third Party Administrator (TPA) as their claims managers and issue time loss payments through that TPA.
The first time-loss compensation payment must be mailed within 14 calendar days.
The 14-day clock begins the day after the receipt of either the Report of Industrial Injury form or the worker’s application for benefits, or
The 14-day clock begins to run the day after the department receives either contention or certification from your doctor that time-loss compensation benefits are payable.
Self insured employers can be penalized for late or for missing time loss payments. You can request penalty from the Self Insured Section of the Department of Labor and Industries. The law assesses a penalty of the greater of $500 or 25% of the amount due. Payment is to the injured worker.
For claims managed by the Department of Labor and Industries there is no penalty however you can request to speak to the unit supervisor and ask them to intervene.
You can request a penalty on a self insured claim by writing to the Self Insured Section of the Department of Labor and Industries. The director of L&I is required to issue an order within 30 days of your request.
Contact your claims manager to advise that your time loss rate is not correct. If an order has been issued setting your time loss rate, you must properly submit a timely WRITTEN protest or appeal that order. Do not hesitate. Time is of the essence. See How to Disagree with an L&I Decision. Provide the claims manager with your pay information if your employer is not responding to requests for wage information.
Time loss paid while the claim is under investigation is provisional time loss. It is different in character then time loss. Provisional time loss comes with strings attached. If your L&I claim is later denied with a final order you must pay back all the provisional time loss you received. L&I does not always initiate provisional time loss while they are waiting to make a decision on allowing or denying your claim. They do have to pay it, so if you deserve it and want it, then request that L&I pay provisional time loss.
Time loss statute is RCW 51.32.010
L&I time loss gets cut off for a number of reasons:
Late time loss is no fun. You should do something about it. What you do depends upon the reason it is late.
Wage and Family Calculation
Your time loss rate is determined by multiplying wages times a family status percentage [wage rate x family status percentage = time loss rate].
Family status determines the % of wages
The above % of wages figures are limited for high income earners. There is a dollar maximum of time loss per month, which is determined by your wage as of your date of injury. This maximum dollar amount changes yearly. If the wage and family status calculation above ends up greater than the figures below, then you are a high wage earner and your maximum rate is set out below.
COLA Increase Effective 7/1/2021
|Date of Injury||Max Time Loss Amount ($)|
|7/1/96 – 6/30/22
|7/1/95 – 6/30/96
|7/1/94 – 6/30/95
|7/1/93 – 6/30/94
|7/1/88 – 6/30/93
|7/1/71 – 6/30/88
*SAW – State’s average (monthly) wage
**For details see L&I’s Maximum Time Loss Rate
The % of wages figures don’t apply to persons who earn very low wages. If the wage and family calculation for you is less than the below figures, then you will receive the amount set out below.
Minimum Time-Loss Rate for a DOI or DOM on or after 7/2/08
15% of the State Average Monthly Wage
|Date of Injury||15% of State Average Wage|
|07/01/21 – 6/30/22||$959.26|
|07/01/20 – 6/30/21||$871.25|
|07/01/19 – 6/30/20||$816.26|
|07/01/18 – 6/30/19||$773.59|
|07/01/17 – 6/30/18||$736.96|
|07/01/16 – 6/30/17||$703.41|
|07/01/15 – 6/30/16||$685.37|
|07/01/14 – 6/30/15||$657.94|
|07/01/13 – 6/30/14||$644.94|
|07/01/12 – 6/30/13||$623.68|
|07/01/11 – 6/30/12||$602.03|
|07/01/10 – 6/30/11||$589.41|
|07/01/09 – 6/30/10||$578.20|
|07/01/08 – 6/30/09||$559.01|
For details see L&I’s Minimum Time Loss Rate
Kept on salary is an employer continuing to pay his worker the wages they were earning at the time of injury. When an employer keeps their injured worker on salary, the worker is not entitled to time loss payments for that same time period.
Be sure you pay attention to the L&I order setting your wage rate. Make no mistake about this: the wage rate set in that order, once it becomes final, is the wage rate you will be stuck with, for the life of your claim. If it isn’t right, then timely protest the order in writing and insist the claims manager get it right. Continue to protest or appeal as necessary. See How to Disagree with an L&I Decision. If L&I doesn’t get it right, then get a lawyer, before it’s too late.
Telephone – Call for information or a free strategy session – 206-343-1988