If you have been injured at work, you may have a claim for benefits under Washington’s worker’s compensation laws, administered by L&I, the Department of Labor and Industries.
If you are injured on the job, you are insured by the Washington State Fund, unless you are employed by a self-insured employer. The same rules apply in both cases, though, with self-insured employers, you will be dealing with a claims management company handling the claim for your employer, and not with L&I.
The following is a brief overview of work injury claims; if you have even a hint of a question regarding your work injury, please call us for free consultation, even if your claim is allowed and you are receiving benefits.
What Is a Work Injury?
A work injury is an injury that happens at a specific time at work. There are specific rules regarding what happens if you injured when going to and from work, what happens if you become sick due to occupational exposure at work.
What to Do if You Are Injured at Work?
If you’re injured at work, report your injury to your employer, and seek medical attention as soon as possible. You can file your claim in one of three ways:
- Online at lni.wa.gov/filefast.
- By phone, call L&I at 1-877-561-3453.
- At your doctor’s office when you’re seen for your work injury.
It is important you tell your doctor exactly what happened, and that you’re accurate when giving your injury history and where it hurts. It is also very important to follow your doctor’s recommendations, and do exactly what she or he says. Your doctor will complete forms required by L&I to support your injury and your inability to work, which is critical if you are to receive full L&I benefits.
It is also important that you are responsive when dealing with the claims manager; this is when it helps to speak to an attorney regarding your case, to ensure your claims process goes as smoothly as possible. Again, even if your claim is accepted, call us for a free consultation.
What Benefits Are Available?
Medical Treatment: If L&I except your claim, you are entitled to all medical care for as long as the care improves your injury, including any hardware needed to help you recover, like wheelchairs, crutches, braces, or prostheses.
Treatment that improves your condition is called curative treatment; palliative treatment only treats the injury symptoms, and does not make you better. L&I will pay for curative treatment expenses; you will have no out-of-pocket expenses. L&I does not pay for curative treatment.
For your initial doctor’s visit, you can go to any qualified doctor. After that, your primary treating doctor must be enrolled in the L&I network, and if they’re not enrolled, they must be willing to enroll. If you at some point become unhappy with your doctor, you may also switch to another doctor within the L&I network.
Time-Loss Compensation: If your doctor certifies you are unable to work because of your injury, you will receive Time-Loss Compensation (TLC), a portion of your regular wages. TLC may vary between 60-75% of your gross income depending on your marital status and whether you have dependents, which includes the value of your hourly wages or salary, health benefits, overtime pay, and more. You will receive TLC as long as your doctor certifies it; TLC will stop once your doctor certifies you can return to work. If you have any questions regarding this, please call us.
Loss of Earning Power: LEP is paid if you’re able to return to part-time work; it is the difference between your regular TLC rate and your part-time income, and needs to be certified by a doctor.
Vocational Services: If you are unable to performed the duties of your regular job after you reach maximum medical improvement, you may have access to paid vocational services, including job retraining and community college, depending on whether you have transferable work skills.
Permanent Partial Disability: Once you have reached maximum medical improvement, which is when no further treatment will improve your condition, you may be due a PPD award if you have some loss of bodily function. This is determined by a schedule implemented by the Washington State legislature. To establish this, L&I will have you examined by a doctor of their choice; but these doctors are usually not impartial, so it is critical your own doctor evaluates whether you have remaining disability. This area often becomes contentious, as the opinions between L&I doctors and treating physicians often vary widely.
Permanent Total Disability: if your physician determines you are not able to perform any gainful employment after you no longer improve from treatment, you may have a claim for PTD, which is essentially a state pension based on your Time-Loss Compensation rate.
Protesting L&I Decisions: If your claim has been denied, terminated, or certain benefits have been terminated, it is critical to know that such decisions must be protested within 60 days of the date of the letter with the adverse decision, or you will forfeit the right to appeal forever. Please call us for a free consultation if you have a claims denial or termination.
Reopening Closed Claims: if you have an L&I claim for work injury that is closed, you may be able to reopen it if your injury objectively worsens. Reopening claims can be quite difficult; please contact us if you have any questions.
Must Your Employer Hold Your Job for You? Injured workers understandably become concerned with whether they will have a job once they’re done with their treatment. Employers may not fire you for filing a workers’ compensation claim, but, under Washington law, employers are not required to hold your job for you until you’re able to return to work. If your employer terminates you after certain amount of time, it does not mean your workers compensation benefits also end; but, as this is a tricky area, please call us for a consultation. We will be happy to discuss it with you.