Labor and Industries (L&I)Workers compensation legal info

Self-insured employer vs L&I workers’ compensation claim in Washington State

self insured versus l&i workers compensation claim in Washington State

I’m frequently asked whether I represent injured workers who have Self-Insured employers. The answer is YES!

 

In the State of Washington, claim administration can either be State funded or Self-insured and both types of claims are governed by the same Industrial Insurance Act. We have experience representing all Washington State injured workers, regardless of whether the claim is State funded or self-insured.

 

The main difference between the two types of claims is that State funded claims are managed and administered by the Department of Labor and Industries (L&I), whereas self-insured claims are managed and administered by a third party administrator (TPA). Common TPA’s in Washington State include Sedgwick, Helmsman, Eberle Vivian, Comprehensive Risk Management, AIG Claim Inc., Broadspire, CCMSI, Crawford & Company, ESIS, Corvel, Gallaher Bassett, Penser, and Liberty Mutual. However, a complete list of self-insured employers and TPAs can be found on the L&I website.

 

Self-insured employers and their TPAs provide any and all appropriate benefits to injured workers and are responsible for payment of benefits during the time a claim is open. The self-insured employer remains liable for benefits during a lengthy reopening period and continues to be liable for worker benefits whether their self-insured certification is continued or surrendered. L&I has a division that oversees the provision of workers compensation benefits to injured workers consistent with L&I’s rules and regulations, and reviews self-insured employers’ financial strength to make sure that all workers’ compensation obligations can be met.

 

For those of us experienced in representing insured workers, the differences between state funded and self-insured claims are nuanced but important. We are well versed in navigating self-insured claims and in ensuring that injured workers are being treated fairly and are being provided with the benefits they are entitled to under the Industrial Insurance Act.

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