L&I Claim – Info for Work Injury Claimants

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What do I do when I get injured?

The most important thing is to take care of yourself first. You can worry about your workers’ compensation claim later. It is best to see a doctor right away and report your injury to your employer even if you think you will recover quickly. If you need to file a workers’ compensation claim, your doctor will help you. Your doctor will complete the official form called “Application for Benefits” and you will receive a claim number.

Documentation of your injury is very important. You should check if there were witnesses to your injury. If there were, get their names, phone numbers and addresses. You may need to contact them later in the claim process. Once your employer is notified that an injury occurred, they are also obligated to document the incident. Your employer will report the incident with their documentation to the Department of Labor and Industries (L&I).

How will I pay attorney fees?

Workers’ compensation attorneys in Washington State cannot charge hourly fees. Instead, they must work on a contingent fee basis. This means that workers’ compensation lawyers may not charge you up-front retainer or hourly fees for working on your claim. Attorney’s fees will be deducted as a percentage of benefits secured on your behalf. Simply put, if you don’t get paid, the attorney doesn’t get paid.

At Reck Law we work hard to ensure that injured workers receive the benefits they deserve. Even if you are not sure that you need an attorney, pick up the phone and call us. We provide free consultation. We will review your case and tell you if you are receiving the benefits you should be getting.

Who is entitled to workers’ compensation benefits?

Did you sustain a work injury while working in the State of Washington? Or for a Washington State company? If the answer to either question is Yes, then you are likely covered by the Industrial Insurance Act.

You can file a workers’ compensation claim for benefits if you are a full-time or part-time employee. You can also file if you are a temporary or seasonal worker. Moreover, you can file a claim regardless of whether you’re a U.S. citizen or not. If you have any questions or you are not sure if you’re covered, then call us. Consultations are free. We can help you determine if you are a covered worker.

How do I file a workers’ compensation claim?

If you were injured at work, go see your doctor right away and report your injury to your employer. It is your choice what doctor you see, even if your employer tells you to go see a different or specific doctor.

Your doctor will file a claim by submitting an “Application for Benefits” form if either: (1) He or she knows that your injury occurred at work; or (2) Your doctor feels that the distinctive conditions of your employment caused your symptoms. You will need to complete some of the sections in the “Application for Benefits” form, and your doctor will fill the rest. When completing the form, you need to be as thorough and accurate as possible. The answers you provide may impact your claim and the benefits you will receive later. The “Application for Benefits” will have a claim number pre-printed on the top. It is always a good idea for you to write down your claim number and the date of injury. Keep them for your records.

Your doctor will submit the “Application for Benefits” to the Department of Labor and Industries. Once the Department receives your application, they will determine whether your claim should be allowed. Then, they will send you a decision either allowing or rejecting your claim.

Note: After you receive the decision from the department, you only have 60 days to protest or appeal. If the Department rejects your claim, call us immediately. We will help you determine if you should protest or appeal well before the 60-day deadline.

What types of benefits am I entitled to?

The Industrial Insurance Act outlines your benefits. These benefits may include:

(1) Treatment for conditions that have been caused or aggravated by your work injury or activity.

(2) Wage loss replacement, which is also called time-loss compensation or loss of earning power benefits. This benefit applies if you are unable to work or are doing a job that earns you less than you were making at the time or injury.

(3) Vocational retraining at the discretion of the Director of the Department.

(4) Permanent partial disability (PPD) benefits if you are left with residuals from your injury.

(5) Permanent total disability benefits (i.e., a pension), if your injury is so catastrophic that you cannot return to work.

Many of these benefits are only provided if certain guidelines are met, or if certification is provided. Our office has extensive experience in providing the necessary documentation to ensure timely authorization or certification for benefits. If you are having trouble securing your benefits, please contact our office for a free consultation.

What if the injury is my fault?

Under the Industrial Insurance Act you are protected regardless of who is at fault.

How will I be paid while I’m out of work receiving treatment?

There are different types of monetary benefits you may receive while being out of work for treatment:

  • Temporary Total Disability or time loss compensation benefits – These benefits are paid when a worker has physical or mental limitations that prevent them from working for a temporary period. A medical provider must certify the inability to work. In addition, the physical limitations must have some objective basis.
  • Loss of Earning Power benefits – These benefits are provided when a worker can work but earns less than they were making at the time of injury. These are temporary benefits in nature.

How do I find a doctor who will help me with my claim?

Injured workers with allowed claims need an Attending Physician. Your Attending Physician should be a doctor of your choosing that you trust. However, your provider must be a member of the Department’s Medical Provider Network (MPN). There are many doctors throughout the state that are members of the MPN, so you have options.

Your Attending Physician will be responsible for providing essential medical opinions in your claim. He or she will also respond to inquiries from the claim administrator. You can search and see the list of attending physicians in the MPN here: https://secure.lni.wa.gov/provdir/

What if I can’t go back to my job?

Your treatment concludes when you reach maximum medical improvement or medical fixity. At that point, the Department will attempt to determine the nature and extent of your abilities, both physical and mental or emotional. This is often determined by your Attending Physician. However, in some cases the Department may send you for an “Independent medical Examination” (IME) with a provider of their choosing.

If the Department determines you cannot return to your job of injury, you may be eligible for retraining. The Director of the Department makes this decision at their discretion. If you cannot work and cannot be retrained, you may be eligible for permanent total disability benefits or a pension.

My claim is closed. Can I reopen a claim?

Yes, you may reopen your claim for monetary and medical benefits within 7 years after your claim first closed. You may reopen your claim any time for medical benefits only. However, under the law, the Department will only reopen your claim if you experience objective worsening of your physical condition between the date of closure and the date you file to reopen.

Objective worsening is a medical opinion. Therefore, you need see your doctor so that they can evaluate for objective worsening. If your doctor agrees that your condition has worsened, you should ask them to help you file an Application to Reopen the claim. The Department will evaluate the medical evidence and determine if reopening is appropriate. Note that if the basis of your worsening is a mental health condition, objective worsening does not apply since mental health conditions are inherently subjective in nature.

If the Department rejects your application to reopen the claim, you should contact our office for a free consultation immediately. You only have 60 days to protest or appeal the decision.

Why should I hire Reck Law?

At Reck Law we work for injured workers. We believe that it is our job to assist injured workers in securing all the benefits they should receive under the Industrial Insurance Act. Injured workers must be treated with respect, and we know how challenging it can be to navigate a claim and the claim process.

We have been dedicated to representing injured workers for decades and helped hundreds of clients achieve optimal outcomes in their workers’ compensation claims. We fight and advocate for our clients with a compassionate tenacity and genuinely care about achieving the best outcome for every client.