How to Protest an L&I Decision
What is an L&I order
When L&I makes a determinative decision in a workers’ compensation case, that determination is usually communicated to injured workers in an order. An order is a written decision and may be titled "payment order", "order and notice", "wage order" or "notice of decision" amongst other things. Whenever L&I issues a decision that is incorrect, that decision must be protested or appealed within 60 days or it will become final and binding. Even if the decision is factually incorrect or contains a legal error, it cannot be changed or fixed once the 60-day protest or appeal period passes. For a protest to be valid, L&I must receive the protest in writing within 60 calendar days of the date the decision was received (or within 15 days for vocational decisions). Protests can be validly submitted online through L&I’s secure Claim & Account Center or by mailing a written letter of protest and mailing it to L&I.
How to protest L&I decisions
Injured workers, employers and health care providers all have the right to protest L&I decisions. In order to submit a valid written protest to L&I, first find the name and address of the claims manager on the document being protested and address the letter of protest to them at the address listed on the document. In the body of the letter, specifically use the word “protest” and state the date and subject matter of the decision being protested. If possible, also state the date the decision was received. In addition, include the reason for the protest and attach any documents (such as medical records) that you believe support the basis for the protest. Be sure to include the injured worker’s name and claim number on the protest as well.
Whenever L&I receives a timely protest, they will then issue another decision that modifies, reverses, or affirms the original decision. If there is still disagreement with the new decision, it can be appealed to the Board of Industrial Insurance Appeals (Board). Once again, the appeal must be submitted within 60 days following receipt of the decision and failure to appeal within the allotted timeframe will result in the decision becoming final and binding, even if it is incorrect.
When to hire an L&I attorney
If L&I has affirmed a decision and a Board appeal is required, it is probably a good idea to consult with an experienced attorney about the nature of the appeal, requirements for meeting the burden of proof, and the likelihood of success. One of the most challenging circumstances attorneys representing injured workers' face is when we are asked to take over representation later in the Board appeal process because it gives us relatively little time to evaluate all the evidence and put together a winning case strategy.
7 thoughts on “How to Protest an L&I Decision”
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I am not being allowed to complete recommended physical/occupational therapy. Even though the doctor, therapist and vocational counselor disagree with my cM, she refuses to listen. I dont understand after knee surgery and shoulder surgery why she would not let me participate in something that will help me return to work.
I have missed my 60 day appeal but my Doctor told me to appeal it after the 60 days what can I do
Hi Christopher. You should call an attorney. It’s very difficult to get an appeal approved after the 60 days elapsed. If can still try, but your chances of getting the appeal approved are not good.
how long does l&I have to answer protests?
Hi Jerry. I apologize for the delayed reply. There is no time limit for L&I to answer a protest. If you feel like L&I is taking a long time to act, then it’s best to reach out to your claim manager and ask them to give your matter some attention.
I was informed by a lawyer that l&I had wait to make a decision in my protest until they had my own ppd rating done which due to scheduling conflict that is well after my 60 days. I protested with my appointment date they say original claim order closing still stands and that I need to file an appeal. Is this correct?
Hopefully this overview will help: Once L&I issues an order that you disagree with, you have 60-days to protest it in writing. Once you file a written protest, L&I must issue a new order stating whether the original determination is affirmed or reversing the original decision and making a new/different determination. If L&I affirms the original decision and you still disagree, then you have another 60-days to file an appeal with the Board of Industrial Insurance Appeals (BIIA). Based on what you described, I assume you protested the original closing order, L&I affirmed it, and now you are within the 60-day window to file an appeal. You can file an appeal online by following this link: https://fortress.wa.gov/biia/efiling/EFile/BIIA02.aspx The 60-day window is very strict, do not miss it. Make sure you file your appeal on time even if you don’t have the evidence yet. You will have time to submit your doctor’s PPD rating even after you appeal.