What is L&I Pension in L&I Claims or Self-insured Employer Claims?

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L&I pension overview

L&I pension is a life-time benefit. The Department of Labor and Industries (L&I) pays pensions to people that can never work again. In short, L&I pension is a type of L&I claim settlement. It’s like getting time-loss payments for life in exchange to closing your L&I claim. Work injury claimants should consider a pension when their L&I claim is about to close. Some people will never be able to find and maintain a job because of their work injury. If you are one of those people, then you should receive a pension.

Pension for self-insured employer claim

Self-insured employers use a private insurance company (like Sedgewick) to cover workers compensation claim. There are many employers in Washington State that are self-insured. For example, Boeing, Lowes, Home Depot, Costco, and many others. Some people suffer a workplace injury or occupational disease while working for a self-insured employer. However, all the L&I rules apply here as well. If you cannot return to employment because of the work injury, then you should receive a pension. Again, the rules for self-insured employers are similar to L&I.

Closing L&I claim and pension benefits

Once you open an L&I claim, you’ll receive medical treatment. After that, at some point, you’ll be at Maximum Medical Improvement (MMI). Maximum medical improvement doesn’t mean that you healed. It just means you won’t get any better even with more medical treatment. When you’re MMI, L&I will look at your future employment options. Here, they look at your medical provider’s opinion and IME reports. They also look at your age, education, experience, and work skills. Then, between your claim manager and vocational counselor, they will decide if you can return to work.

Upon closing, some people have permanent medical or mental limitations from their work injury. Yet, if you can return to work despite the limitations, then you’ll get a PPD. Sometimes, if there are any pending issues in the claim, people choose to do an L&I structured settlement. Finally, if you’re unable to gain employment because of the work injury, you’ll receive a pension.

Permanent total disability and pension

L&I uses the term Permanent Total Disability to describe people that qualify for pension. It means that, from L&I standpoint, a person is totally disabled. It also means that they will never be able to work again. However, many work injury claimants think that the term permanent total disability is harsh. Therefore, it’s important to understand this term. Explicitly, this doesn’t mean you cannot have a normal life. It also doesn’t mean that you have to depend on others for the rest of your life. Remember, it’s just a term that L&I uses to categorize the level of your work injury and employment.

L&I attorney to help with getting pension

You don’t have to hire an L&I attorney or workers compensation attorney to get a pension. You can manage the entire process yourself. However, it’s going to be difficult. You must prepare to show evidence in every step of the way. Also, you’ll probably have to file L&I claim appeals. Appeals are like a court where you appear in front of a judge at the Board of Appeals. Here too, you can represent yourself. However, a good L&I attorney knows how to get a pension. We, L&I attorneys, do this for a living. An L&I lawyer can make things move faster and hit less roadblocks. Additionally, we can look for red flags and avoid them. Hence, while you don’t have to have an L&I attorney by your side, it’ll significantly increase your chances of getting a pension.

Common questions about pensions

Can I get an L&I pension?

The short answer is Yes if you qualify. However, it’s a long and complicated process. It’s definitely not easy. Financially, a pension from L&I is the most amount of money you can get from an L&I claim. That’s why only a small percent of L&I claims end up with pension. If you are seriously considering getting a pension, you should find a good L&I attorney.

Is a pension from L&I like a regular pension plan?

No. A regular pension is something you get from your employer and their retirement plan. A pension from L&I is something you receive because you’re unable to work again. Moreover, if you get a pension from L&I, you must never work again. Think of this as an L&I retirement. If you receive payments from L&I for your pension and you get paid for any type of work, you’ll get in trouble with the law. In contrast, if you have a regular pension or retirement plan, this limitation doesn’t apply to you.

Should I get a pension from L&I?

We get this question very often. Our answer is always – it depends. Think about your life. Now, consider getting time-loss payments for the rest of your life. Is this the quality of life you want to have? If so, then you should pursue a pension from L&I.

When should I not consider a pension?

Our office sometimes gets calls from young people after a serious work injury. Some of them didn’t make much money in their job of injury. Their time-loss payments are not sufficient to cover independent living expenses. Therefore, many of them want nothing more than to retrain and return to work. In fact, some of them want to return to work so badly even though they have a severe disability.

Do I have a good case for a pension?

First, if you want to know if you have a case, you should call an L&I attorney. Why? Because we provide free consultation and can evaluate your case for you. However, you should know that getting a pension from L&I is challenging. In order to get the pension, you must show that you are not employable. This applies to any job. In other words, you have to prove you’re unable to find and maintain full-time employment because of the work injury. Here, you’ll have to get written opinions and support from your medical provider. In general, you will also have to fight independent medical examiners (IME). Many times, IME reports contradict the opinion of your medical provider. Next, if you have skills, you’ll have to go through a vocational process. Finally, you’ll have to convince your claim manager an L&I that you indeed deserve the pension.

The claim manager will look at many factors:

  • Strengths and weaknesses
  • Work history
  • Training and experience
  • Age
  • Level of education

Just remember, it’s a long tedious road to get a pension. You should definitely find an L&I attorney or workers compensation attorney to help.

Is L&I pension better than PPD?

PPD stands for Permanent Partial Disability. It’s when a person has physical or mental limitations because of a work injury or occupational disease. Although, it also means that the person can return to work. For PPD, L&I evaluates the work injury claimant. They call this process PPD rating. Then, when the rating is available, they decide the value of the person’s limitations. From a financial standpoint, a pension from L&I is worth more (and sometimes a lot more) than PPD. However, receiving a PPD versus a pension depends on the facts of your L&I claim.

Does L&I pay for medical treatment after I get a pension?

You receive a pension when your L&I claim closes. Hence, since the claim is closed, L&I no longer covers medical bills (see RCW 51.36.010(4)). Nevertheless, if your doctor thinks you’ll need more treatment, they can request a treatment order. When approved, they’ll attach the treatment order to your claim for future care. Otherwise, if you need more treatment, your medical provider must apply for it. They have to submit a written request to L&I. Then, they need to get approval before providing medical care. If you receive medical treatment before approval, then L&I will deny coverage.

When will I get my L&I pension?

If your L&I claim is about to close, and you qualify, then you should get a pension. However, there’s no exact schedule to getting a pension. Claim managers can take their time to finish your claim evaluation. Sometimes, L&I claim managers cause very long delays. In such rare cases, you can involve an L&I attorney to expedite the process. Also, it’s very important to continue with medical visits during the entire time.

When does L&I make pension payments?

The schedule for pension payments is monthly. L&I makes payments on the 15th of every month.

Do I pay taxes for L&I pension payments?

No. Pension payments from L&I in Washington State is not subject to tax. The same goes for other workers compensation benefits.

What’s my L&I pension worth?

A monthly pension payment is approximately the same as your time-loss compensation payment. For example, a single person with no dependents gets 60% of wages. Time-loss payments are bi-weekly whereas pension payments are monthly. Hence, the annual value of your time-loss is one time-loss payment times 26.

If you want to calculate how much your L&I pension is worth, you can follow calculation below:
1) Annual time-loss value = One time-loss payment x 26
2) Life expectancy – Calculate how many more years (on average) you’ll be alive
3) Total pension value = Annual time-loss value x Life expectancy

If you want to be more accurate, you can also consider Cost of Living Adjustment (COLA). In addition, if you receive social security benefits, you should also take into account Social Security Offset. If you think you qualify for a pension, talk to an L&I attorney to go over all these details.

Do I have to hire an L&I lawyer to get a pension?

No, you don’t. However, your chances of getting a pension are much hire when you have one of the best L&I attorney or law firms on your side.

Can I get one lump sum instead of ongoing payments?

There are ways to settle the claim and get one payment. It is, however, strongly advisable to avoid this option. In general, you’re likely to leave a lot of money behind.

How much does it cost to get an L&I pension?

Like everything else in L&I claims, it all depends on your case. Often times, you’ll need expert medical and vocational witnesses. They cost money. Other times, for example with very severe injuries, getting a pension is cheaper and faster. It’s best that you talk to an L&I attorney. A good L&I lawyer will look at the claim and facts. They will tell you if you can get a pension. On top, they will calculate the costs and advise about the next steps. Finally, there are L&I attorney fees. For us, L&I attorney fees come out of pension payments. There’s no upfront cost to you.

What is my pension reserve?

L&I must prepare to pay you money for the rest of your life. For that, L&I reserves money in an account. The pension reserve is interesting because it indicates the costs incurred by L&I. There are ways to calculate the amount of your pension reserve. Also, you can use the pension reserve to reach L&I claim settlement agreements. However, it’s a very complicated subject. Speak with an L&I attorney if you wish to learn more.

Can L&I make me pay back pension money?

Yes, in some special cases. For example, if you receive both social security benefits and an L&I pension. This is a complicated topic. It’s called Social Security offset. Also, if L&I finds that you’re working while on pension, they’ll make you pay back.

What happens to my pension if I die?

There are several options here. In some cases, you can pass the pension to your spouse. You can even pass the pension to your kids. These are not very common cases. Yet, they are doable. Speak to an L&I attorney to get more details. It’s a complicated topic.