What is a Self-insured Employer Claim versus L&I State-Funded Claim?

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Many people ask if our law firm handles work injury claims for self-insured employers. The answer is YES!

Self-insured employer claim vs L&I claim

There are 2 types of work injury claims in Washington State. The first type is an L&I claim. The other type is self-insured employer claim. The State of Washington funds L&I claims. In contrast, self-insured employer claims get funding from employers and private insurance companies. Yet, the Industrial Insurance Act governs both types of claims. We have experience representing work injury claimants across Washington State, regardless of whether the claim is state-funded or self-insured.

The main difference between the two types of work injury claims is the administration. Explicitly, the Department of Labor and Industries (L&I) manages and administers L&I claims. In contrast, third-party administrators (TPAs), such as Sedewick, administer self-insured employer claims. Common TPA firms in Washington State include Sedgwick, Helmsman, Eberle Vivian, and Comprehensive Risk Management. Others are AIG Claim Inc., Broadspire, CCMSI, and Crawford & Company. Then, there are ESIS, Corvel, Gallagher Bassett, Penser, and Liberty Mutual. Interestingly, you can find the list of self-insured employers and TPAs on the L&I website.

Benefits under self-insured employer claim

Self-insured employers and their TPAs provide the proper benefits to work injury claimants. On top, they are responsible for paying benefits while the work injury claim is open. Furthermore, the self-insured employer remains liable for benefits during a lengthy claim reopening period. That employer is also liable for worker benefits whether they continue or surrender their self-insured certification.

L&I has a division that ensures that all employers meet the rules and regulations for workers’ compensation benefits. The division regularly reviews the financial strength of self-insured employers. In fact, the goal is to verify that employers can meet their workers’ compensation obligations.

L&I attorney for self-insured employer claim

For us, workers’ compensation attorneys that represent work injury claimants, the differences are important. We have vast experience navigating both self-insured employer claims and L&I claims in Washington State. We also ensure that claim administrators treat work injury claimants fairly. Finally, we make sure that claim admins provide the appropriate benefits over time.