In a recent social media poll we asked what YOU wanted to know about the L&I process. Your overwhelming response: How to File an L&I Claim! Read on to learn more from our experienced legal team.
First, What Is An L&I Claim?
An L&I claim is a file of important information about a worker, their injury or exposure, their specific job, and their employer. An L&I claim is monitored and managed by an L&I Claim Manager who sees the process through from initial claim filing to closure. If all goes as planned, your claim is accepted by L&I and you will receive certain benefits.
How Does L&I Work?
When you get hurt or contract certain types of illnesses at work, you are entitled to workers’ compensation benefits. You can file an L&I claim in Washington State through the L&I website’s File Fast tool, by calling the L&I office at 877.561.3453, or at your doctor’s office.
Who Is Covered By L&I?
Virtually all employees in Washington State are covered by L&I workers’ compensation insurance. Two-thirds of Washington State workers are entitled to workers’ comp benefits through L&I. The remaining one-third of workers file claims directly through their self-insured employers. To determine whether you are covered by L&I or a self-insured employer, use the Find A Self-Insured Employer search tool on the L&I website.
What Qualifies As An L&I Claim?
L&I, or your self-insured employer, can approve your claim if your doctor certifies that you were injured at work, or have an occupational illness. If your claim is accepted by L&I you will receive certain benefits. Some of the benefits to which you may be entitled are medical care, time-loss, vocational rehabilitation, and L&I disability pensions for the most severely injured individuals. However, due to the bureaucratic nature of the claims process, many cases get bogged down in red tape, paperwork, and technicalities. An L&I claim could be denied for almost any reason including the following:
- The injury is considered preexisting.
- The injury is determined to have occurred outside of work.
- The injury occurred in a parking lot, which means it is not covered.
- The injury is a mental health condition and is denied due to a lack of objective medical evidence.
- An Independent Medical Exam (IME) diagnosis that determines the injury is not as bad as claimed, or non-existent.
Now for the Main Attraction!
How To File An L&I Claim In Washington State
In order to receive benefits from L&I there are two very important things that you must do right away, even before a claim is filed:
- Get medical help.
- Tell your employer.
If you are injured at work, you have three options to file a Washington State L&I claim:
- File by phone at 877.561.3453.
- File online through the L&I website’s File Fast tool.
- File at your doctor’s office.
Note that if you work with a self-insured employer, you must file your claim with them.
To file an L&I claim in Washington State, you must provide the following:
- The location where the injury occurred
- Contact information for any witnesses to the injury
- Employer information
- Wage information
- Names and birth dates of your dependents
- If you have already seen a doctor:
- Your doctor’s first and last name
- The hospital or clinic where you received treatment
If you are eligible for time-loss, and no further information is needed, L&I or your self-insured employer will send the first benefit check within 14 days of receiving the report. If your doctor is one of the many healthcare providers that do not handle workers’ compensation claim cases, you can find an L&I-approved doctor on the L&I website. If your L&I claim is approved, L&I will cover the initial visit even if it wasn’t with one of their approved doctors.
L&I or your self-insured employer must receive your Report of Accident within 1 year of your injury date to file a claim. Occupational illness claims must be received within two years from the date that your doctor notifies you in writing that your injury is work-related.
Claim Value
To determine the value of your L&I claim offered in Washington State. L&I settlements are paid out once the claim is closed, though the total settlement amount awarded upon claim closure depends on the size of the settlement. L&I settlement amounts vary widely and typically fall into three categories:
- L&I Disability Pensions: a life-long pension awarded to injured workers who will never be able to return to gainful employment due to a severe or life-threatening injury.
- Permanent Partial Disability (PPD) Awards: a one-time sum paid to injured workers when their L&I claim is closed. The worker can re-enter the workforce following a PPD award.
- Claim Resolution Settlement Agreement (CRSA): an L&I settlement option where all parties agree to close an injury claim for a specified amount. When agreeing to this settlement type, the injured worker exchanges all future benefits, except medical, for the payment.
How Do I Know If I Have A Case?
The bottom line is that anyone who isn’t familiar with L&I claims in Washington State should seek the input of experienced L&I attorneys who do.
After years of helping injured workers, Emery | Reddy has recovered hundreds of millions for our clients. Our team of L&I attorneys is experienced in litigating L&I claims, injury law claims, and employment violations. We understand how to leverage each claim in state or federal court and before the Board of Industrial Insurance Appeals to maximize the value of all of your claims.
Emery | Reddy Can Help You With Your L&I Claim
Emery | Reddy is the only law firm in Washington State that is equipped to provide comprehensive representation on your case from every angle. We thoroughly assess every case to determine if our clients have additional claims, and at times this can extend far beyond the underlying workers’ compensation claim.
If you have been injured in the workplace call Emery | Reddy today to speak with our legal team for a free case review. Please remember to have your L&I claim number readily available.
