Washington State L&I Claim Closure Process
After you file your Washington state L&I claim, you will follow several steps in order to reach claim closure and, with the help of an experienced Seattle workers’ compensation and L&I attorney, receive the benefits to which you are entitled.
- You will complete an Independent Medical Exam (IME) from an approved L&I provider stating that you have reached maximum medical improvement (MMI) and that your medical care is complete.
- Your Vocational Counselor will release you to work.
- L&I will release a written closing order.
A Washington state L&I claim closure is when an L&I-approved provider certifies the following:
- The worker is at maximum medical improvement (MMI).
- The worker has been released to work.
Maximum Medical Improvement (MMI)
Maximum medical Improvement (MMI) occurs when your medical condition is considered fixed and stable. This means that your workplace injury or industrial disease status will not change, with or without treatment.
Released to Work
Your Washington state L&I claim can also be closed when your doctor has released you to work. This may be released to full-duty, released to full-duty but with reduced hours, released to light-duty, or released to light-duty with reduced hours.
Washington State L&I Claim Approval
If your Washington state L&I claim is approved, you will receive a written order from the Department of Labor and Industries explaining your benefits. You have the right to a variety of L&I benefits to help pay for treatment costs and replace lost wages during the recovery period.
Future Employment Issues
L&I must address future employment issues before your Washington state L&I claim can close. If your workplace injury or illness prevents you from returning to your previous position or prevents you from working at all now or in the future, you are entitled to compensation.
In order to determine if you are employable, you may be asked to attend an Independent Medical Exam (IME). An IME is a patient interview and evaluation requested by L&I or a self-insured employer to review your medical history and the details of your accident and to establish finding, opinions, and conclusions about your physical condition. IMEs are conducted by approved L&I providers, and as such, it is important to note that they are not always on your side.
This doctor will also rate your injury and its severity to determine your level of impairment as part of your claim and send the information to your employer, L&I, and your primary doctor. An IME is not a medical treatment appointment. It should be considered more of an evaluation where the L&I-approved doctor gathers all critical information about your injury and how you are currently healing so they can provide a comprehensive rating in accordance with the L&I PPD Awards Charts.
How Much Is My L&I Settlement or Award Worth?
In Washington state, the money awarded to a claimant is determined by numerous factors making it difficult to provide an accurate L&I settlement calculator. Factors that determine a settlement amount include the date the injury occurred, the severity of the injury, and the steps the injured worker takes to receive the compensation they need.
- Permanent partial disability (PPD) award: Payment is typically based on the type and severity of the injury and whether an Independent Medical Examination (IME) agrees or disagrees with the physician’s opinion. L&I updates injury payouts each year based on the cost of living adjustments (COLA); the date of your injury will influence your L&I award amount.
- The seriousness of your disability: During the course of your workers’ compensation claim, you may be required to complete one or more Independent Medical Exams (IMEs) conducted by a doctor other than your primary provider. The purpose of this exam is for L&I to have indisputable facts as to why treatment is needed regarding your medical condition. Your injury is rated as a percentage in its category and given a value of 1 – 9. Typically, the higher the number, the more significant your injury is. Your PPD award is calculated from those numbers before your case is closed. The Permanent Partial Disability L&I settlement calculator is the L&I Disability Awards Charts.
- What you’ve done to help yourself: If you’re proactive regarding your injury claim and work hard to ensure your claim has the correct information, you could earn more in your settlement payout.
What If My Claim Is Denied?
If your claim is denied at claim closure, you can protest the decision. You, your employer, and your doctor all have the right to protest or appeal any decision made about your workers’ compensation claim. L&I must receive a written protest within 60 calendar days of the date the decision was received (15 days for decisions about vocational benefits) or the decision will become final.
You may also appeal directly to the Board of Industrial Insurance Appeals (BIIA). The decision becomes final if your written appeal is not received within the following legal time limits from the date you received the decision:
- 60 days to appeal a claim decision or a payment decision
- 20 days for providers to appeal a billing decision that reduces the amount paid, or demands repayment
Reopen a Claim
If your workplace injury or industrial disease worsens after claim closure, you and your doctor may apply to reopen your claim. There must be medical evidence from an L&I-approved provider stating that after your claim closed, the condition caused by the original workplace injury worsened and needs more medical attention.
How Much Time Do I Have to Reopen My L&I Claim?
The amount of time that you have to reopen your Washington state L&I claim depends on the benefits you are seeking.
- For medical treatment only, you may apply at any time.
- For both time-loss benefits and medical benefits, apply within 7 years of the date your claim was first closed (10 years for eye injuries).
- If your claim has been closed for more than 7 years, you may apply for medical benefits. However, only the L&I Director may grant additional disability benefits such as wage replacement or disability awards for these claims.
Your Washington State L&I Claim Is Worth More If You Also Have an Employment Claim
A significant number of Washington state L&I claims often involve additional legal claims such as employment or third-party claims. Many people file their claims without seeking representation from an experienced Seattle workers’ compensation and L&I attorney and thus never discover that, in addition to their Washington state L&I claim, they may be missing out on the ability to file an employment claim or a third-party claim. Pursuing additional legal action with the help of an experienced Seattle workers’ compensation and L&I attorney has the potential to significantly increase a claim’s overall compensation. At Emery | Reddy, our experienced Attorneys practice both Employment and Labor Law and Workers’ Compensation Law, which means we will investigate all aspects of your claim to make sure you aren’t missing out on any potential benefits.
Many injured workers find that their employer has taken, or plans to take, adverse action against them because they filed an L&I claim or they are out of work. You can file a lawsuit against your employer for several reasons, including retaliation, wrongful termination, discrimination, or unpaid wages. An L&I attorney who is experienced in both L&I — Workers’ Compensation Law and Employment and Labor Law can help you with your Washington state L&I claim while simultaneously filing a federal or state law claim for the violation of workers’ rights by your employer.
A third-party claim is one in which someone other than your employer or co-worker is responsible for your injury. If you have been injured on the job due to someone else’s actions or negligence, you may be entitled to additional compensation through a third-party claim, which combines your Washington state L&I claim with a personal injury claim using the same facts.
Unlike workers’ compensation payments, there is no limit to the amount of compensation an injured worker may seek in third-party damages. Third-party claims are private matters and are typically litigated directly with the Washington State Superior Court.
If you have a Washington State L&I claim or wonder if you should contact an experienced Seattle L&I worker’s compensation attorney, ask yourself the following:
- Have I been denied the medical benefits to which I am legally entitled?
- Has L&I asked me to undergo an Independent Medical Exam (IME)?
- Do I have questions about the Washington state L&I claim process?
If any of the above apply to you, Emery | Reddy may be able to help.
Navigating a Washington state L&I claim can be difficult and very time-consuming, especially when you’re ill or injured. You want to focus on healing and make sure your bills are paid, but if you don’t file things properly or on time, your health, home, and job could be in jeopardy. Many individuals miss out on much-needed L&I benefits because they don’t understand what to do or how to get the most compensation for their injuries. If you are experiencing any challenges in your case, a Seattle workers’ compensation and L&I attorney can assist you. By contacting Emery | Reddy as soon as possible after you’ve been injured, we can help you avoid the common pitfalls of filing and navigating an L&I claim. Our Seattle Workers’ Compensation and L&I Attorneys are here for you every step of the way.
Emery | Reddy Can Help You with Your Washington State 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. Our Seattle Workers’ Compensation and L&I Attorneys 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 for a Free Case Review with an experienced Intake Specialist to learn more about how we may be able help. No fee unless we recover for you.
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To determine the value of your L&I claim, you first need to understand the different types of L&I awards offered in Washington state.
The Labor and Industries claim process is anything but straightforward. Find out the answers to your L&I — workers’ comp questions today.
During the course of your workers’ comp claim, you may be required to complete an Independent Medical Exam (IME) conducted by a doctor other than your primary provider.
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The Seattle Workers’ Compensation and L&I Attorneys at Emery | Reddy, PLLC are passionate about helping workers with L&I claims and Employment and Labor Law issues. We help workers.® It’s our motto and what drives us every day.
We know how L&I and big companies think, and we understand the tactics they use. Our Seattle Workers’ Compensation and L&I Attorneys use that knowledge coupled with over eight decades of experience to help our clients get access to the L&I benefits to which they are legally entitled and hold employers accountable when they break the law.
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