Most Washington businesses with employees are required to pay for workers’ compensation insurance (WC or workers’ comp insurance). The insurance provides compensation to employees who suffer work-related injuries. Here are some basic facts that you need to know about workers’ comp insurance in Washington as a business owner and employer.
If your Washington business has just one employee, even if that employee is part-time, you’re generally required to carry workers’ compensation insurance. However, there are a variety of narrow exceptions, such as:
For a complete list of exceptions, check the L&I Employers’ Guide.
In addition, business owners, such as members of LLCs, corporate officers, partners in partnerships, and sole proprietors, usually are not required to be covered by workers’ compensation insurance. However, there are some limitations on this exception.
The Washington State Department of Labor & Industries (L&I) is the primary state agency that handles workers’ comp claims. Most of the law for WC insurance is contained in Washington’s Workers’ Compensation Act (Title 51 of the Revised Code of Washington). In addition to the Act, there are also administrative rules (Chapter 296-17 of the Washington Administrative Code) that cover workers’ compensation in Washington.
In Washington, you typically will obtain workers’ compensation insurance through an insurance pool called the Washington State Fund. You apply for coverage by filing a business license application with the Washington Department of Revenue. There is also an option to self-insure, but this may not be practicable for smaller businesses, in part because it requires that a lot of money be set aside to cover potential claims.
You are responsible for ensuring that an injured employee immediately gets required medical care for a doctor or hospital of the employee’s choice. This includes providing transportation, such as an ambulance, if necessary. For initial treatment, the employee may see someone outside the L&I Medical Provider Network. However, additional or ongoing care must come from providers in the network. For most injuries, employees must make a claim within one year. For a few types of injury or illness, an employee has two years to make a claim.
The injured employee should report the injury to you as soon as possible. In cases where a medical provider is involved, the provider will give the employee a Form F242-130-000, Report of Accident (Workplace Injury, Accident or Occupational Disease), known by the abbreviation ROA, which the employee completes and submits to L&I to start the claims process. Often this filing will be done online.
You will receive a request for information form from L&I. You should complete it and return it as soon as possible. Include your copy of the ROA. Beyond these initial steps, there are subsequent steps to the WC claims process, not covered here.
If you don’t think your employee’s workers’ comp claim is valid, state that on the request for information form that you return to L&I . Then, within 60 days of a decision by L&I to accept the employee’s claim, you can file a protest through L&I’s Claim & Account Center webpage.
Disputes about the validity of claims initially are adjudicated by L&I. If you are unhappy with L&I’s decision, you can file an appeal with the state Superior Court within 30 days of the decision. You can then further appeal the matter to the Court of Appeals.
If you don’t carry workers’ compensation insurance you may be subject to various penalties and fines. There are also penalties for not paying WC premiums on time and not filing required WC reports. A few penalty rules are contained in Section 296-15-266 of the Washington’s Administrative Code.
There are many other workers’ compensation requirements for Washington employers that are not covered here, such as putting up posters about workers’ compensation coverage where employees can see them. The Nolo website has a section devoted to workers’ compensation. In addition, the L&I website also contains many useful resources.