Washington workers’ compensation pays benefits to employees who suffer occupational injuries or illnesses. Workers may receive medical treatment, compensation for wage loss, and other financial assistance. To collect benefits, you must take certain steps, including reporting your injury to your employer and making a timely claim for benefits.
In Washington, most employers are insured by the Department of Labor & Industries (L&I). However, about a third of the state’s employers are self-insured. (Only large, financially stable employers typically qualify to self-insure.) If your employer is insured by L&I, the state will review your claim and determine your eligibility for benefits. If your employer is self-insured, it will review your claim and decide whether to accept or deny it.
Washington has a no-fault workers’ compensation system. You do not need to show that your employer acted carelessly in order to receive benefits. As long as your injury happened while carrying out work activities, you will typically be eligible for benefits.
Eligible workers may receive a variety of benefits, including:
Notifying your employer is the first step to starting a workers’ compensation claim. In Washington, employees should report their injuries as quickly as possible. Employers and insurance companies are skeptical of delayed claims and tend to deny them. Giving notice and getting medical treatment early on will reduce the likelihood of a claim denial.
When you notify your employer, provide as much detail as possible, including:
Your employer may also ask you to fill out a written accident report. When completing the report, be as accurate as possible. Accident reports are frequently used as evidence in disputed claims, and any inconsistencies may be used against you.
After you give notice, your employer should send you to its occupational doctor. It is important to provide the doctor with accurate information about the cause of your injuries and the severity of your symptoms. Insurance companies rely heavily on medical records of initial treatment when they evaluate claims. Either downplaying or exaggerating your symptoms may result in a denial of benefits.
The process of filing a Washington workers’ comp claim varies, depending on whether your employer is insured by L&I or self-insured. You should confirm your employer’s insurance status before filing a claim, using L&I’s online directory of self-insured employers.
Reporting a work injury does not automatically start a Washington workers’ compensation claim. You must also file a formal claim in order to receive benefits. If your employer is insured by L&I, you must file a Report of Industrial Injury or Occupational Disease. This report can be completed either online, by telephone, or with the help of your occupational doctor. If your employer is self-insured, your claim is filed when you complete a Self-Insurer Accident Report. Your employer should provide you with a copy of this form.
It is your responsibility to make sure your workers’ compensation claim is filed within one year of your workplace injury. If you are diagnosed with an occupational illness (such as mesothelioma), you must file a claim within two years of your diagnosis.
Once it has received your claim, L&I or your self-insured employer will determine your eligibility for benefits. A claim investigation may involve:
In Washington, many accepted claims are approved within 14 days of filing a Report of Accident. However, processing times may vary from case to case. If your claim is approved, you will start receiving wage replacement payments and other benefits. Unfortunately, insurance companies deny many workers’ compensation claims. (For common grounds for a denial, see Denied Workers' Compensation Claims.)
If your claim is denied, you have the right to appeal. Appeals typically must be filed within 60 days of a denial of benefits. Unless your claim is very simple, you should consider hiring a workers’ compensation lawyer for your appeal. (For more information, see Should I Hire a Workers' Comp Attorney or Can I Handle My Own Case?)
You also can contact Project Help, a joint effort between L&I and the Washington State Labor Council to assist injured workers with their workers' comp claims.