Some work injury claimants have 2, 3 or more L&I claims. In fact, you’d be surprised how many people have more than 1 workman’s compensation claim. Sometimes, you can combine multiple L&I claims into one. In legal terms, when you combine multiple claims into one, we call it “claim consolidation”. When can you consolidate several L&I claims? It depends. You can only combine claims if you meet certain requirements. For one, you can combine claims if they are duplicate L&I claims. Alternatively, you can consolidate L&I claims if they involve a subsequent aggravation.
Duplicate L&I claim
What is a duplicate L&I claim? Say you already have a workman’s comp claim for a work injury or occupational disease. A duplicate claim is when you file a 2nd claim for the same injury or illness. The new claim has the same injury date. And, it contains the same diagnosis or body part.
Sometimes, duplicate claims happen when you file an L&I claim that should be a self-insured employer claim. For example, say your doctor’s office filed a state-funded L&I claim on your behalf. Then, when they discover that your claim needs to be a self-insured claim, they file a second application. The 2nd submission is for the exact same work injury. Another example is when different medical providers file duplicate paperwork. For instance, a worker goes to the ER for an acute injury. After that, the worker follows up with a regular provider the next day. The regular provider may submit an L&I claim. However, they might not realize the ER provider also filed a claim the day before.
Subsequent aggravation resulting in multiple L&I claims
Say that L&I accepts your worker’s compensation claim. Here, under this first claim, L&I accepts coverage responsibility for certain medical conditions. A subsequent aggravation is when you file a new claim for an aggravation of these conditions, when:
1) There is already an open and symptomatic claim;
2) The conditions accepted in the first open claim are susceptible to re-injury; and
3) There weren’t new incidents or additional exposure.
For example, a workplace injury claimant develops a muscle strain lifting heavy objects. The worker files a claim. Moreover, L&I allows the claim and the claim is open. Fast forward, the person is getting treatment. Later, the medical condition gets worse. Eventually, the doctor files a new L&I claim for the worsening condition. Hence, if this happens, the new claim is a duplicate of the original claim.
When should I not combine all my L&I claims?
If the new claim isn’t duplicative and isn’t a subsequent aggravation, then you shouldn’t consolidate claims. In fact, I get calls from work injury claimants telling me their doctor, employer, or self insured third party administrator combined their claims. Every time I hear this – it’s a red flag. Only L&I has the power to consolidate claims.
If anyone thinks that consolidating claims is appropriate, they must ask L&I to do it. The request will be handled by the claim manager. Or, by the adjudicator responsible for the original claim. It’s important for L&I to make a formal decision about consolidation. This way, it gives the parties protest or appeal rights when the consolidation isn’t correct.
Additional examples for consolidating multiple L&I claims
On occasion, work injury claimants simply want to consolidate claims to manage their claims more easily. I certainly understand why they feel this way. Having multiple open claims at the same time can be confusing and difficult. However, unless the claims are duplicative or subsequent aggravations, consolidation isn’t appropriate. It doesn’t matter how much easier it may seem to manage the claims. You simply shouldn’t do it.
To summarize, there are only two circumstances to combine multiple L&I claims. The 1st is when you have duplicate claims. Then, the 2nd is if you have a claim for subsequent aggravation. Most importantly, only L&I can consolidate claims. If anyone else does it, you better contact a worker’s compensation attorney. Finally, by law, convenience alone isn’t a sufficient reason to combine claims.