Tara Reck, Managing L&I Attorney at Reck Law PLLC - Workers' Compensation Attorneys

Find a Doctor for an L&I Claim in Washington State

Every workers compensation claim in Washington State must have an attending provider, which is sometimes referred to as the attending physician or attending doctor. But how do you find an L&I doctor? It’s not easy. Whether you have a state-funded L&I claim or a workers comp claim with a self-insured employer, you must have an attending physician on the record. This attending doctor sees you regularly throughout your L&I claim and is primarily responsible for medical opinions supporting your entitlement to benefits. These benefits include both medical treatment and coverage, as well as monetary benefits such as time loss compensation. Moreover, the attending physician is usually the person who makes referrals to other treating doctors and specialists.

 

Find an L&I doctor on the L&I Medical Provider Network (MPN)

The Department of Labor and Industries (L&I) maintains a list of attending physicians. This list is called the Medical Provider Network or MPN in short. Looking at the list, you’ll see that there are LOTS of doctors on the Medical Provider Network. Some are local and reside here in Washington State and serve patients in your area. Others are out-of-state doctors that serve work injury victims that got hurt in Washington State and later moved out of state.

 

If you got injured at work in Washington State, you can choose your own primary doctor for your L&I claim. Here, the only rule is that your doctor must be a member of the Medical Provider Network. Also, when your attending physician refers you to other doctors and specialists, with very rare exceptions, all those other treating providers must also be part of the medical network. These include physicians, surgeons, chiropractors, naturopathic physicians, podiatric physicians, ARNP providers, PA-C physicians, dentists, optometrists, and so on.

 

Challenges finding a medical provider for your L&I claim

The MPN was enacted by the legislature in 2011. It was implemented and later launched by L&I in 2013. Since then, I have seen a significant increase in difficulties for work injury claimants to find an attending physician. Some challenges that we regularly see at our office include:
(a) Trouble finding willing MPN attending providers in a location reasonably close to the injured worker;
(b) Inability to find a new attending provider if the prior attending provider is no longer available for whatever reason; and
(c) Difficulty finding an attending provider willing to take over if the claim is more than a few months old.

 

The reason for these challenges (in my opinion) is because L&I claims are time consuming, they are riddled with challenges, and they are not lucrative. Being an attending provider is very time consuming. As a doctor, you have to examine the injured worker roughly every 30 days. On top, you must also complete regular administrative paperwork like the Activity Prescription Form or APF. You must also respond to inquiries from the claim manager and vocational counselor. If a work injury claimant has an attorney, the doctors are likely to get inquiries from their workers compensation law firm as well. If that’s not enough, doctors have to complete the relevant paperwork outside clinical practice hours.

 

Being a medical doctor on a claim is time consuming

Being an AP is tough. Members of the MPN are required to follow strict treatment guidelines that L&I says are evidence-based best practices. These requirements limit a provider’s ability to exercise their own knowledge and expertise in formulating opinions and making recommendations. However, claims are contentious. Medical providers often find themselves unable to move a claim forward due to legal disputes. Sometimes, attending doctors must provide a testimony in a deposition to help resolve the dispute. All these activities take time away from other aspects of their medical practice.

 

Finally, while I’m not an expert on rates, I frequently hear medical doctors complain that L&I pay rates are very low. So, combining the extra time and frustration providers put into these claims, they also get paid at a bottom dollar rate. Consequently, I’ve seen some good doctors still willing to help and take on L&I claim cases, but they limit the number of L&I patients they treat at any given time.

 

How to find an L&I doctor? L&I is not helping

Since the MPN was launched in 2013, I’ve seen L&I do nothing to help incentivize medical providers to treat injured workers. Furthermore, L&I makes injured workers jump through hoops before willing to assist in finding a willing attending provider. I represent many injured workers currently looking for a new attending provider because their previous doctor recently retired. With claims that are years old, it’s nearly impossible to find willing attending physicians in the Medical Provider Network.

 

Finding a doctor for an L&I claim can be tough

The first step in obtaining a new attending provider is using the L&I Find a Doc search to identify potential providers. At first, the prospects look promising. For example, searching all providers within 15 miles of our Port Orchard office yields 1,819 options. Removing specialties such as dentistry, we still see 617 providers in general practice, orthopedics, internal medicine, occupational medicine and the like. With 617 options to choose from, you’d think it would be easy to find a willing provider. I can tell you from first-hand experience – it is extremely difficult, daunting, and disheartening.

 

Injured workers must call the providers to determine if the doctor is willing to see them. In most cases, the answer is a simple No. However, before saying no, some providers ask for medical records or access to review the claim file on Claims and Account Center (CAC). In those cases, it can take weeks to get an answer. Usually, this process continues for months.

 

In our office, we ask our clients to maintain a journal to document the providers they call, when they call, and the provider’s response. In several cases, we have clients who called hundreds of providers without any success. During that time, the Department is often threatening to terminate benefits.

 

Conclusions and final notes

L&I requires that injured workers have an attending physician. Yet, L&I fails to adequately incentivize or encourage medical providers to take on workers’ compensation claims. As an L&I attorney representing work injury claimants in Washington State, it makes the life of my clients very difficult. It’s hard for injured workers to find doctors that are willing to see them. And, throughout this entire process and struggle, L&I almost always threatens to terminate benefits.

 

Workers compensation attorneys like me report these issues with the MPN all the time. However, when an injured worker asks L&I for help to find a doctor for a claim, L&I forces the work injury claimant to prove they aren’t able to find a doctor on their own. This is just another example of how L&I is not making injured workers a priority.

14 Comments

  1. Jackie

    If Labor and Industries treated cats and dogs the way they treat humans they would be marched thru the streets and have garbage thrown at them, and that’s being nice.

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    Jerold lucas

    I worked in construction for over 12 years. Filing L&I was not acceptable and you would be out of the job working for private contractors which also means I did not have medical coverage and went to work even if my wife had to tie my boots. 15 years since this serious now suffering from osteoporosis degenerative disc disease often and more frequently. I can’t even get up for a few hours or more screaming pain can’t get to the bathroom can’t eat can’t get coffee or nothing. I recently filed an L&I claim after spending the afternoon on the floor. But L&I won’t cover it because I never made a claim within the last 7 years and it’s a past injury. I haven’t pursued this. Doesn’t sound like I have much action to take but it’s totally work-related and now I’m totally screwed. That doesn’t seem right and at the same time I’m not sure what to believe.

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      L&I attorney

      Thank you for reaching out. What you have described sounds like an occupational disease. An occupational disease is something caused by the distinctive conditions of your employment. If L&I is rejecting your claim on the basis that you didn’t file something within 7 years, it sounds to me like you may have filed an application to reopen an old claim. However, you have indicated that you didn’t file prior claims because it was frowned upon. As a result, it is difficult for me to determine with any certainty with L&I has rejected your claim. I do offer free consultations and claim investigations, if you would like us to look into this further.

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        Adam

        This lawyer sounds compassionate and caring ! L&i is a life destroyer that’s for sure that’s why you should always have a lawyer to fight for your rights . It’s horrible what the injured worker is going through and the lawyer said he would try to help now that’s a good person because L&i is their to try not to pay you while you pay into it and so does the employer is horrible

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    Nick

    I REALLY need to speak with you. I have a L&I claim that just closed but LNI is leaving it open. I would take hours waiting all my questions to you. But I really need some advice please.

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    Chris

    To really tell you the truth L&I is nothing but an insurance company with bloody ignorant just trained to treat more than poorly to the most vulnerable people who had got injured in their job. They need to be XXX because the stress they gave to my husband. He ended up with a heart attack which all his doctors are willing to testify that his heart attack caused by what L&I doing.

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      Rhonda

      exactly they caused my stroke and injected me with poison

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    Alicia Juarezb

    I just had my L &I claim closed for an injury that occured in 2015 and they didn’t do sh** about my claim. The Dr that got when I moved didn’t care about my injury, and he released me to work with no restrictions and him knowing I can’t utilize my right shoulder all the way down to my finger tips. I’m having a hard time getting a job due to my ability to use my right shoulder and all.

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    EveLynn Schoenheider

    My husband has been on L & I for 2 years with a brain injury (which this is 4th one). He got his 3rd one Sept. 2019 his attending put him on light duty for weeks but there was no light duty for him to do so he didn’t get to go to work, then she out him on full duty 10/31/2019 he was still having issues with post concussion syndrome and missed days of work. Then Nov 2019 got hit in the head again which caused a double impact concussion. His neurologist stated if he hasn’t shown signs of recovering by now he most likely won’t. But L and I wants to drag this thing out and his attending is pushing for a program with therapies he had already done and she always misses his appointments.
    Trying to see if we need to get lawyer now because we are living off 60% of his pay his vacation and sick time was used to pay for benefits which we no longer have. Just so over this!! It’s hard to see someone completely change because of an injury.

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      Adam dickmeyer

      I’m sorry your going through this you need to get a lawyer asap the stresss alone is enough to drive you crazy I’m so sorry that your husband is going through all this ! I hope god bless’s you amd your husband and you are advocating for him but please hire a lawyer asap! L&i don’t care about your husband life at all they just try to saving company’s money and not pay out what they oh with your husbands head I jury which is serious and can make it so you husband do t act like the person you first met so please hire a lawyer NOW or asap a good L&i lawyer can help give you your husband back I’m sure it’s causing mental health issues also to send a person back to work with a brain injury is so dangerous for the injured worker ! He should of never even been sent to work for light duty ! Even if his head injury had healed some one jolt or bump to the head brings back the injury but way worse and can change a person into someone they can’t even recognize them selfs in a mirror ! I’m so sorry and my heart hurts for you and your family it’s so horrible the bad decisions drs make make for I hired workers just because they don’t want to do paper work or fight with L&i IM JUST IN DISBELIEF THAT A DR SENT YOUR HUSBAND BACK TO A JOB THAT COULD GET HIM HURT WORSE OR EVEN GET HOM KILLED IF ITS CONSTRUCTION OR ANY PHYSICAL JOB ! It takes a long time for a brain to heal from those kinds of injuries pluss I’m sure it caused him and you to have mental health problems and if you get a lawyer he can help get your husbands life back or have a positive out come for your family and dealing with L&i by your self is like a full time job ! And makes your mental health worse ! And that can be added to your husbands claim and a good lawyer can make that happen . So please hire a good attorney to save your family from all this pain and worry ! I will pray for you and your husband .

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    octavio rodriguez

    steps to reopen a claim,from 2012,closed in 2013 kept working until 2017 brain injury will not heal im on disabilty for life.other body parts getting fixed.

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    Tatyana

    Please need help I am in pain ..

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    Williamn

    I need a Dr for my L&I claim for vocatioal.

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