What’s the value of my L&I claim? What’s my workers’ compensation case worth? I get these questions all the time. And, my answer is always the same: “It depends”. For a better answer, it’s important to review the value of your L&I claim benefits.
What is the value of my workers’ compensation claim?
Knowing the value of your workers’ compensation claim or L&I claim in Washington State is tough. Calculating it isn’t easy. Remember- first you have to file your claim. Then, if the Department of Labor and Industries (L&I) allows it, you may receive various L&I claim benefits. Some of these benefits have a monetary value. Furthermore, the value is unique to each L&I claim because every claim is different.
The purpose of this article is to help you figure out the potential value of all available benefits. Remember, there’s no one-size-fits-all answer. There is no formula to calculate the exact value of your workers’ compensation claim. But, if you want to get a rough estimate, you can sum up the total value of all L&I claim benefits.
L&I claim benefits: Medical treatment
It’s very difficult to put a dollar amount on the value of medical treatment. For many, and in my opinion as well, it is invaluable. Generally, if your claim has been allowed, then L&I (or the self-insured employer) will cover your medical bills and expenses. That is, so long that the treatment is for conditions that relate to your work injury claim.
It is important to keep in mind that certain treatment recommendations must go through an authorization process. However, once you receive authorization, then L&I will cover your treatment 100%. This means that there are no out-of-pocket expenses. For example, co-pays or deductibles. It’s also reassuring knowing that you have a path to medical recovery. It’s always good to know that L&I will cover your medical bills for your L&I claim treatment.
Time-Loss Compensating – a key benefit
Say that you have an L&I claim. Also, say that L&I already allowed your claim. In addition, let’s assume that you’re unable to work. Then, you are eligible for monetary wage replacement benefits. Time loss compensation (TLC) is one such benefit. It’s what you get when you are temporarily incapable of working.
Your time loss wage rate is based on what you were making at the time you got injured at work. A single male of female individual with no dependents receives 60% of their wage. For time-loss calculations, take the 60% at the time you got hurt on the job. If you are married or have children, then you’ll receive a higher percentage.
Loss of Earning Power under an L&I claim
In some cases, after a work injury, some people are still able to work with limitations. For example, some work injury claimants can work less hours than before. Others might perform a light duty job that pays less than their job of injury. If you can after your injury, and your new salary is lower than before – you’ll receive compensation for lost wages.
Loss of Earning Power (LEP) covers this situation. It’s an L&I benefit. L&I pays it when you’re doing limited work that results in 5% (or more) decrease in your wage-earning capacity. This is a significant monetary value in any workers compensation claim. The specific value varies from individual to individual. As explained earlier, it all depends on your earnings at the time of injury at work or occupational disease manifestation.
Vocational services in L&I workers compensation claims
Some people are permanently incapable of returning to your work. If you are one, you can be eligible for retraining. If L&I approves your retraining, they will pay for your retraining program for up to two years. The total cost is approximately $18,000. But that’s not all. In addition to the $18,000 cost of retraining, L&I will pay time-loss compensation benefits. L&I will pay it throughout your entire retraining program.
The topic of vocational services in workers compensation claims is very broad. It is also very complex. There are many steps and services. You can read about important topics relating to vocations services by following the resources below:
1) Option 1 vs Option 2
2) Vocational services plan development
3) Job analysis
as well as many others. You can also refer to the high-level summary of vocational services in L&I workers compensation claims.
Permanent Partial Disability in L&I claim
Permanent partial disability (PPD) refers to loss of bodily function because of a work injury or work illness. The degree to which you lose bodily function is what we call PPD rating. In this context, you have to go through a PPD rating exam by a qualified medical professional.
There are many rules in PPD rating exams. Say that your permanent condition if for parts of the body that can be amputated. For example, an arm or a leg. Here, the PPD rating is based on percentage of loss of function. Then, there are parts of the body that cannot be amputated. For instance, the spine or mental health disability. In such cases, the PPD rating is based on levels called “categories of impairment”. These categories, and other rules and guidelines, are available in the Washington Administrative Code (WAC).
Either way, a doctor will try to assess the loss of your body function. For that, the examining doctor compares your condition with the condition described in the categories. Then, the doctor selects the category that best describes your level of impairment. The monetary value of the PPD is based on a PPD award schedule. The PPD award schedule is available on the L&I website.
Permanent Total Disability is an important L&I benefit
Total disability is a physical or mental impairment that prevents you from working. Usually, medical professionals or vocational counselors decide if you can work. If your disability prevents you from returning to work in the foreseeable future – we refer to it as Total Disability. L&I considers it to be a permanent condition.
With total disability, you must obtain an opinion from a medical provider. The provider will establish the likelihood that your disability will continue to impact your ability to work in the future. If you are indeed permanently totally disabled (PTD), then you’ll probably receive a pension under your L&I claim.
Pension in L&I claims
An L&I pension means that you receive monthly payments for the remainder of your life. L&I will send you payments so long as you cannot, and do not, return to work. As before, your pension payments depend on the amount you were earning before the injury. The pension benefit provides a source of income for people with severe injuries that can never return to work.
Have I been entitled to receive the extra help of $600 per week while still on my L&I claim payments of $390 x 2 per month? I receive $409 SSI per month. I was injured at work as a caregiver through a company, which necessitated in shoulder surgery last year in April. I am scheduled for an MRI next week,on the other shoulder, which is part of the claim. I am 70 years old and have been advised by the surgeon that I can not return to caregiving but could do part time wellness consulting, even though there is nothing on offer in this capacity. I completed the physical assessment and am also in contact with a vocational counselor. My claim payments began in June/July last year 2019. I’m struggling to make ends meet, especially during this COVID period.
Thank you for posting your comment on my website. I’m very sorry to hear about your injury and that you are struggling financially. I would like to provide you with a complete answer to your question, but I need a little clarification.
You asked whether you have been entitled to receive the extra help of $600 per week while still getting your L&I payments of $390 every two weeks, plus SSI benefits. In order to tell you whether you are entitled to the extra help, I need to know where that $600 is coming from and why you have been getting it?
If the $600 is simply being given to you by the generosity of another and you aren’t doing anything in return for the money (in other words it is simply a charitable kindness to you) then it probably isn’t an issue and you are probably still entitled to your L&I payments. However, if there is some other reason you are receiving the $600 extra help, I’ll need you to tell me more about that so I can help you determine whether there is an issue.
Question…I know a kid who was working at a Berry place like raspberries and he got injured on the job and lost 3 fingers…he is still having medical things done and has not settled for the injury but he is trying to get re-trained as he will not be able to work in the berries anymore due to his injury he was told they would give him $800 a year for school? Does this sound right to you?
Every workers compensation claim is unique, and it is difficult to say with any certainty whether this situation is right or not. However, based on what you’ve said, it would probably be good for this injured worker to speak with an an experienced workers compensation attorney, because what you have described certainly raises some questions.
I have an L&I claim going right now and they accepted responsibility for one thing but two of the things that the doctors found they are denying it. But the 2 that they are trying to say there not responsible for is because of there IME I have done for them. The IME was done 9 months later. The injury happened in January 16 2020 and to this day I haven’t had any treatment. My ankle is still hurting my knee gives out on me. It’s been almost a year since the work injury. I have read that if some of the injuries aren’t taking care of that I will have major problems in the future. What can I do about the pain and agony i’ve been going through this whole time?
It’s good to know that a married person or someone who has kids will receive a higher percentage of their wage. I always thought that some of the percentages given during insurance claims seemed a bit off. I’m glad to see that they do change depending on your living situation.
It only goes up 7 percent so it’s not that high of a percentage. My husband has been home for over two years due to a head injury he got from work. He just did his IME in October 2021. We are still waiting on that. His neurologist said after two years if there is no improvement by now there won’t be. So we are trying to see what his rights are because it’s putting us in complete financial ruin and his mental state isn’t good either.
Informative post. You have revealed many of my query. Keep going. If you have been injured in an accident, you may have questions that you need answered. You have the right to seek compensation for your losses.
Hi I’ve been a welder for 40 years and now have significant lung damage, I’m turning 62 next weeks, I also smoked 20 years. Can I claim ppd? My lung capacity is about 40%,
I recently filed an L & I claim against my employer due to “hostile work environment.”
This has been ongoing for over a year.
I have reached out to many entities for help but either get told, we can’t do anything until you’re fired, they haven’t done anything to a protected class, the issue appears to have been resolved…
What has happened to society that employers can continue to mistreat employees and get away with it?
My workplace has placed so much undue stress on me that I have contemplated suicide, it truly has gotten that bad. I am blessed to have my grandkids that are my glue holding me together right now!
Quitting isn’t an option, I need an income.
Applying for other opportunities but I don’t even get interviews, perhaps age and over qualified. I am also a Veteran which doesn’t mean anything anymore either.
I truly don’t know what to do or how to proceed.
I am heartily impressed by your blog and learn more from your article. Thank you so much for sharing with us.
I am receiving 1400 every2 weeks. I went from working 75 hour weeks and 5000 a month to zero after we found out I had severe carpal tunnel syndrome in both hands. It took almost 8 months to get approved for L& i because there is a legal process they have to go through.