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”.
What is the value of my workers’ compensation claim?
Knowing or calculating the value of your workers’ compensation claim or L&I claim in Washington State is tough. If you file a work injury claim and the Department of Labor and Industries (L&I) allows your claim, then you may be entitled to a variety of 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 or 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 benefits.
Medical treatment under L&I claim
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, as long as 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 authorized, the treatment is covered 100%. This means that there are no out-of-pocket expenses such as co-pays or deductibles. Moreover, when you are incapable of working because of your work injury conditions, having a path to medical recovery and the peace of mind that your medical bills will be covered, is priceless.
Time-Loss Compensating benefits in L&I claim
If you have an allowed workers compensation claim or L&I claim and you are unable to work, then you are entitled to 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 at the time they 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 injured workers can work reduced hours. Others might perform a light duty job that pays less than their job of injury. If you’re able to work after you were injured at work, and your new salary is lower than what you were making before, then you might be entitled to receive compensation for lost wages.
Loss of Earning Power (LEP) benefits are paid when you are doing limited work that results in a 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. And as explained earlier, it all depends on your earnings at the time of industrial injury or occupational disease manifestation.
Vocational services in L&I workers compensation claims
If you have an allowed L&I claim and you are permanently incapable of returning to your work, then you should be eligible for retraining. If L&I approves your retraining, they will pay for your retraining program for up to two years at total cost of approximately $18,000. In addition to the $18,000 cost of retraining, L&I will pay time-loss compensation benefits throughout your retraining program.
The topic of vocational services in workers compensation claims is very broad. They include 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 a loss of bodily function because of an industrial work injury or a work disease. The degree to which you lose bodily function is called PPD rating. In this context, a PPD rating exam must be performed by a qualified medical professional.
In general, for parts of the body that can be amputated such as an arm or a leg, the PPD rating is based upon percentage of loss of function. For parts of the body that can’t be amputated, like the spine or mental health disability, the PPD rating is based on levels called “categories of impairment”. These categories, alongside other rules and guidelines, are outlined in the Washington Administrative Code (WAC).
In order to assess the loss of body function, 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, which is available on the L&I website.
Permanent Total Disability in L&I claim
Total disability is a physical or mental impairment that prevents you from working. Usually, medical professionals or vocational counselors determine if you are capable to work. If your disability is preventing you from returning to work in the foreseeable future, then we refer to it as Total Disability and consider it to be a permanent condition.
You must obtain an opinion from a medical provider to 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 are likely entitled to receive a pension under your L&I claim.
Pension in L&I claims
A pension in workers’ compensation claims mean that you receive monthly payments for the remainder of your life. Payments are made so long as you cannot, and do not, return to work. Like to time-loss compensation, your pension payments depend on what you were earning at the time of your work injury or disease manifestation. The pension benefit is intended to provide a source of income under an L&I claim for people with severe work injury that can never go back to work.