Workers Compensation - Washington

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

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L&I Claim Expense Reimbursement and Refund

The Department of Labor and Industries (L&I) in Washington State provides reimbursement for some expenses under your workers’ compensation claim. Expense refund may include travel costs as well as personal property losses. However, if you want L&I to refund these kinds of expenses, you must first meet certain requirements.

 

L&I claim and refund for travel expenses

Under an L&I claim, L&I doesn’t usually cover travel expenses to and from medical treatment. Yet, there are some exceptions. Reimbursement for traveling to (or from) treatment is contingent on the following requirements:

(1) Travel reimbursement must be pre-authorized by your L&I claim manager;
(2) The medical provider must be more than 15 miles one way (30 miles round trip) from the home address of the work injury claimant;
(3) There can’t be other medical professionals that can provide the treatment closer to the home address of the work injury victim; and
(4) The work injury claimant must complete a Travel Reimbursement Request form and provide copies of all receipts to L&I.

If the requirements are met, then L&I might also reimburse for parking over $10 and for toll road payments.

 

L&I claim property reimbursement

In some cases, L&I may also reimburse the work injury victim for property lost (or damaged) during a workplace accident. Here, you can get a refund only for certain kinds of personal property. For example, property can include prescription eyeglasses, contacts, clothing, shoes, boots, and personal protective equipment (PPE). To be eligible, the person that suffered the work injury should complete and submit a Statement for Miscellaneous Services to the claims manager.

 

Final remarks

Workplace injury and work-related diseases have some serious negative financial impact on workers. The goal of the Industrial Insurance Act in Washington State is to minimize the suffering and economic losses for people with a work injury claim. These types of expense reimbursements are one good way for L&I to try and uphold the purpose of the Industrial Insurance Act.

 

L&I Claim for Crime Victims

Did you know the Washington State Department of Labor and Industries (L&I) provides coverage and benefits following for crime victims, after a violent crime? L&I provides this coverage under the Crime Victims Act. Yes, you can have an  crime victim L&I claim. It can be extremely helpful to victims with significant injury or limited health insurance. It can also be very useful for families of homicide victims. While there are important differences, the L&I claim process to administer these claims is similar to a workers’ compensation claim.

 

L&I claim benefits and requirements for victim of crime

Crime victim L&I claim benefits are available to individuals that sustained a physical injury or mental health trauma from a gross misdemeanor or felony crime. Eligibility requires the injury victim or the family of the deceased to: (1) Report the crime to law enforcement; and (2) File a timely application for benefits.

 

Filing a report and applying for benefits

A necessary first step is filing a police report. Surprisingly, failure to make a police report is one of the most common reasons for L&I to deny a claim. Then, in addition to reporting the crime, the victim must cooperate with the investigation. Timing wise, you must file the report within one year from the date of the crime.

 

Furthermore, the injury victim (or family of the deceased) must sign and submit an application to L&I. Here, there are different forms available for injury victims versus the family of homicide victim. On top, you have to file the application within two years of the date of the police report. However, in some circumstances L&I may allow you to file the application up to five years. Additionally, for minors, applications are timely if submitted within two years of their 18th birthday. Given all these variances, it’s best to file the police report and application for benefits without delay.

 

Crime victim L&I claim: payments and limitations

Every L&I claim for crime victims is different. Consequently, L&I pays different benefits based on the facts and circumstances under each claim. Potential benefits include medical, dental and/or mental health treatment (including grief counseling). Moreover, they can include medication, partial wage replacement, and funeral expenses. In some cases, they can also cover expenses such as copays and deductibles. However, L&I does not cover payments for crime scene cleanup, identity theft, or loss of personal property.

 

The maximum payment amount under an L&I claim for crime victims is $190,000. Yet, other limitations also apply. For example, just like time-loss compensation benefits, wage replacement benefits in a crime victim L&I claim is 60% of the victim’s wages. The maximum dollar amount paid in wage replacement benefits for temporary disability is $15,000. In actuality, this money can be a vital lifeline for recovering victims. If a victim is permanently and totally disabled and cannot return to work, wage replacement benefits are limited to $40,000. Similarly, medical expenses also have limits. More explicitly, $150,000 is the maximum coverage amount for medical and mental health treatment.

 

Finally, L&I claims for crimes include benefits to families of homicide victims. Family benefits are limited to $40,000. This figure includes a maximum of $6,620 for burial expenses.

 

Work injury as a result of a crime

In conclusion, if you suffer a crime-related injury while you were working, then you are covered by the Industrial Insurance Act. This is the same law that covers any other work injury claim or workers’ compensation claim in Washington State. Furthermore, this act is not subject to the limitations above, for L&I claims for crime victims. Also, individuals that suffer an injury while committing a felony crime are not eligible for benefits under either act.

 

Filing a new L&I Claim or Workers’ Compensation Claim in Washington State

People sometimes contact my office shortly after they suffer an injury at work. Other times, I get calls from people that started to develop a work illness or occupational disease. Often, these people are scared. They don’t know what to do. I can certainly understand why they want to call and talk to a work injury attorney. However, there’s very little I can do until they file an L&I claim. In fact, the most important thing for anyone injured on the job is to get medical attention right away.

 

How to file an L&I claim after a work injury

The Department of Labor and Industries (L&I) maintains the L&I website. The website contains lots of information (and forms) about filing a workers’ compensation claim. However, almost always, the first steps to file a work injury claim should be: (i) Report the work injury or work disease to your employer; and (ii) Get the medical attention and medical treatment you need.

 

The doctor will determine whether the injury or disease relates to your work. If they think it does, they will help you file a workers’ comp claim. The doctor’s office should already have the necessary paperwork, which is called Report of Accident. Furthermore, the doctor decides when the work injury claimant can return to work, and recommends follow up treatment. If for some reason the doctor doesn’t file the claim, L&I makes filing easy with their new Report of Accident online tool.

 

What happens after you file an L&I claim

When filing the L&I claim (either online or at the doctor’s office), L&I will need some information from the work injury victim. This information includes:
1. The place where the work injury happened (or where you developed the occupational disease);
2. Contact information for any witnesses;
3. Employer information;
4. Wage information;
5. Names and birth dates of your dependents; and
6. Medical provider information where you first received treatment.

 

Once L&I gets the claim paperwork, it decides whether to allow the claim. Then, if L&I allows the claim and provides appropriate benefits, the work injury victim may not need legal help. Early benefits may include treatment authorizations and wage replacement benefits. The benefits depend on your inability to work due to claim-related conditions. After that, if you receive any unfavorable decisions, you must protest or appeal them within 60 days. Otherwise, they become final and binding.

 

When to call a workers’ compensation attorney

Therefore, if L&I denies your workers’ compensation claim, it’s a good idea to speak with a workers’ compensation attorney right away. A good L&I attorney can help you determine your rights and options. From there, you can proceed to protest the L&I decision, and continue to follow the L&I claim process.

 

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