Washington State Workers’ Compensation – How to Start Your Claim

If you were directly hurt from a work injury, there may be a way to mitigate your losses as you recover from your wounds. You may not have to pay for your work injury if you’re covered under Washington State workers’ compensation laws.

The best part about workers’ compensation is that it runs in a no-fault system. In other words, you may be paid for your medical bills and lost wages regardless if you caused the accident.

Despite it being a no-fault system, there are some hoops you have to jump through to qualify for workers’ compensation in Washington State. That’s when a workers’ comp attorney can help you raise your chances to qualify for a legal claim.

An attorney can arrange the paperwork and represent you to grant you the highest chances of success. To start, here is a guide on how to begin your injury claim if you live in Washington.

Who Qualifies for Workers’ Compensation in Washington State?

Most Washington businesses have to carry workers’ comp insurance to protect themselves from personal injury lawsuits caused by work injuries.

Washington State qualifies most employees suitable for workers’ compensation such as full-time, part-time, temporary or seasonal, and undocumented workers.

Employees listed under those titles may be entitled to workers’ compensation due to injury or illness from performing work duties.

Businesses in Washington State often pool from the following resources to insure their employees from work-related injuries:

• State funds: Most companies contribute to the workers’ comp program run by the Washington State Department of Labor & Industries (L&I). They provide benefits for injured workers like medical treatments, partial wage replacement, disability benefits, and pension awards.
• Self-insurance: A program in Washington state where employers are liable to pay workers’ comp benefits to injured workers. However, they must meet the criteria such as being in business for three years and establishing stability, security, and financial adequacy.

Workers’ comp laws differ in each state, thus, an injured worker should hire a lawyer to guide them on the next steps to acquire reimbursement.

Exceptions to Washington’s Workers’ Comp Rule

There may be exceptions you should consider before starting a workers’ comp claim. According to Washington State laws, employers are not required to provide coverage for certain workers, like independent contractors.

Some examples of workers not covered by Washington State workers’ compensation include:

• Domestic workers in private homes. Except if two or more employees work regularly for 40 or more hours a week, they must be covered.
• Maintenance, gardening, or repair workers hired to do work in an employer’s private home. This doesn’t include individuals hired for home improvements or upgrades.
• An individual working in return for aid or sustenance for a religious or charitable organization.
• A child working under 18 years of age and employed by a parent in agricultural studies on the family farm.
• Musicians or entertainers if:
  • Primary business is other than entertainment.
  • They don’t primarily work for the business.
  • They don’t perform regularly for the business. (Ex. The guitarist plays irregularly and doesn’t work at the bar, and the contract is not regular between them and the bar owner).

There are many more exceptions that can potentially bar you from compensation if your situation applies. The best way to verify if you qualify for workers’ comp is by consulting with a Washington State workers’ compensation attorney.

What to Do When Injured at Work in Washington State

The first step to take when injured at work is to report your injury to your employer. Let the treating doctor know your injury occurred at work. Know that your physician cannot charge you for work injuries when approved for workers’ compensation. This includes surgery as well if you sustained severe injury.

You must file a workers’ comp claim with L&I as soon as possible through a report of accident form.

Save all medical documents and take pictures and videos of your injuries. Document details of the incident—time and date of injury, location, key witnesses from coworkers or others, and how the injury occurred.

Cooperate with the L&I and your employer to take the necessary steps for medical treatment throughout the claims process. Although you can’t choose your physician directly, your employer and L&I may have a list of preferred medical providers.

Never delay reporting your injury to your employer and the L&I because that may jeopardize your workers’ comp claim. Consider hiring a workers’ comp lawyer to guide you through the process and possibly seek higher reimbursement.

What Injuries Does Workers’ Comp in Washington State Cover?

Washington State covers unexpected injuries on-the-job that may not be limited to:

• Acute injuries
• Bruises or surface wounds or foreign objects in the eyes or face
• Musculoskeletal disorders (WMSDs)
• Chronic injuries from repetitive movements
• Occupational diseases from toxic environments
• Burn injuries
• Overexertion injuries
• Exposure to dangerous substances

Washington State is a no-fault state, meaning no matter who is at-fault, as long as an employee was working and sustained injury, they are eligible for benefits.

If the employer is self-insured, Washington State employees should file a claim directly with the employer instead of L&I.

Accidents That May Qualify for Workers’ Comp

Insurance adjusters may try to intimidate you and make you believe you qualify for less than you deserve. Although you must prove that your accident occurred within the course and scope of employment, many types of injuries qualify for workers’ compensation.

Some accidents that qualify for workers’ comp are:

• Slips, trips, and falls
• Falling objects
• Machinery accidents
• Transportation accidents
• Burns from toxic fumes or fire explosions
• Dangerous electrical accidents
• Collisions with equipment

According to the U.S. Bureau of Labor and Statistics in Washington State, recent data from 2022 revealed 104 male workers involved in workplace accidents.

Transportation incidents showed 32 accidents that year, and violence by persons and animals amounted to 23 accidents,19 suffered slips and falls, and 16 suffered harmful exposure to toxic substances.

Workers’ Comp for Self-Insured Workers

Sometimes corporations located in Washington State would rather investigate their workers’ compensation claims themselves rather than going through L&I. That’s when they can apply for self-insurance to allow a third-party to investigate their workers’ comp claims.

However, not every Washington State business is eligible for self-insurance. Requirements for applying for self-insurance in Washington State are highlighted in Wash. Admin. Code § 296-15-221, but general guidelines include:

• Being in business for at least 3 years
• Established an L&I-approved accident prevention program
• Met specific financial requirements under Code § 296-15-221
• Retained an investment-grade minimum credit rating
• Completed necessary forms to apply for self-insurance

Washington State’s L&I has a self-insured employer lookup tool to see if the company you worked for was self-insured during your injury.

If an employee was hurt while working for a self-insured company, they would work directly with their employer to settle the claim. They must file a Self-Insurer Accident Report for their employer and a Provider Initial Report for their medical provider.

Employee Rights in a Workers’ Comp Claim

You’re entitled to various types of benefits when getting approved for workers’ compensation in Washington State. Examples of such may include:

• Medical care
• Lost wages
• Temporary and permanent disability benefits
• Rebate for prescriptions, travel expenses to the doctor’s appointments, etc.
• Reopening claims if conditions worsen
• Vocational retraining when necessary
• Pensions

Always keep in mind your rights when applying for workers’ compensation. Don’t be compelled to return to work if your condition has not reached maximum medical improvement.

Your condition will only get worse if you push yourself and make mistakes while sustaining a work injury.

The Deadline to Apply for Workers’ Comp in Washington State

Depending on the type of claim and injury you’re filing for, keep in mind these deadlines when applying for Washington state workers’ compensation:

• Statute of Limitations—you must file a claim within a year from the date of injury.
• Occupational disease—must be filed within two years of receiving a written notice from a health-care provider, confirming that your condition is work-related.
• Third-party violence—a claim involving third-parties such as workplace violence or animal attacks, you have up to three years from the date of injury.

Typically there is a two-year deadline from the date of injury. However, it’s best to do it as soon as possible since missing the deadline can put your claim at-risk of rejection. Employees also have a right to reopen claims if their condition has worsened.

What if You’re Ordered to Return to Work?

If your employer asks you to return to work, you must get approval from your physician first and can only return to light-duty work that fits your medical needs. You cannot be pressured to return to work if your doctor advises against it.

You may rightfully refuse work while obtaining workers’ comp benefits if your condition hasn’t recovered. If your employer forces you to return to work, you may consult with an attorney to defend you and help you understand your rights and options.

How Much Does Washington Workers’ Compensation Pay?

The amount an employee receives in workers’ compensation varies on their injuries and occupation elements, but, typically, workers’ comp pays 60-75% of the injured worker’s monthly gross income.

L&I sets the minimum and maximum limits paid for an injured employee. The average settlement for a workers’ comp claim in Washington State is about $20,000 but can vary wildly depending on your losses.

These costs may include wage replacements, health benefits, disability benefits, and other bonuses or factors.

Disputing a Workers’ Compensation Claim in Washington State

The employer or third-party representative is liable for arranging your workers’ comp claim. If you disagree with the settlement offer or arrangements, work with your attorney to reopen your claim.

If you’re dissatisfied with how your claim is handled, you can contact L&I to request assistance at 360-902-6901. You may also write to L&I or file a dispute electronically at their customer portal.

Hire a lawyer to aid you in your workers’ comp claim process; they can advise you on what to do when disputing low settlement offers.

Find an Attorney Who Can Take Care of Your Case With LegalASAP

LegalASAP can help you find an attorney to assist your workers’ compensation case. Our network extends throughout the United States with hundreds of firms and thousands of experienced attorneys.

Complete a free quick consultation form to see if you qualify for a workers’ comp claim. Call us at our 24/7 toll-free number at 888-927-3080 for any questions or concerns.