You may already be familiar with the existence of Workers’ Compensation in Washington and its purpose. However, general knowledge will only take you so far when you need to file a claim.
Step 1: Evaluate whether your injury qualifies for Workers’ Compensation benefits
Workers’ Compensation will cover almost any injury or illness as long as it has some connection with your employment. (We will call these injuries and illnesses “claim events” from here on). Claim events include sprains, torn muscles, repetitive stress injuries, wounds suffered in accidents, respiratory afflictions, and physical reactions to hazardous materials.
Although most claim events will take place at the location where you work, that is not a requirement. Anything that happens to you while you are “on the clock” will still be a work-related claim event.
There are few situations which do not qualify for benefits:
- Misconduct or unauthorized activities. If you are engaging in horseplay on the job site, intoxicated at work, or getting into a fight with a coworker, this may preclude claim eligibility.
- Pre-existing conditions. If you start employment with a bad back, your new employment status will not “bootstrap” such an existing condition into a claim event. The claim event must happen to you as a result of your work duties, and not be something you brought in with you. An exception to the pre-existing condition claim preclusion, however, can exist if the performance of your job aggravates that condition.
- Unforeseeable events. Sometimes referred to as “Acts of God” events like being struck by lightning or injured in an earthquake may not qualify.
Step 2: Reporting and filing your benefits claim
The first thing you must do is to seek immediate medical treatment. An urgent care or emergency room doctor or your primary care physician can help you complete and submit the claim paperwork to L&I. This is preferable because they can supply the required medical evidence to support your claim. It is then very import to report the claim event to your employer, preferably in writing, either directly or through your immediate supervisor. This is a state law requirement, so failing to report can compromise your claim. Your employer has a legal duty to forward this notice to the L&I, which sets in motion that department’s assistance to you in the form of providing you with information to help you understand your rights under Workers’ Compensation. Before you file a Workers’ Compensation benefits claim with the Washington Department of Labor and Industries.
Like so many causes of action for injury under Washington law, Workers’ Compensation claims are subject to time limits known as statutes of limitation. The time limit for injury-related claims is one year from the date on which it happened; for work-related illnesses, the time limit is two years from the date when a doctor, nurse or other health care practitioner informed you of the existence of the condition.
If your claim event involved a third party, personal injury claims in Washington are subject to a three-year statute of limitation.
If your employer attempts to persuade you not to report the claim event or takes action on its own to keep the Dept. of L&I from finding out about it, that is “claim suppression” and is illegal. It is also against the law for your employer to discriminate against you or otherwise retaliate for your claim filing.
It is not a requirement to have an attorney help you to file your claim, although if third-party liability is an issue (auto accident or construction site accident) then this will involve a civil legal claim and you will probably want to have an attorney.
What happens next?
Once you have timely filed your benefits claim, L&I will assess whether you are eligible. If you encounter any problems during this period, such as a claim denial, that is not necessarily the end of the process. You can appeal an adverse decision, but before doing so you might want to consult with a law firm that practices in Washington Workers’ Compensation cases. This helps ensure that nothing is overlooked and no avoidable mistakes are made which could negatively affect your appeal. We will cover the claim appeal procedure in another post installment.