Injured? What you need to know
Rejected claim
Claims can be rejected if the doctor cannot certify the worker's medical condition is related to something specific that happened at work or an occupational disease. This legal standard frequently requires the L&I claim manager to collect background information about the worker's accident and the worker's medical and job history.
Know your rights
You, your employer and your doctor all have the right to protest any decision made about your claim. Or, you may appeal directly to the Board of Industrial Insurance Appeals.
Protest a claim decision online.
Questions workers have
How do I protest to L&I about a decision made about my claim?
L&I must receive your written protest within 60 calendar days of the date you received the decision (15 days for decisions about vocational benefits). If we do not receive a protest by this time, our decision is final and you lose your right to be heard. (RCW 51.52.060).
- Online at the secure Claim & Account Center Login or signup.
- By writing a letter Read protest instructions.
May I appeal if L&I rejects my protest?
You have the right to appeal L&I's decision to the Board of Industrial Insurance Appeals (BIIA). Read appeal instructions.
May my doctor or employer protest or appeal an L&I decision about my claim?
Yes. They receive copies of our decisions and have the same protest/appeal rights and instructions that you have.
What if I get a benefit check after my claim is rejected?
Don't cash it. You are required to send it back to L&I.
May I phone in my protest?
No. Your protest must be in writing. It must clearly state what you are protesting and why. Read protest instructions. You can also submit your protest online at the Claim & Account Center.
Do I need to hire an attorney in order to protest the closing of my claim?
No. You have the right to be represented by an attorney, but you are not required to have one.
Can I get help understanding why my claim was rejected?
If you need guidance on your claim and how the process works, you can call Project HELP at 1-800-255-9752. They are a cooperative effort between L&I and the Washington State Labor Council (AFL-CIO), and can provide you with one-on-one counseling and individual claims assistance on your behalf.
Project HELP can assist you with both self-insured and state fund claims.
What if I live or move out of state?
- Your rights, benefits, and responsibilities for your claim will remain the same. Washington laws will always apply to your claim regardless of where you live.
- Many doctors and health-care providers in other states don't accept workers' compensation cases. Find a Doctor in your area.
Did you know?
If you need advice or legal assistance, you may contact the following free services: Project Help 800-255-9752 or CLEAR (Coordinated Legal Education, Advice and Referral) 1-888-201-1014)
Your employer needs to:
- Decide whether to protest to L&I if he/she believes the claim should have been approved.
Your doctor needs to:
- Decide whether to protest to L&I if he/she believes the claim should have been approved.
- Bill L&I for the cost of the worker's initial visit and any examination L&I requests.
More about workers' comp claims
Claim information online in Claim & Account Center
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