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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.
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.
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).
You have the right to appeal L&I's decision to the Board of Industrial Insurance Appeals (BIIA). Read appeal instructions.
Yes. They receive copies of our decisions and have the same protest/appeal rights and instructions that you have.
Don't cash it. You are required to send it back to L&I.
No. You have the right to be represented by an attorney, but you are not required to have one.
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.
If you need assistance, you may contact the following free services: Project Help 800-255-9752 or CLEAR (Coordinated Legal Education, Advice and Referral) at 1-888-201-1014. CLEAR can also provide free legal assistance.
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