Filing Claims

The Provider's Responsibilities

If you're the first doctor to diagnose a worker for an occupational injury or disease, you're responsible for reporting to L&I or the self-insured employer.

If the claim might be federal, tribal, or another insurer, find out how to file claims and bill the correct entity (373 KB PDF).

If you aren’t sure whether you need to file, see "Deciding whether to file a claim for a patient".

To file a claim here in Washington State, follow these 4 steps:

Step 1: Find out if your patient is insured through L&I or a self-insured employer

There are 3 ways you can find out:

Step 2: File a claim right away

To initiate a claim for your patient, fill out one of the following forms:

How to file a claim.
If your patient is insured through You should fill out a

Report of Industrial Injury or Occupational Disease (ROA), either:

A self-insured employer Providers Initial Report (PIR)

Step 3: Get paid

How to get paid.
If your patient is insured through You should

Find out about billing L&I, including how to submit reports.

A self-insured employer Find out about billing self-insured employers.

Step 4: Get the worker further treatment if necessary

Starting January 2013, to treat an injured worker beyond the initial visit, you must be in our network.

If you are not, you should apply to join, or refer the worker to another provider that is in our network.

Rules and laws related to filing a claim

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