Self-Insurance

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L&I's Self-Insurance Section monitors the management of industrial insurance claims in Washington State. Provisions of vocational services apply to self-insurance claims, just as they do to L&I's workers' compensation claims. See the sections of WAC 296-19A (www.leg.wa.gov) for more information.

Because vocational providers receive referrals from the employer of injury or the third party administrator, vocational reports should go directly to the third party administrator, not to L&I.

Vocational consultants in the Self-Insurance Section are available to consult with vocational providers and other stakeholders, but the vocational providers' main contacts should be their own vocational supervisors and the employer/TPA claim manager.

• The employer is then responsible for submitting specific reports to L&I.
• Progress Reports and copies submitted to the claim manager should not be sent to the vocational consultants in the Self-Insurance Section.
• Self-insured employers are not entitled to reimbursement for pre-job accommodation costs from L&I.
• The professional consultation fee for job modification services is not reimbursable by L&I.

In order to receive reimbursement for job modification expenses, a provider should submit the following documents:

Job Modification Assistance application (F245‑346‑000).

• Medical information from the attending physician regarding the need for the modification.
• Completed ownership agreement.
• The invoice.
• Proof of payment (may be in the form of a receipt, photocopy of a check or an invoice stamped "paid").

L&I does not pay money in advance.

Once the funds used for a Job Modification are spent, the purchaser (employer, vocational provider, ergonomic consulting firm, etc.) can request reimbursement on the Job Modification Assistance application (F245‑346‑000).

The fee schedule for vocational services and the qualifications required for providing vocational services are the same for both L&I's workers' compensation and self-insurance claims.

Unlike L&I's worker's compensation, the self-insured employer can choose to combine referral types:

• Early Intervention.
• Ability-to-Work Assessment.
• Plan Development with Plan Implementation.

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Additional information

• WAC 296-19A-210 (www.leg.wa.gov)
  What are the qualifications to provide vocational rehabilitation services to industrially injured or ill workers?
• Fee Schedule information.
• RCW 51.32.090 (www.leg.wa.gov)
  3 (a) Legal basis for a self-insured claim manager to stop time loss.
• WAC 296-15-4302 (www.leg.wa.gov)
  What is the Self-Insurance Vocational Reporting Form?
• WAC 296-15-4304 (www.leg.wa.gov)
  What must the self-insurer do when an assessment report is received?
• WAC 296-15-4306 (www.leg.wa.gov)
  When must a self-insurer submit a vocational rehabilitation plan to the department?
• WAC 296-15-4308 (www.leg.wa.gov)
  What must the vocational rehabilitation plan include?
• WAC 296-15-4310 (www.leg.wa.gov)
  What must the self-insurer do when the department denies the vocational rehabilitation plan?
• WAC 296-15-4312 (www.leg.wa.gov)
  What must the self-insurer do when the vocational rehabilitation plan is successfully completed?
• WAC 296-15-4314 (www.leg.wa.gov)
  What must the self-insurer do if the vocational rehabilitation plan is not successfully completed?
• WAC 296-15-4316 (www.leg.wa.gov)
  What must the self-insurer do when the worker declines further vocational rehabilitation services and elects option 2 benefits?
• WAC 296-15-4318 (www.leg.wa.gov)
  What must the self-insurer do when the worker elects option 2 benefits and the claim is closed?