Steps to Stay at Work reimbursement

• Comply with the medical provider’s restrictions.
• Get a light-duty job description approved by the attending provider. (See tab 2)
• Apply for Stay at Work wage reimbursement. (See tab 3)
• Apply for Stay at Work expense reimbursement. (See tab 4)

Create a Light Duty Job Description

A light-duty job description approved by the attending provider is a required for reimbursement. Here are some recommended steps:

1. Review the worker’s medical restrictions
   The medical provider completes the Activity Prescription Form (APF) to communicate the worker’s ability to work and restrictions. If your employee is restricted from performing their usual work (for example, modified duty or limited hours), consider options for light-duty within their restrictions.
   
   
2. Create a light-duty job description
   The next step is to create a written description of the light-duty job. If you use L&I’s Employer's Job Description Form, check the box for “Light Duty/Transitional.” Describe the physical requirements for the light-duty job, and clarify how it’s different from the worker’s regular duties. Ensure that the physical requirements for the light-duty job don’t exceed the worker’s restrictions on the APF.
   
   Need help? L&I’s Early Return to Work Consultation team can help you identify light-duty tasks and create a series of light-duty job descriptions. Email ERTW@Lni.wa.gov to request a free consultation.
   
   
3. Get the attending provider’s approval
   The attending provider is the medical professional treating the injured worker. You may find the attending provider’s name and phone number on the APF. Here are some tips for requesting the attending provider’s approval:

• Consider hand-delivery. You can ask your employee to bring the light-duty job description to their next appointment.
• If you send it by fax, confirm the attending provider’s fax number. Include a cover letter to clarify your request.
• Also send a copy to the L&I claim file (fax 360-902-4567). If you don’t get a response after three documented attempts, email us at StayAtWork@Lni.wa.gov.

NOTE: You may need to repeat this process if there is a significant change in the light-duty job or the provider’s restrictions (for example, after surgery).

Apply for wage reimbursement

Stay at Work offers reimbursement for 50% of the worker’s base wages for up to 66 light-duty working days (max $10,000) per claim.

Base wages are the gross hourly wages or salary the worker earned while performing the approved light-duty job, and can include overtime (if not restricted). Base wages don’t include tips, bonuses, commissions, etc.

Checklist for Stay at Work wage reimbursement:

• Get the attending provider’s approval of the light-duty job description.
• Ensure the worker performs the light-duty job within their restrictions.
• Apply for reimbursement within one year of the first date of light-duty work.
• Provide payroll records and timecards.

You have up to one year to apply for reimbursement. You can apply as soon as the attending provider approves the light-duty job description. However, many employers wait to apply until the worker returns to their regular job duties, so they only need to submit one application.

Here are the steps to apply for wage reimbursement:

1. Determine the modified duty period. It starts the date the attending provider releases the worker to modified duty or limited hours, and ends when they return to their regular duties. Identify the light-duty working days during this timeframe.
   
   
2. Choose the dates for reimbursement. The maximum number of days eligible for reimbursement is 66 per claim. Only choose working days (no vacation days, sick leave, Kept on Salary, etc.). The dates you request for reimbursement don’t need to be consecutive. A partial workday counts as one of the 66 days.
   
   
3. Provide payroll records & timecards for those dates. Payroll records are required to verify the amounts paid. Timecards are required to verify working days (unless the worker is overtime exempt).
   
   
4. Complete the wage reimbursement application. Apply online by logging into your My L&I account and clicking on “Request Stay at Work reimbursement.” Sign up for a “Stay at Work & How to Apply for Reimbursement” webinar to learn how to fill out the online reimbursement application.
   
   If you don’t want to apply online, you can use the Stay at Work Wage Reimbursement Application form, but it must be submitted by fax or mail (not by email). Include the L&I claim number on each page. The form only has space to request 33 days, but you can use two copies for additional days.

If you have questions, email us at StayAtWork@Lni.wa.gov.

Apply for expense reimbursement

Stay at Work offers reimbursement for tools and equipment (up to $2,500), training (up to $1,000), and clothing (up to $400) per claim. For an expense to be eligible for reimbursement, it must be:

1. Necessary for the worker to perform the approved light-duty job. “Nice to have” items won’t be reimbursed. Also, we can’t reimburse for items you normally provide for other employees.
   
   
2. Purchased on or after the job offer. We can’t reimburse for items purchased before the light-duty job was offered to the worker. A job-offer letter is a best practice, but isn’t required for reimbursement. If you verbally offer the light-duty job to the worker, document the date.

Examples of equipment and tools:

• Specialty tools
• Sit-stand desk

Examples of training:

• Safety certification
• Purchased technical skills training

Examples of clothing:

• Office clothing
• Specialty shoes or boots

Checklist for Stay at Work expense reimbursement:

• The attending provider approved the light-duty job description.
• The expense is necessary for the worker to perform the approved job.
• The expense was purchased after the light-duty job offer.
• Apply for reimbursement within one year of the purchase and provide a copy of the receipt.

Steps to apply for expense reimbursement:

1. Complete the expense reimbursement application. Apply online using your My L&I account and clicking on “Request stay at work reimbursement.” You have up to one year from the date of purchase to apply. Sign up for a “Stay at Work & How to Apply for Reimbursement” webinar to learn how to fill out the online reimbursement application.
   
   If you don’t want to apply online, you can use the Stay at Work Expense Reimbursement Application form, but it must be submitted by fax or mail (not by email). Note the L&I claim number on each page.
   
   
2. Include the receipt. Provide a copy of the dated, itemized receipt for the expense.

If you have questions, email us at StayAtWork@Lni.wa.gov.