The Self-Insurance Program at L&I oversees self-insured employers' provision of industrial insurance benefits to their employees.
The Self-Insurance Program's oversight includes three key regulatory actions:
We conduct regular audits of self-insured employers. There are three different kinds of audits: performance-based audits; issue-based audits, and complaint-based audits.
The Performance-based audit is conducted on a 2-year cycle. It begins in even-numbered years and includes 3 tiers.
All self-insured employers are audited at the Tier 1 level. The area of performance reviewed may vary with each audit cycle, and is unique to Tier 1. A pass or fail threshold is set. A failed audit at Tier 1 requires the employer to participate in a Tier 2 audit.
Only the employers who do not pass Tier 1 are required to participate in Tier 2. Generally, this review includes a different, but connected area of performance.
Employers who do not pass Tier 2 are reviewed in Tier 3. Multiple related areas of performance are reviewed in Tier 3.
An issue-based audit reviews a specific compliance requirement across the board for all self-insured employers. The type of requirement and the scope of the audit are evaluated with the advice of the Audit Governance Committee and assigned at L&I's discretion.
A Complaint-based audit is initiated by L&I when specific matters about an individual self-insured employer are brought to our attention. The type of requirement and the audit scope are determined based on the nature of the complaint that is registered.
If you have questions, call us at 360-902-6840.
Self-insured employers are required to allow or deny a claim within 60 days.
Self-insured employers submit the request to L&I to review workers' compensation claims for allowance or denial. In some cases, a temporary order may be issued by L&I extending the time for decision while additional information is gathered.
For specific claim questions
Call 360-902-6901 and ask for the claim adjudicator assigned to the claim.
Adjudicating a workers' compensation claim requires the use of judgment, and there is not always agreement about the claim-related decisions that are made. If an injured worker and their self-insured employer cannot agree about a claim-related outcome, injured workers can ask L&I to intervene.
To make that request, an injured worker can:
- Report the dispute online through our Customer Service Portal.
- Send a written dispute to:
Department of Labor & Industries
PO Box 44892
Olympia, WA 98504-4892
Claim-specific questions: Call 360-902-6901 and ask for the claim adjudicator assigned to the claim.
General claim questions: email us at SITrainerquestions@Lni.wa.gov