In the State of Washington, claims arise in two ways: (1) because of an industrial injury or (2) because of the development of an occupational disease. With rare exception, suing the employer is not an option if a worker suffers a traumatic injury at work or develops an occupational disease. Instead, injured workers must file a claim for workers’ compensation benefits pursuant to the Industrial Insurance Act. The difference between an industrial injury and an occupational disease is that an injury occurs as the result of a sudden and tangible event at work whereas an occupational disease develops naturally and proximately out of distinctive conditions of employment. Simply put, if you can identify the place, time and location that an injury occurred, it is most likely an “industrial injury”. If symptoms developed over time, or if there was no identifiable precipitating event, it is most likely an “occupational disease”.
It is important for the injured worker and his or her medical provider to determine what type of claim should be filed because the deadlines for filing the claims are different. In order for an industrial injury claim to be considered for allowance, it must be filed within one year of the date of the injury. In order for an occupational disease claim to be considered for allowance, it must be filed within two years of the date that the injured worker is notified in writing by his or her medical provider that he or she has developed an occupational disease condition. In order to file a claim, the injured worker and medical provider must complete a “Report of Accident Workplace Injury, Accident, or Occupational Disease”. Most medical providers should have applications for benefits available. However, these forms can be ordered or filled out electronically on the Department of Labor and Industries’ website at http://www.lni.wa.gov/FormPub/Detail.asp?DocID=1599. In the case of self-insured employers, the application that must be completed is different. The form is called a “Self-Insurer Accident Report” or “SIF-2” and should be provided to workers by the self-insured employer or the employer’s third party claims administrator. However, this form can also be ordered through the Department’s website at http://www.lni.wa.gov/FormPub/Detail.asp?DocID=2466.
The accident report asks for information regarding the injury, the employer of injury, wages, diagnoses, and treatment in addition to other background information. Your medical provider may also complete a “Physician’s Initial Report” and if your industrial injury or occupational disease limits your ability to work, your medical provider should also complete an “Activity Prescription Form” which can be downloaded from the Department’s website at http://www.lni.wa.gov/FormPub/Detail.asp?DocID=2286.
Your medical provider should submit the claim forms to the Department or self-insured employer within five days of your evaluation and completion of the claim forms. Claim processing time varies depending on the type of claim. However, if you are eligible for wage-replacement benefits (also known as time loss compensation), and no further information is needed, the Department or the self-insured employer must send the first benefit check within fourteen days of receiving the claim forms.
At Foster Law, P.C. we are expert, we are fierce, and we are compassionate. Our team offers decades of experience to helping literally thousands of injured workers obtain the benefits that are so crucial to maintaining their welfare and that of their families. If you have any questions or concerns about filing an industrial injury or occupational disease claim, we invite you to contact us. Initial consultations are complimentary. Don’t leave your workers’ compensation claim to chance; consult with experts.