Litigating Your Worker's Compensation Claim

You may find that L&I or your Self-Insured Employer (SIE) is wrongully denying your benefits. L&I and SIEs often deny benefits to those who are lawfully entitled to them. If this sounds familiar, you may need to litigate to secure your benefits. When you and L&I disagree about your entitlement to benefits, you can protest its decision. If a protest is unsuccessful, you may appeal to the Board of Industrial Insurance Appeals (BIIA). 

Protesting an Order

L&I issues written decisions regarding your benefits in the form of orders and notices. You have 60 days from the date of receipt of an order to protest an L&I decision. It is critical that you monitor these deadlines closely, because an unprotested order becomes final and binding after 60 days. If you disagree with an L&I order, a protest allows you to provide L&I with information showing you are in fact entitled to the benefits in question. Your claim manager has 90 days to consider the new information. The claim manager can either affirm or reverse his or her prior decision. If the claim manager affirms a decision denying your benefits, you may appeal to the Board of Industrial Insurance Appeals (BIIA).

What is the Board of Industrial Insurance Appeals?

If L&I or your SIE deny your benefits and the issues are not resolved with a protest, the issue must be appealed to the Board of Industrial Insurance Appeals. The Board of Industrial Insurance Appeals is a judicial agency that hears appeals of L&I decisions. After you appeal, your case will be set for mediation between the parties before a judge in an effort to resolve before a hearing. If there is no resolution in mediation, your case will be moved on for a hearing.

Whaqt is a hearing at the Board of Industrial Insurance Appeals?

A Board of Industrial Insurance Appeals hearing is essentially an administrative trial before a judge to determine whether you are entitled to dsputed benefits. Board hearings involve almost all the components of full-scale litigation: Discovery, the evidentiary rules, direct examination, cross-examination, motions, and so on. At the hearing, each party presents the expert and lay witness testimony. The evidence goes before a judge who issues a decision based on the evidence presented by the parties. Board hearings are formal and can be high stakes. It is most advisable to have a skilled attorney by your side at your Board hearing.

What if I lose my case at the Board of Industrial Insurance Appeals?

The Board of Industrial Insurance Appeals is not the last stop for litigating your claim. If you lose at the Board, you may file another appeal to the Washington superior court. At the superior court, your case may go before a jury for the issue to be decided by your peers. Your case may also go to the superior court for a bench trial to be decided by another judge. Once your case is in the superior it can be appealed to the court of appeals and even the Washington supreme court.