How to Apply for Washington Workers’ Compensation Benefits

Note: We updated this article in September 2024 after fact checking against Washington state workers’ compensation laws. Unless you’re a federal employee, state law outlines who gets Washington workers’ compensation benefits and how the process works. Sick or injured workers in the Evergreen State don’t all follow the same process to file workers’ compensation claims, however.

Learn the workers’ comp claim process if you work for a self-insured employer, the federal government, or other Washington business below.

Workers Comp in Washington State: Key Takeaways

• Most employers have workers’ compensation coverage through the state fund, not a private insurer.
• Most injured workers can choose the first doctor they see after workplace accidents. However, you will likely need to see a doctor in L&I’s network of approved providers for ongoing treatment.
• If you qualify for any lost wages, you will receive anywhere from 60%-75% of your average weekly paycheck amount. This amount is subject to state maximum and minimums for the current calendar year. The state also uses the number of dependents you support to determine your final percentage and pay rate.
• You will follow a different claims process depending on whether your employer’s self-insured or purchased coverage through the state fund.
• Federal employees always file directly with the government agency that employs them, and are subject to different rules.
• Injuries that arise from horseplay, fighting, committing crimes, or that occur while intoxicated are not eligible for Washington workers’ compensation.

Do I Have Washington Workers’ Compensation Insurance Coverage?

Workers’ compensation insurance coverage is required for all Washington businesses with one or more employees. This workers’ compensation insurance requirement also applies to part-time employees. However, Washington state law also lists many automatically exempt employees from this workers’ comp insurance coverage rule:

• People renting booths to work at events
• Certain musicians and entertainers
• Domestic workers employed less than 40 hours per week in private homes with no other employees
• Independent contractors
• Children hired by their parents to engage in farm work
• Cosmetologists, barbers, and other salon employees that rent or lease a space to work in
• LLC members and corporate officers
• Maintenance or repair workers and gardeners working in a private home
• Sole proprietors
• Volunteers
• Federal employees (see the relevant section below)

Pro Tip: Are you self-employed (i.e., a contractor or sole proprietor)? You can opt to purchase workers’ comp insurance in Washington state. Simply file a business license application with the Washington State Department of Labor & Industries (L&I).

Important: Most employers (2 in 3 Washington business owners) have insurance coverage through the state fund. However, coverage works somewhat differently for federal employees and any person working for self insured employers (1 in 3). So, keep reading to understand those specific workers’ compensation requirements if you’re in one of those two groups.

What Employees of Self Insured Employers Should Know

Any Washington business must meet all the following requirements to become a self-insured employer:

• Assets worth at least $25 million
• An accident prevention program available in writing for a minimum of 6 months
• Show business earnings from operating within the state for at least 3 years prior to filing a self-insurance application

Washington employers who meet all requirements above may potentially purchase insurance coverage from a private insurer. However, the state must first approve the company’s request.

Click here for an alphabetical list of employers who handle workers’ compensation claims through a private insurer. If your employer’s on the list, check out your claim process in this Guide to Workers’ Compensation Benefits. Otherwise, you should file your claim directly with the Washington state fund.

Work for the Government? File Your Claim Under the Federal Employees Compensation Act (FECA) Instead

All federal employees follow the same process to file workers’ comp claims, no matter where they work or live. Learn how workers’ comp claims work for injured workers employed by the federal government.

Steps to File Your Washington Workers’ Compensation Claim

Important: Seek emergency treatment immediately if you require urgent medical care. When you arrive, tell the medical provider you see that you have a work-related injury or occupational disease.

If your employer isn’t self-insured, follow these steps to apply for workers’ compensation benefits from the Washington state fund:

1. Notify your supervisor as soon as possible.

Warning: Don’t wait to tell your employer about your workplace injury or illness. Delaying could result in denial of your claim for benefits.

2. For your first doctor’s visit or initial treatment, you can choose any doctor you like.

Be aware, however, that you must choose a doctor from an authorized list of L&I providers for ongoing medical treatment.

3. Ask the first doctor who treats you to submit your workers’ compensation claim with L&I within 5 days.

Ultimately, you are responsible for making sure L&I receives a Report of Accident (ROA) form when you’re injured. So, be sure to ask for a copy to keep for your own records in case you need to follow up with L&I directly.

Important: You must initiate the claims process within a year of your injury or two years of your illness. Otherwise, you may lose your right to claim any workers’ comp benefits.

4. You must be off the job for more than 3 days due to a work-related injury or illness to get paid time off.

If L&I approves your claim and the doctor says you temporarily cannot work, you will qualify for wage-loss benefits on day 4. This is known as the required waiting period before you can get Temporary Total Disability (TTD) payments. However, those first 3 days off are always unpaid unless you must miss more than 15 days of work. After that, the state will pay you for those first 72 hours you had to miss work.

4. If you qualify for time off, you should get your first lost wages benefit check within 14 days.

These checks automatically expire after 180 days (6 months), so don’t wait to cash or deposit it!

But if the doctor says you can go back to work immediately, even part time, then you’re only eligible for medical benefits. This means L&I will pay any medical bills related to your illness or on-the-job accident. However, you will not receive any compensation to cover the time you lost from work.

Important: Be sure to list all your dependents on your ROA form (i.e., spouse, children younger than 18). This helps the state calculate the percentage of lost wages an injured worker receives after the required waiting period ends.

4. You can still appeal if L&I denies your claim.

You can either protest L&I’s decision or appeal directly to the Board of Industrial Insurance Appeals.

Important: You must appeal in writing within 60 days. If you miss the deadline, L&I’s decision is final and you lose your right to appeal.

Understanding Washington State Workers’ Compensation Trends

The U.S. Bureau of Labor Statistics issues an annual workers’ compensation report covering most U.S. states and territories. Here’s what the data show about the Evergreen State’s claims activity from 2018 to 2022:

The total number of claims plummeted in 2020, then climbed 8% to a new peak in 2022. As you can see, service industry workers typically file anywhere from 50%-55% of claims in a given year. The number of employees who missed work, transferred, or received restrictions followed a similar trend line.

Talk to a Washington Workers’ Compensation Attorney for Free

Working with an experienced workers’ comp lawyer can make the process easier and faster. Not to mention, approximately 25,862 people filed denied workers’ comp claims in 2022. A Washington workers’ comp attorney is the best person to help you successfully appeal a claim’s unfair denial.

What’s more, these attorneys always work on contingency. That means they charge you $0 in legal fees unless your claim succeeds. And if you win a settlement, then you only pay one small fee afterwards. State law says that fee cannot be more than 30% of the increase in your contested award amount.

Want to talk to a local advocate about your case for free? Click the button below to start your free online benefits quiz and see if you may qualify:

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