Time Loss Compensation - WA L&I Payments for Lost Wages (2024)

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What is time loss?

Time loss is partial wage replacement for an L&I claim. It is money paid every two weeks while you are not working because of a job injury.RCW 51.08.178 & 51.32.090.

Who gets time loss?

To get time loss you need all of the following:
(1) an open L&I claim
(2) certification by your doctor that you are unable to work. The doctor can use an Activity Prescription Form which they need to send to L&I
(3) you need to be not working, and verify this by completing a Work Status Form and sending it to L&I because of a medical condition which iscausally related to your injury or occupational disease

What can I do while on time loss?

You can go about your daily activities within the limits and restrictions outlined by your doctor. You should be receiving medical treatment and attending medical appointments while on time loss. Use this time to focus on your recovery.

Can I volunteer while on time loss?

You can volunteer while on a time loss, however you should be careful and do it correctly. Get your doctors approval. Have it be a therapeutic thing which is good for your physical and mental health. Don’t do too much. Don’t receive wages for volunteering and inform L&I of the volunteer activity. Don’t have it rise to the level of work type activity.WAC 296-14-4123(1). Don’t volunteer so much that L&I says you are employable WAC 296-19A-010.

The time loss rules. What should I not do while on time loss?

  • Do not work while on time loss
  • Do not perform activities that look like work, especially in your front yard where you are in full view of L&I investigators
  • Do not post anything on social media which contradicts what you are saying to L&I and to your doctor. L&I investigators read the social media posts of injured workers every day. They are looking for people who are working. They are looking for people who perform activities that are the equivalent of work
  • Do not miss your medical appointments
  • Do not engage in sports or other activities which are inconsistent with your medical restrictions. Follow your doctor’s advice about activity
  • Understand this: L&I works overtime to look for dishonesty and to prosecute dishonesty as fraud.

Who pays the time loss for my lost wages?

The Department of Labor and Industries makes the time loss payment to injured workers on State Fund Claims.

If you work for a Self Insured employer, your employer pays your time loss. The self insured employer may have a Third Party Administrator (TPA) as their claims managers and issue time loss payments through that TPA.

How long do claims managers have to start paying time loss?

The firsttime-losscompensationpayment must be ordered and mailedwithin14 calendardays. Payments are due on the date of the department order.

The 14-day clock begins the day after the receipt of either the Report of Industrial Injury form or the worker’s application for benefits, or

The14-dayclock begins to run thedayafter the department receives either contention or certification from your doctor thattime-losscompensationbenefitsare payable.

What if the self insurer or L&I won’t pay time loss or pays time loss late?

Self insured employers can be penalized for late or for missing time loss payments. You can request penalty from the Self Insured Section of the Department of Labor and Industries.The law assesses a penalty of the greater of $500 or 25% of the amount due.Payment is to the injured worker.

For claims managed by the Department of Labor and Industries there is no penalty however you can request to speak to the unit supervisor and ask them to intervene.

How do I get paid penalty money for late time loss compensation?

You can request a penalty on a self insured claim by writing to the Self Insured Section of the Department of Labor and Industries.The director of L&I is required to issue anorderwithin 30 days of your request.

Who do I complain to if my time loss rate is not correct?

Contact your claims manager to advise that your time loss rate is not correct. If an order has been issued setting your time loss rate, you must properly submit a timely WRITTEN protest or appeal that order. Do not hesitate. Time is of the essence. See Provide the claims manager with your pay information if your employer is not responding to requests for wage information.

What is provisional time loss?

Time loss paid while the claim is under investigation is provisional time loss. It is different in character then time loss. Provisional time loss comes with strings attached. If your L&I claim is later denied with a final order you must pay back all the provisional time loss you received. L&I does not always initiate provisional time loss while they are waiting to make a decision on allowing or denying your claim. They do have to pay it, so if you deserve it and want it, then request that L&I pay provisional time loss.

What if I return to work for less money?

You can apply and possibly receive Loss of Earning Power

What does the law say about time loss?

Time loss statute is RCW51.32.010

Are time loss orders important?

  • Pay attention to all L&I orders, including time loss orders
  • An order is a legal communication from L&I. Your benefits are affected by these orders. Pay attention to when you get the order. Look at the amount of time you have to protest. This information is written at the bottom of the order.
  • If an order is unfavorable then protest or appeal in writing, or get a lawyer to do it for you, and do it before it’s too late.
  • The first time loss order you receive is the most important, because it sets your wage rate which determines your time loss rate. Be sure you pay attention to the L&I order setting your wage rate. This may be the most important order on your claim. Make no mistake about this: the wage rate set in that order, once it becomes final, is the wage rate you will have for the life of your claim. If it isn’t right, then do something about it. Protest the order in writing . You can protest in writing first, and get them the evidence later. Insist the claims manager get it right. Continue to protest or appeal as necessary. If L&I doesn’t get it right, then get a lawyer, before it’s too late.

Why does time loss end?

L&I time loss getscut off for a number of reasons:

  • Return to work
  • Vocational services end and the injured worker is found employable
  • Doctor fails to certify time loss
  • Employer offers a job within the medical restrictions
  • IME doctor or the attending physician says worker can return to work
  • Self Insured makes a mistake, or is unreasonable
  • L&I makes a mistake

What to do when time loss ends before it should?

  • Disagree with any decision you think is wrong. Do it on time. See
  • Figure out why time loss ended and solve the problem. If you don’tknow why time loss ended, review your file online and talk to the claims manager
  • If the employer has made a job offer, be sure that job offer complies with the Time loss and Job Offers issues covered by INTERIM POLICY 5-15.
  • If the self insurer unreasonably delays or refuses to pay benefits as they become due, ask for a penalty. RCW 51.48.017 and WAC 296-15-266
  • Talk to an attorney

How to keep time loss benefit going

  • See your doctor
    • communicate your work situation
    • make sure he reports to L&I
  • Communicate with your claims manager
    • Help get information to them
    • Make it easy for them to pay you

What If My Time Loss is Often Late?

Late time loss is no fun. You should do something about it. What you do depends upon the reason it is late.

  • The Self Insured is at fault for late payments. See Penalties to the Self Insured Employer for Unreasonable Delay
  • L&I is at fault. See L&I Time Loss
  • If you are the reason my time loss is late See Time Loss Cut Off
  • If your lawyer is the reason time loss is often late. This is a special problem. See How Lawyers Handle Client Money.

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What is the time loss formula?

Wage and Family Calculation

Your time loss rate is determined by multiplying wages times a family status percentage [wage rate x family status percentage = time loss rate].

Wages include:

  • your date of injury wages
  • contractual bonus
  • wages from a second job, if any
  • reported tips
  • board, housing, fuel, or other consideration of like nature,
  • the employers cost of health care insurance, if any, you may have lost since the injury.

Family status determines the % of wages

  • Single = 60%
  • Married = 5% more
  • Children = 2% more each up to 10% maximum
  • The child’s portion is paid to the parent/guardian with legal custody
  • Child’s 2% only to age 18 or 23 if in school full time.

Maximum Time Loss Rate

The above % of wages figures are limited for high income earners. There is a dollar maximum of time loss per month, which is determined by your wage as of your date of injury. This maximum dollar amount changes yearly. If the wage and family status calculation above ends up greater than the figures below, then you are a high wage earner and your maximum rate is set out below.

COLA Increase Effective 7/1/2021

Date of InjuryMax Time Loss Amount ($)
7/1/96 – 6/30/22
(120% SAW)
5,895.70
(196.52)
7/1/95 – 6/30/96
(115% SAW)
5,650.04
(188.33)
7/1/94 – 6/30/95
(110% SAW)
5,404.39
(180.14)
7/1/93 – 6/30/94
(105% SAW)
5,158.73
(171.95)
7/1/88 – 6/30/93
(100% SAW)
4,913.08
(163.76)
7/1/71 – 6/30/88
(75% SAW)
3,684.81
(122.82)

*SAW – State’s average (monthly) wage
**For details see L&I’s Maximum Time Loss Rate

Minimum Time Loss Rate

The % of wages figures don’t apply to persons who earn very low wages. If the wage and family calculation for you is less than the below figures, then you will receive the amount set out below.

Minimum Time-Loss Rate for a DOI or DOM on or after 7/2/08
15% of the State Average Monthly Wage

  • An additional $10.00 is added per month to the base rate for a spouse or registered domestic partner and $10.00 for each dependent child up to five dependents.
  • If the worker’s gross monthly wage is less than that sum then the worker is entitled to a time loss rate equal to 100% of their gross monthly wage or the minimum rate in effect prior to 7/2/2008 whichever is greater.
  • Any applicable cost of living increases should be added.
Date of Injury 15% of State Average Wage
07/01/21 – 6/30/22$959.26
07/01/20 – 6/30/21$871.25
07/01/19 – 6/30/20$816.26
07/01/18 – 6/30/19$773.59
07/01/17 – 6/30/18$736.96
07/01/16 – 6/30/17$703.41
07/01/15 – 6/30/16$685.37
07/01/14 – 6/30/15$657.94
07/01/13 – 6/30/14$644.94
07/01/12 – 6/30/13$623.68
07/01/11 – 6/30/12$602.03
07/01/10 – 6/30/11$589.41
07/01/09 – 6/30/10$578.20
07/01/08 – 6/30/09$559.01

For details see L&I’s Minimum Time Loss Rate

Can an Injured Worker Get Sick Pay and Time Loss for the Same Period?

  • Yes. The injured worker can double dip when using their earned benefits. Holiday pay, vacation pay, sick leave, or other similar benefits shall not be deemed to be time loss payment by the employer
  • The same is not true for Washington Paid Family Leave.

What is Kept on Salary?

Kept on salary (KOS) is an employer continuing to pay the worker all the wages they were earning at the time of injury. When an employer accurately and timely keeps their injured worker on salary, the worker is not entitled to time loss payments for that same time period. The employer benefits from KOS because they can keep their L&I claim cost lower. The worker benefits because KOS is often higher than the time loss rate. RCW 51.32.090 (8)

To Get a Fair Time Loss Rate

Be sure you pay attention to the L&I order setting your wage rate. Make no mistake about this: the wage rate set in that order, once it becomes final, is the wage rate you will be stuck with, for the life of your claim. If it isn’t right, then timely protest the order in writing and insist the claims manager get it right. Continue to protest or appeal as necessary. See . If L&I doesn’t get it right, then get a lawyer, before it’s too late.

Time Loss Compensation - WA L&I Payments for Lost Wages (2024)

FAQs

What is L&I time loss in Washington state? ›

L&I Time-Loss & Wage Replacement Compensation. Time-loss compensation, also known as wage replacement benefits, is a partial wage replacement for an L&I claim and is paid every two weeks while you are not working due to a job injury or an occupational illness.

What is the maximum payout for workers compensation in WA? ›

What is the maximum payout on workers compensation in WA? The maximum payout that a claim worker can receive per week on workers compensation is equal to twice the average weekly earnings that the Australian Bureau of Statistics has calculated for that year.

How is Washington workers compensation calculated? ›

Only actual hours worked are used when determining the WC calculation. Vacation, sick, holiday pay and so on, should not be counted, even if it's paid leave. The formula for WC calculations is: rate x hours worked. 80 hours are worked during the pay period.

What is the loss of earning power in WA? ›

How To Calculate Loss Of Earning Power Benefits. LEP calculations are one of the following: 80 percent of the difference between your date of injury wages and current wages. 1 minus the percentage of your current reduced wages to your date of injury wages times your current time loss rate.

What are loss of time benefits? ›

Loss of time benefits help you meet your financial obligations when you are unable to work because of a non-occupational accident or illness. To receive this benefit, you must be eligible under the Plan, totally disabled, unable to perform your job, and under the care of a medical doctor.

What is loss time to injury? ›

A lost time injury (LTI) is something that results in a fatality, permanent disability, or time lost from work. It could be as little as one day or a shift off work being lost, or months of rehabilitation. It can arise from a small incident, like a paper cut, or from a notifiable event such as a fall from height.

Does workers' comp cover lost wages in Washington state? ›

Workers' compensation pays for medical care directly related to your accident or illness. If you are unable to work following your injury, you may be eligible for reimbursem*nt of a portion of your lost wages.

Who pays for Washington Workers compensation? ›

Employers purchase coverage through the Department of Labor & Industries (L&I). L&I manages all claims and pays benefits out of an insurance pool called the Washington State Fund. The fund is financed by premiums paid by employers and employees, not by general revenue taxes.

What counts as loss of earnings? ›

Claiming for a loss of earnings may not just involve claiming a shortfall in your salary. If you have missed out on other income – such as bonus payments, the chance of regular overtime, or some other opportunity to top up your usual earnings – this can usually be recovered on top of your standard pay as well.

How to calculate loss of wage earning capacity? ›

His loss of lifetime expected earnings is calculated by finding the difference between multiplying his pre-injury earning capacity (after accounting for fringe benefits) by his pre-injury worklife expectancy and multiplying his post-injury earning capacity (after accounting for fringe benefits) by his post-injury ...

What is loss of expected earnings? ›

It refers to an accident victim losing their future wages due to injuries. This concept will mainly apply in cases where the injury affects your long-term capacity to work.

What is the statute of limitations on L&I in Washington state? ›

Washington State L&I Statutes. of Limitations Explained

In the land of Labor and Industries, occupational disease claims have a two-year filing time limit, while you only get one year to file industrial injury claims.

Can you be fired while on L&I Washington State? ›

An employer can lay you off or fire you for any good reason, or no reason at all. You cannot be legally laid off or fired: because you filed a L&I claim. for any reason found discriminatory to include race, gender, national origin, disability, religion, genetic information, for your age if you are over the age of 40.

What is compensatory time off in Washington state? ›

(4) Compensatory time (comp time), is paid time off given to an employee instead of overtime pay in compensation for extra hours of work. However, if the employee later receives this leave as a paid cash out, that payment is for overtime previously worked and therefore is basic salary.

What is a loss time adjuster? ›

The Lost Time Claims Adjuster is responsible for managing all aspects of a workers compensation file. Essential Duties & Responsibilities: • Review, examine, analyze and investigate workers compensation claims. • Adjust claims according to state specific statutes and regulations.

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