Does Your Work Related Injury Qualify You for Provisional Time Loss?
Getting injured on the job isn’t just physically painful and emotionally exhausting. It can also put you in a tough financial situation. In addition to your regular bills, suddenly you have a slew of new medical expenses, but you can’t work.
That’s why, if you were injured while working in the State of Washington, you may be entitled to worker’s compensation, which can include medical benefits, disability, and something called provisional time loss.
What Is Provisional Time Loss?
If you cannot work at all due to a job related injury or illness, provisional time loss allows you to receive monthly payments that make up a percentage of the wages lost while you’re unable to work.
Provisional time loss protects injured workers from financial hardship due to a delay in receiving disability payments or other worker’s compensation benefits.
It’s also a way of compensating you for your loss of earnings during the time you are unable to work.
Provisional time loss is only one of the benefits included under worker’s compensation laws in Washington. Time loss benefits are not meant to cover your medical expenses, for example. Other worker’s compensation benefits may cover those instead.
Who Is Eligible for Provisional Time Loss?
To be eligible, you must be unable to work for more than three days after the day you were injured. On the fourth day, you are eligible to start receiving time loss benefits.
If you are eligible for provisional time loss benefits, you will be paid 60% to 75% of your normal wage tax free.
Payments are calculated based on your monthly wage, health care benefits, marital status, and how many dependent children you have.
Who Handles My Provisional Time Loss Claim?
That depends on whether your employer is self-insured or not. How much compensation you receive is the same either way. But if your employer is self-insured, your employer handles your paperwork and pays the claim. If your employer is not self-insured, that responsibility falls on the Department of Labor & Industries (L&I). L&I handles disputes in either scenario.
Not sure if your employer is self-insured? You can look up your company here.
Provisional time loss acts as an incentive for self-insured employers to work up claims in a timely manner when their employees get injured. Provisional time loss benefits still have to be paid even if the claim has not been processed yet.
In the case of employers who aren’t self-insured, provisional time loss encourages Labor & Industries to act quickly on claims.
Which Washington Laws Cover Provisional Time Loss?
Under RCW 51.32.210 (state fund claims) and RCW 51.32.190(3) (self-insured claims), if your time loss is reported on the accident report or otherwise certified by a doctor, you must be paid within 14 days.
Payments must continue at least semi monthly until L&I issues a determinative order allowing or rejecting your claim. If your claim is ultimately rejected, RCW 51.32.240(3) requires you to repay the provisional time loss payments you’ve received.
That is the State of Washington’s way of prioritizing workers’ social and economic needs over the potential risk of paying compensation benefits that might ultimately need to be recouped if the claim is rejected.
If you feel an unfair decision has been made regarding your injury claim, get in touch and we’ll set up a free consultation to discuss your options.
What Benefits Can You Expect?
In the State of Washington, time loss payments are calculated as follows:
Injured workers are entitled to 60% of their gross monthly wage, plus 5% for a spouse and 2% for each dependent child. (You can claim up to five children.) Therefore, the percentage you are owed will be between 60% and 75% of your wage.
The state also imposes a limit on how much one person can receive. That cap varies from year to year, but you can see this year’s maximum here.
There are other legal considerations that help determine how much time loss compensation you are entitled to, including whether you are divorced and when, and who qualifies as a dependent.
A good lawyer can work through all those details with you and help you estimate what your monthly compensation will be.
What Are Your Rights?
As an employee in the State of Washington, you have certain rights, including your right to be compensated for your loss of earnings and your right to work with an attorney to make sure that compensation is fair.
When you are unable to work, you need to know as soon as possible if your claim has been allowed, and you deserve to be compensated in the meantime. Losing a paycheck is a financial emergency that can be detrimental to your recovery from injury and your household’s well being.
Because you receive provisional time loss benefits before you know whether your claim is allowed or rejected, your compensation does not depend on the eventual validity of the claim. You’ll only stop receiving time loss payments when L&I makes a determination, either allowing or rejecting your claim.
You are also entitled to receive time loss benefits even if you worked for a different employer at the time of your work related injury. Similarly, if you move out of the state of Washington after your injury, there’s no reason you can’t continue to receive time loss benefits.
How to Prove You Can’t Work
After your injury, it’s important to see a doctor as soon as possible to get a medical certification that you are not able to work because of your work related injury. Unfortunately, L&I doesn’t care whether you feel you can work or not. A professional medical opinion is needed, so get to a doctor right away if you have been injured at work.
Before you can receive time loss benefits, you need to prove you haven’t worked since your injury, so you’ll need to complete a Worker Verification Form. A good attorney can help you fill out this form properly and deliver it to L&I.
Provisional time loss is designed to protect you in the event of a debilitating work related injury, but unfortunately, the system is not flawless.
Sometimes people don’t receive the provisional time loss benefits they are entitled to. If you feel you’ve been unfairly compensated after a work related injury, or you’re not sure how to make sure you receive your provisional time loss benefits, give us a call.