Washington Department of Labor & Industries Listening Sessions Signal Changes to Claim Process
On January 7 and 23, 2025 the Department held two listening sessions open to attendance by members of the self-insured community regarding The Claims Process Project. These listening sessions were aimed at increasing efficiency and consistency of adjudication and improving accuracy, timeliness, and quality of claim management by all parties involved.
Generally speaking, the Department is looking to reduce timeframes before making decisions. The following changes are slated to be in effect by July 1, 2025, but could start as early as April or May depending on the Department’s IT team and the amount of time to make form, template, letter, and order changes. Some adjudicators have started implementing changes already.
Requests Subject to 15 Day Deadline
The Department is imposing a 15-day deadline on requests for information that had been previously subject to 90 day deadlines. This change will not allow much time to obtain information. Therefore, we at SBH recommend that the self-insured employer and their third-party representative work together to maintain a file of information subject to potential requests to ensure compliance with all deadlines.
Disputes: Rather than issue a notice acknowledging a dispute from one party or the other, the Department will now issue a notice of dispute to all parties and request that they respond within 15 days with their position on the dispute and the particular records to be considered. The Department specified that sending a copy of the claim file alone would not be sufficient. Instead, these requests are designed to illicit specificity from each party. We recommend contacting a SBH attorney before claims get contentious to ensure that your legal representative can quickly and effectively identify the relevant materials and rules for a successful outcome.
Wage Documentation: This impacts documentation including all earning statements, daily time records, definitions of pay codes, bonuses and lump sum payments paid 12 months prior to the date of injury. Failure to issue a timely or incomplete response is subject to penalty. We recommend that adjudicators request all of the above information from employers upon receipt of the filing of a claim to ensure timely compliance with such requests.
Incomplete or Missing SIF-2s: Employer will be subject to penalty for failing to submit a SIF-2. The Department will request issuance within 15 days once the absence is identified, but unless the worker has returned to work it may be difficult to obtain a signature from the worker in that amount of time. We recommend working with your employer representatives to ensure claimants sign this critical document as soon as a claim is identified. This is important even if there are validity concerns. Please contact us if you have concerns about the validity of a specific claim.
Reduced Interlocutory Periods
The Department plans to reduce the amount of time allowed for each interlocutory request. The initial request will receive 30 days from the first valid request, and no more than 90 days. The second valid request will receive an additional 30 days, and no more than 120 days total. The Department noted that validity is assessed on what steps the employer has taken to obtain information, and the specific cause of the delay. The current timelines are 90 and 120 days for the first and second valid request, respectively.
The listening sessions also addressed Department concerns with delays in the vocational process, multiple changes to Department developed forms, and additional processes and procedures. We will provide another update soon addressing these additional matters.
If you have any questions or want to discuss the content of the Claims Process Project and Department Listening Sessions in greater detail, please feel free to contact me at or 503 595-6103.
Posted by Madeline Mahugh.