Washington L&I Self-Insurance Reminders About Employer Claim Closures
Happy 2025 from SBH Legal! Let’s start the year off with a refresh on self-insured employer closures in Washington.
Self-insured employers have the authority to close claims if: (1) there have been no Department Orders resolving a dispute, (2) the claimant has returned to work for the same employer or at a job with 95 percent of the wages and benefits, (3) and when the closing medical report was sent to the attending provider with 14 days allowed for response.
When a self-insured employer is closing a claim with permanent partial disability, the closing medical report must be sent to the attending provider with the instruction that the provider has 14 days to respond. If the provider agrees the claimant is at maximum medical improvement, and agrees with the disability rating, or does not respond in 14 days the employer may close the claim.
If the attending provider does not agree within 14 days that the claimant is at maximum medical improvement, then the employer must obtain a supplemental medical opinion from an examiner on the Department’s approved examiner list or forward the claim to the Department for closure. Alternatively, if the attending provider agrees that the claimant is at maximum medical improvement but disagrees with the permanent partial disability rating then the self-insurer must obtain a supplemental opinion or forward the claim to the Department for closure. Additionally, if the attending provider disagrees that the claimant is at maximum medical improvement or with the disability rating after the claim closure Order is issued but before it is final and binding—the employer must forward the claim including the doctor’s response to the Department as a protest within five working days of receipt.
Regarding notice, the self-insurer must send the claim closure Order to the attending provider and the claimant on a Department developed form. Notice to the Department must be provided for medical-only claims by the end of the month following closure. Time-loss and permanent partial disability claims must be provided to the Department at the time of closure with copies of the SIF-2, the closure Order, a completed Claim Closure Request Form with supporting medical documentation, and the permanent partial disability payment schedule. Identically to Department closure Orders, the self-insured closure Order is final and binding after 60 days if there are no protests. As discussed above, protests to claim closure should be forwarded to the Department within five working days.
When the Department sends a letter requesting missing information required for claim closure, please do not issue a new closing Order. Instead, simply submit the requested information. The Department instructs the employer not to issue a new closing Order unless a new closing Order was specifically requested. When a new closing Order is issued, the Department must issue several additional Orders superseding and correcting the original closing Order if there are multiple closing Orders. So please save the Department from this headache!
If you have any questions or want to discuss self-insured employer claim closures, please feel free to contact me at or 503-776-5416.
Posted by Sara Densmore.