What to Do If Your L&I Claim Is Denied in Washington

Getting a denial letter on an L&I claim is stressful, especially if you’re already dealing with pain and missed work. The good news: a denial isn’t necessarily the end of your claim. Washington has a clear process for disputing an L&I decision, with real deadlines and two different paths depending on what you want to do. Here’s how it works.

1. Read the decision letter carefully — and note the date

Every L&I decision letter starts a clock. The deadlines below are counted from the date on the letter, not the date you happened to open it, so the first thing to do is find that date and write it down somewhere you won’t lose it.

2. Understand your two options: protest or appeal

Washington gives you two different ways to challenge a claim decision, and it helps to know the difference before you pick one.

A protest is a request for L&I itself to take a second look at its own decision. You write to your claim manager explaining why you disagree and include any new medical information that supports your position. L&I then issues a new decision — which may modify, reverse, or reaffirm the original one.

An appeal goes to the Board of Industrial Insurance Appeals (BIIA), a body that is independent of L&I. You can appeal directly to the BIIA without protesting first, or you can protest first and appeal afterward if you’re still not satisfied.

Both a protest and an appeal generally must be filed within 60 days of the date on the decision letter (some decisions, like vocational benefit denials, have a shorter 15-day window — which is another reason to read the letter closely). Missing the deadline can mean losing your right to dispute the decision at all, so this isn’t something to sit on.

3. How to file a protest

A protest is typically a written letter to your claim manager stating clearly that you disagree with the decision and why. Include your claim number, and attach any medical records, imaging, or provider notes that support your case — particularly if the claim was closed and you believe treatment is still needed. This is exactly why consistent documentation from your provider matters: a protest backed by clear medical records carries a lot more weight than a letter alone.

4. How to file an appeal with the BIIA

If you’d rather go straight to an independent review, or if your protest didn’t resolve things the way you hoped, you can appeal to the BIIA. The appeal should include your claim number, the decision you’re disputing, and your reasons for disagreeing, along with any supporting information. Once filed, the BIIA notifies L&I, who has a chance to reconsider. If L&I doesn’t change the decision, the BIIA schedules a hearing.

You can reach the Board of Industrial Insurance Appeals directly at 360-753-6823 or 1-800-442-0447.

5. Why treatment gaps hurt your case

One of the most common mistakes we see is a patient pausing treatment while they wait to hear back on a protest or appeal — either because they’re discouraged or because they’re unsure if it’ll be covered. Gaps in treatment are one of the first things a claims examiner or the Board looks at when weighing whether an injury is as significant as reported. Whatever else is happening with the paperwork, staying consistent with evaluation and documented treatment is one of the strongest things you can do for your case.

6. When to bring in an attorney

Not every protest needs a lawyer — plenty get resolved with a well-documented letter. But if your claim has been denied outright, if you’re heading to a BIIA hearing, or if there’s a lot riding on the outcome, it’s worth talking to an attorney who handles L&I appeals. If you’re already working with one, we provide the medical documentation and reports they’ll need.

How we can help

As an approved L&I provider, Dr. Gill can evaluate your injury, document your condition thoroughly, and provide the kind of consistent treatment records that support a protest or appeal. If your claim is being contested, that documentation is often the difference-maker.

For everything else on how an L&I claim works — choosing your own provider, what a claim covers, and what your first visit looks like — see our Work Injury & L&I Care page.

The information on this page is general in nature and is not legal advice, and it is not a substitute for guidance from the Department of Labor and Industries or the Board of Industrial Insurance Appeals. Deadlines and processes can change and depend on your individual claim — for official information, contact L&I directly at 1-800-547-8367 or visit lni.wa.gov.