To encourage the Washington Department of Labor & Industries and self-insured employers to promptly work up claims, the Washington Legislature has provided that provisional time loss compensation must be paid even if a workers' compensation claim has not been worked on. Under RCW 51.32.210 (state fund claims) and RCW 51.32.190(3) (self-insured claims), if time loss is contended on the accident report or otherwise certified by a doctor, it must be paid within 14 days. Payments must continue at least semimonthly until the department issues a determinative order allowing or rejecting the claim. If the claim is ultimately rejected, RCW 51.32.240(3) allows the department to recoup the benefits from you.
The purpose of the provision is to protect injured workers from possible financial hardship due to a delay in benefits, and to encourage the department to quickly act on claims. Timely action is certainly necessary if you are unable to work, since the loss of a paycheck is certainly a financial emergency. According to the Board of Industrial Insurance Appeals, the “Legislature has apparently decided that this social and economic need of workers outweighs the prevention of the payment of any compensation until a determinative administrative decision has been made.”
Provisional time loss does not depend on the eventual validity of the claim, and it only ends with the issuance of a binding determination on the allowance or rejection of the claim in the form of a definitive, official order.
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