Washington Affidavit for Time Loss Compensation Benefits is a sworn statement submitted by an injured worker who is applying for time loss compensation benefits in the state of Washington. This affidavit is used to prove that the worker has suffered a work-related injury, and that the worker is entitled to receive time-loss compensation benefits as a result. The affidavit must include the date of injury, the cause of injury, the date of disability, and the estimated period of disability. It must also include a statement from the injured worker's physician that confirms the injury and the estimated period of disability. There are two types of Washington Affidavit for Time Loss Compensation Benefits: Injured Worker's Affidavit and Employer's Affidavit. The Injured Worker's Affidavit is submitted by the injured worker and must include the date of injury, the cause of injury, the date of disability, and the estimated period of disability. The Employer's Affidavit is submitted by the employer and must include a statement from the employer that confirms the injury and the estimated period of disability.
Washington Affidavit for Time Loss Compensation Benefits
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FAQ
Wage replacement If your worker misses time from work and their doctor certifies they are unable to work, L&I may pay for a portion of their lost wages, which is called "time?loss compensation." However, the first 3 days immediately following the worker's injury are considered a waiting period.
Is there a waiting period before I will be eligible for time-loss benefits? Yes. The waiting period is three consecutive calendar days, beginning with the day you lost wages or did not complete your work shift as a result of your accidental injury or exposure.
Whether an injured worker is covered by L&I's Washington State Fund, or a self- insured employer, he or she is entitled to no-fault accident and disability coverage. This ?workers' compensation insurance? covers medical expenses and pays a portion of wages lost while a worker recovers from a workplace injury.
Maximum Time-Loss Rate In Washington, the maximum L&I time-loss rate for 2023 is $8,250 per month, equivalent to 120% of the state's average 2020 monthly wage.
What is the L&I INJURY Statute of Limitations (SOL) in Washington State? If you have an injury on the job, you must file a Report of Industrial Injury within one year of the incident, or else you lose your right to do so. RCW 51.28.
Time-loss compensation payments will not be as much as your regular paycheck. The benefit amount is 60 to 75% of the wage you were earning, depending on how many dependents you have. The minimum and maximum L&I can pay is set by the state legislature.
Workers' compensation (industrial insurance) coverage protects both workers and employers from the financial impact of a work-related injury or occupational disease. It pays for an injured worker's approved medical, hospital and related services that are essential to their treatment and recovery.
Workers' compensation claims must be filed within one year of an injury, and within two years of being notified that an illness is work-related. For additional information on Washington State Injury/Illness definitions, see the L&I website.