Introduction
A
claim for workers' compensation starts with an application for benefits filed
with the Department of Labor and Industries or a self-insured employer. [Department
of Labor & Industries]
If
you disagree with a decision made by the Department or self-insured employer,
you should do one of the following:
Do
not file a protest with the Department if you are filing an appeal with the BIIA.
Appeals
You must file an appeal within 60 days of the
date you receive the Department's decision.
Your appeal should include:
- The
name and address of the claimant (and his/her representative) and the name
and address of the employer.
- The
claim number assigned by the Department of Labor and Industries.
- A
description of the injury/disease, including the date it occurred.
- The
date of the Department decision being appealed.
- The
city in which you would like proceedings to be held.
- What
you are asking for.
You
can file a Workers' Compensation appeal online:

You
can file the appeal by mail:
Board of Industrial Insurance Appeals
Attention: Executive Secretary
PO Box 42401
Olympia WA 98504-2401
Or
file in person:
Board of Industrial Insurance Appeals
Attention: Executive Secretary
2430 Chandler Court SW
Olympia WA 98504-2401
Industrial
Insurance Notice of Appeal Form
For
further information you may request the booklet Your Right to Be
Heard.
For more information about
the appeal process, click here.
Return to FILING
AN APPEAL
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