Among other things, the Department of Labor and Industries (Department) is the state agency that administers the workers' compensation fund. The Department determines what benefits are to be provided to an injured worker.

The Board of Industrial Insurance Appeals (Board) is a separate state agency that is independent from the Department.

It is the Board's function to review the Department's determinations when there is an appeal by interested parties. The Board operates like a court to decide the case.

By state law you must file your appeal at our main office in Olympia, Washington (Filing an Appeal). In Olympia, we have a staff assigned to process your appeal in the most efficient manner possible. Our new appeals unit is dedicated to preparing your case for resolution and is there to assist you. [See RCW 51.52.050; WAC 263-12-01501(1)(a)]

When the Board receives your notice of appeal, a docket number is assigned and a Notice of Receipt of Appeal is mailed to each party the next working day. If you do not receive a Notice of Receipt of Appeal, you may call us at (360) 753-6823 to speak with a Judicial Appeals Analyst in our new appeals section.

In workers' benefits appeals, the Department must respond by either:

• Sending its record to the BIIA, which permits the appeal to proceed; or
• Changing or reversing the order under appeal; or
• Advising the BIIA that they will reconsider their decision.

The BIIA has 60 days to decide whether the appeal will be granted. The Department must respond to the appeal within this time frame.

When the appeal is granted, we will send you a copy of the appeal with the Order Granting Appeal. If you would like a copy of the appeal sooner, please call us at 360-753-6823.

No. The Board does not need any additional information to make the decision to grant or deny the appeal. Once the appeal is granted, you should provide the new information during the mediation process.

If you did not file the appeal, you may choose whether to participate in the conferences and/or hearings. If you choose not to participate, it is possible that your interests could be substantially affected by the outcome of the appeal. In some instances, the outcome of the appeal might not have any effect on you. If you are not the appealing party and you would like to participate, feel free to contact our office.

If you have an opinion concerning the outcome of an appeal, you should participate in order to voice your opinion.

It depends. If the provider filed the appeal on their own behalf, they are required to participate.

If the provider filed the appeal on behalf of the worker, they are considered the worker's representative. If they do not want to represent the worker, they should inform the Board at its Olympia address.

Payment of Benefits When an Employer Files an Appeal

The Legislature passed a new law in 2008 that provides for continued benefits during an employer appeal.  The law also allows the employer to request those benefits be stayed (stopped).

The new law does not affect appeals filed by injured workers.

Will I continue to receive benefits if my employer files an appeal?

If the order appealed by your employer was issued on or after June 12, 2008, you will continue to receive your benefits unless your employer is granted a stay by the Board.  An employer must file a motion to stay benefits no later than 15 days after the Board grants the employer's appeal.  

How will the Board decide whether to grant the stay motion?

The Board must base its decision on the information in the Department file as it existed on the date of the order on appeal.  New medical or vocational information in the file or offered by the parties in connection with the motion cannot be considered.

I am an employer.  How do I stop benefits during my appeal?

You can file a motion to stay benefits with your appeal, or file within fifteen (15) days after the appeal is granted.  The motion should specifically request that benefits be stayed during the appeal process.

If your case goes to hearing, we strongly suggest that you hire an attorney. The judge cannot act as your attorney and cannot represent your interests.

Your attorney:

• Can discuss your case and concerns with you.
• Can negotiate with the opposing party to reach an acceptable settlement.
• Will be responsible for scheduling and questioning witnesses.

Once you hire legal counsel, make sure that all communications with the BIIA come through your attorney. Your attorney is in the best position to answer your questions because he or she understands your case.

You can bring an attorney to represent you, or a family member, friend, or union representative to help you.

The Board will provide an interpreter in certain circumstances. If you need an interpreter, please contact us as soon as possible.

Mediation is a process where a neutral person (mediator) facilitates communication between the parties, with the goal of resolving their dispute.

The hearing process is a formal litigation stage where the judge will make a decision based on the witness's testimony and the evidence presented.

Appeal Process

Sometimes parties are not available to travel, but they are still interested in finding a way to resolve the case. Rather than delay the case by rescheduling the conference, the BIIA will often allow parties to appear by phone.

Providing medical testimony can be one of the most difficult aspects of litigation and, because medical witnesses typically charge a fee, it can also be expensive. However, CR 43 directs that the "testimony of witnesses shall be taken orally in open court . . .."

You should plan to present the testimony of your witness. Reports or letters are generally considered hearsay. Hearsay statements are not usually admissible because the opposing party cannot cross-examine the person making the statement to test the statement's accuracy. There are also many exceptions to the hearsay rule. [See ER 801, 802, 803, 804]

The employer's industrial insurance premium may be affected by the allowance of a claim. Therefore, they have a legal stake in the filing of a claim by an injured worker. Also, while they may agree that you were injured at work, they may disagree with the benefits approved by the Department. Accordingly, workers, beneficiaries, employers, or other parties affected by a Department decision may appeal to the Board. [See RCW 51.52.050]

We have judges and staff in several locations around the state. Judges may be assisted by staff in more than one location. It is best to call the main office in Olympia to determine who can assist you.

The Board's main office is in Olympia. We have regional offices around the state, but the majority of our staff is located in Olympia.

A mediation judge helps the parties reach an agreement. The mediator will not decide the case. The mediator may talk to the parties separately. This is called ex parte contact. Talking to the parties individually can often lead to a successful resolution of the case. If the case does not settle in mediation, it will be given to a hearing judge, who will conduct a formal hearing.

The hearing judge will write a decision resolving all issues raised by the Notice of Appeal. The judge considers only admissible evidence presented during the hearing. The hearing judge cannot have ex parte contact with any party to the case. It would be unfair for one party to discuss the merits of the case with the hearing judge without all parties being present.

The Board members are the final legal authority on all Board orders. It would be unfair and unethical for a Board member to speak to any party about an active case.

It takes a court reporter approximately four weeks to transcribe a deposition or hearing. It is the Board's goal that judges issue decisions as soon as possible after all transcripts are received. This generally takes between 20-60 days. At times, due to the complexity of the appeal, it may take longer.

If the Board decides in your favor, it directs the Department of Labor and Industries or the self-insured employer to pay your benefits.

The Department or the self-insured employer is obligated to pay benefits ordered by the Board within a reasonable processing period from the receipt of the Board's order. You should contact the Department immediately after you receive your order to obtain their payment date.

Follow this link for information on checking the status of a claim with the Department: Claim Status at the Department of Labor and Industries

Yes.

Please send a copy of the superior court appeal, including the superior court cause number assigned to the appeal. Please check with us before sending any other documents.