L&I Workers’ Compensation Adjudicator 3

Benefits, Questions, Description, Our Mission, Keep Washington Safe and Working!, Our Values, Customer Focus, One L&I, Respect, Diversity, Equity and Inclusion, Learning and Growth, Reliability.

• Review claim files and apply the law to allow or deny new claims filed for workplace injuries or occupational diseases.
• Authorize or deny wage replacement benefits, and if payable, establish the rate of compensation.
• Make vocational services referrals to include early return to work, vocational assessments, plan development and approval of vocational retraining plans.
• Make determination to allow or deny requests to reopen claims closed for more than 60 days and review and investigate requests for accident fund benefits after the statutory limitations.
• Research medical or legal issues for claim file action using RCW, WAC, policies, case law and training.
• Authorize or deny a worker’s medical treatment, surgery, independent medical examinations, diagnostic studies, transfer of health care providers, and other types of treatment and reimbursement of worker’s travel expenses using the Medical Aid Rules and department coverage decisions.
• Respond to inquiries regarding claim benefits, legal rights, the department’s rules and regulations, and the claim adjudication process.
• Prepare a variety of claim file correspondence such as letters and legal orders.
• Document all claim interactions and decisions and ensure compliance with laws, rules, policies, and case law.
• Document treatment authorizations for medial treatment adjudicator to review and make appropriate payment.
• Issue a legal order granting or denying reopening within 90 calendar days.
• Issue orders resolving protests and send letters of explanation to all parties.

• Strong problem solving and decision-making skills.
• Strong interpersonal skills with the ability to communicate effectively both verbally and in writing.
• Strong customer service skills with the ability to listen and connect with others to build and maintain internal and external customer satisfaction even when assisting upset, confused or demanding customers.
• Ability to independently research and gather information.
• Time management and organizational skills.
• Experience working in a high-paced environment with specific deadlines and frequent interruptions.

• Paid leave
• Tuition reimbursement
• Infants at Work Program
• Generous retirement package
• Flexible custom work schedules
• Telework options
• Paid holidays
• Sick leave
• Vacation (Annual Leave)
• Dependent care assistance
• Other insurance coverage

The Department of Labor & Industries is a diverse state agency dedicated to the safety, health, and security of Washington's workers.