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1. May I choose my doctor?

Yes, you may choose any doctor who is qualified to treat your condition and is reasonably convenient to you. As of January 1, 2013, after your initial visit, any additional treatment must be made with a qualifying, contracted L&I provider.

2. Who do I contact when my doctor takes me off work?

You will need to contact your supervisor and Risk Management at 425-388-3475 immediately and provide an Attending Physician’s Form from your physician stating that you are unable to return to work. Time is of the essence. Your supervisor needs to provide you with the Pay Acknowledgement Form for you to complete. It is critical that you complete this form to ensure your paycheck is calculated correctly.

3. What is time loss compensation?

If you are unable to work as a result of your injury or occupational disease, you will be paid a portion of your regular wages. The time loss compensation payments will not provide you with the same income you earned when you were working. Time loss compensation is calculated on a standard formula established by law.

4. How do I qualify for time loss compensation?

Your doctor must determine that your injury or illness is work-related and provide objective findings to support their certification that you are unable to work. Time loss certifications must be made prior to time missed from work. Backdated Time Loss certifications are not permitted. Time missed for follow up doctor appointments is not covered under time loss and should be applied to the employee’s personal (sick) leave bank.

5. How long do I have to be off work to qualify for time loss compensation benefits?

These benefits are paid if you are unable to work for more than three days immediately
following the date of your injury. The first three days may be compensated by your sick leave
accruals.

6. How long will I receive time loss compensation benefits?

You will receive time loss compensation payments approximately twice a month as long as your doctor verifies (prior to missing time from work) that your condition prevents your return to any work. Without this information, your time loss compensation check could be delayed or stopped.

7. How are my ongoing prescriptions paid?

Pharmacies may bill Modern Medical (card located in packet), or, send their billings directly to:
Eberle Vivian
206 Railroad Ave. North
Kent, WA 98032.

8. Who do I contact when I have questions?

Direct your questions to Lisa Scalf, Industrial Insurance Coordinator. Lisa can be reached at 425-388-3475, Monday through Friday, from 7:30 a.m. to 4 p.m.