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Disclaimer: This article is for informational purposes only and does not constitute legal advice. Consult a qualified attorney or Washington State Department of Labor & Industries (L&I) representative for guidance on your specific situation.

Detailed Answer

In Washington, injured workers whose claims are accepted by L&I or a self-insured employer have the right to know how medical bills are handled. Follow these steps to confirm whether workers’ compensation payments were applied to your medical expenses:

1. Gather Your Documents
   Collect all Explanation of Benefits (EOB) or Payment Summaries provided by your claims administrator (L&I or insurer). These documents list medical providers, billed amounts, approved amounts, and payments issued.
2. Review Medical Provider Statements
   Obtain copies of your medical bills or statements from each provider. Compare billed amounts to amounts marked “paid” or “adjusted” on your EOB. Any difference usually indicates a workers’ compensation payment or write-off.
3. Request a Claims File or Payment Ledger
   Under RCW 51.32.190, your claims administrator must maintain records showing all payments for medical services. You may request a copy of your claims file or a summary ledger that details each payment.
   RCW 51.32.190
4. Contact Your Claims Examiner or Insurer
   Call or email your L&I claims examiner (or the insurer’s case manager). Ask for an itemized list of payments applied to your medical bills, including dates, amounts, and provider names. If you’re with L&I, you can also use L&I’s online portal to view payment details.
5. Follow Up with Your Medical Provider
   If your provider’s statement doesn’t reflect a payment you see on the EOB, contact the provider’s billing office. Sometimes a payment posts late or under a different reference number.
6. Dispute Unapplied or Incorrect Payments
   If you believe L&I or the insurer failed to apply a payment, submit a written request for correction. Cite any relevant EOB line items and billing statements. If the issue remains unresolved, you can request a Review Hearing through L&I (L&I Review Hearings).

By systematically comparing EOBs, medical bills, and insurer records, you can confirm that workers’ compensation payments have been correctly applied to your medical treatment.

Helpful Hints

• Keep digital and paper copies of all EOBs, medical bills, and correspondence.
• Note key deadlines: L&I must issue payment or denial of a medical bill within 60 days of receipt (RCW 51.32.160).
• Ask providers to itemize services by date and code to match EOB line items easily.
• Use L&I’s online portal (My L&I) to track claim status and payment history in real time.
• If you hit a roadblock, consider asking an attorney familiar with Washington workers’ compensation to review your documentation.