Presumptive eligibility and you

Washington State remains in a Public Health Emergency. We do not know when this will be lifted. With COVID-19 cases continuing to rise working in health care remains a risk for contracting COVID-19. Presumptive Law RCW 51.32.185 offers protection from having to use your sick leave and PTO. It is important that you file an L&I claim. Payment begins from your first day of symptoms. Please review the fact sheet.

Presumptive Eligibility for Health Care Workers During a Public Health Emergency

New Information Provided by L&I:

  1. Anytime a nurse or other health care worker requests to file a workers’ compensation claim, the employer is required to allow a claim to be filed.
  2. Per Labor and Industries, most workers’ compensation claims that are filed from health care workers are accepted (and not denied).
  3. If a workers’ compensation claim is denied, it is usually due to insufficient information, (e.g., test results not provided, lack of information on quarantine order).
  4. If a nurse is not allowed (the employer or the third-party administrator) blocks filing a workers’ compensation claim, a Claim Suppression form may be filed with L & I. This alerts Labor and Industries that the employer is disallowing the worker to file a workers’ compensation claim.
  5. If a workers’ compensation claim is denied, the worker has the right to appeal/dispute the decision. Disputes must be in writing and may be sent to either Labor and Industries or the Board of Appeals within 60 days.

Reclaiming PTO from the employer, once workers’ compensation is approved, is the employee’s responsibility.

If you have any difficulties in filing, please contact Travis Elmore Nelson, WSNA Nurse Representative, telmore@wsna.org, 206-575-7979 ext. 3117.