Step 1: Understand Your Eligibility for Temporary Disability Benefits

There are different ways to qualify for temporary disability benefits in Washington, depending on the nature of your condition:

Paid Family and Medical Leave (PFML):

• This program is available to workers who are temporarily unable to work due to their own serious health condition (e.g., an illness, injury, surgery, or mental health condition).
• To qualify, you must have worked at least 820 hours in the previous year for a covered employer.
• The condition must be serious enough to prevent you from performing your usual job duties for a minimum of seven consecutive days.

Workers' Compensation (L&I):

• If you are injured while at work or develop an occupational illness, you may qualify for benefits under Washington State’s Workers' Compensation program (administered by the Department of Labor & Industries, or L&I).
• This program covers medical expenses and a portion of your wages while you are temporarily disabled due to a work-related injury or illness.

Step 2: Apply for Paid Family and Medical Leave (PFML)

If you’re unable to work due to a serious health condition, the Paid Family and Medical Leave (PFML) program can provide temporary disability benefits. Here's how you can apply:

• Step 1: Verify Your Eligibility
  To apply, ensure you meet the eligibility requirements. You must have worked 820 hours in the last year, and the illness or injury must be serious enough to keep you out of work for at least seven days.

• Step 2: Apply Online
  The easiest way to apply for PFML benefits is online. Visit the Washington State Employment Security Department (ESD) website:
• Go to https://www.paidleave.wa.gov/.
• Create an account, if you don’t have one.
• Complete the online application, providing information about your health condition, employment history, and other relevant details.

• Step 3: Submit Required Documentation
  You’ll need to provide medical certification of your condition. This typically involves:
• A form from your healthcare provider outlining your diagnosis and the period of time you are expected to be unable to work.
• Any relevant medical records, test results, or treatment information.

• Step 4: Wait for a Decision
  After you submit your application and documentation, the ESD will review your claim. You should receive a decision within a few weeks. If approved, you will start receiving temporary disability benefits, which will replace a portion of your lost wages. The amount of your benefit is based on your earnings.

Step 3: Apply for Workers' Compensation (L&I) Benefits

If your temporary disability is due to a work-related injury or illness, you may be eligible for Workers' Compensation benefits through the Department of Labor & Industries (L&I). Here’s how to apply for benefits under this program:

• Step 1: Report Your Injury or Illness
  If you’re injured at work, you must report the injury to your employer as soon as possible. For occupational illnesses, report your condition as soon as you recognize it’s related to your job.

• Step 2: File a Claim with L&I
  You can file a workers' compensation claim online through the L&I website or by calling their claims office. Here's how:
• Go to https://www.lni.wa.gov/ and navigate to the “File a Claim” section.
• Complete the online form or call L&I at 1-800-547-8367 to file your claim.

• Step 3: Provide Medical Documentation
  You will need to see a doctor for a medical evaluation, and your doctor must submit medical documentation to L&I. The doctor will detail the extent of your injury or illness, your diagnosis, and the time you expect to be unable to work.

• Step 4: Wait for L&I’s Decision
  Once your claim is filed and the necessary medical documentation is submitted, L&I will process your claim and determine your eligibility. You may receive temporary disability payments to cover a portion of your lost wages, as well as benefits for medical expenses related to your injury.

Step 4: Know How Much Temporary Disability You Can Receive

The amount you can receive depends on the type of program you're applying for:

• PFML Benefits:
  The benefits under the Paid Family and Medical Leave (PFML) program provide partial wage replacement. Typically, you can receive up to 90% of your weekly earnings (up to a maximum benefit amount). The exact amount depends on your income and how much you’ve paid into the system through payroll deductions.

• Workers' Compensation Benefits:
  Workers' Compensation benefits typically cover 60% to 75% of your average monthly wages up to a state-set maximum. If your injury is severe and prevents you from working for a longer period, you may qualify for additional benefits.

What to Do if Your Claim is Denied

If your claim for PFML or Workers' Compensation benefits is denied, you have the right to appeal the decision.

• For PFML: You can file an appeal through the Employment Security Department (ESD) within 30 days of receiving the decision. The process involves submitting additional documentation or requesting a hearing.
• For Workers' Compensation: If your workers' compensation claim is denied, you can appeal the decision through L&I. You’ll need to file an appeal within 60 days of receiving the denial notice.