Claims Adjudication Tune-Up (CAT-U)
February 2026 Edition
Welcome to Self-Insurance’s (SI) Claims Adjudication Tune-Up (CAT-U) newsletter. This is where the Washington State Department of Labor & Industries (L&I) shares best practices and information, as well as highlights opportunities for improvement. The focus of this month’s CAT-U is reopening timeframes.
Legal Corner
Revised Code of Washington (RCW) 51.32.160(1)(d)
“…If an order denying an application to reopen filed on or after July 1, 1988, is not
issued within ninety days of receipt of such application by the self-insured employer or
the department, such application shall be deemed granted. However, for good cause,
the department may extend the time for making the final determination on the
application for an additional sixty days.”
Take away: Only an order denying reopening will “stop the clock” on a reopening request. If L&I does not issue a denial order within the allowed timeframe, then they must issue an order granting the reopening, regardless of whether the reopening is medically supported or not.
News You Can Use
Board of Industrial Insurance Appeals (BIIA) decision
In Re Raymond W Belden BIIA Dec., 12 14005 (2013):
“Where the Department grants a worker's application to reopen for aggravation, the
employer timely protests the reopening order, and the Department holds the reopening
order in abeyance, the Department must deny the application to reopen within the time
limits set out in RCW 51.52.060 or the application to reopen will be deemed granted.”
Summary: Raymond Belden filed an application to reopen his claim on Aug. 3, 2011, giving L&I until Nov. 1, 2011, to resolve his request. Within that timeframe, the department issued an order granting reopening, the employer protested it, and the department issued an order putting the reopening order in abeyance. The department then issued an order denying reopening on March 16, 2012. Since no order denying reopening was issued prior to the Nov. 1, 2011 deadline, the Board of Industrial Insurance Appeals (BIIA) found that the application to reopen the claim was “deemed granted,” per RCW 51.32.160, regardless of the abeyance order.
Claim impact: Reopening may be deemed granted even if the department receives a timely protest. RCW 51.32.160 requires the actual issuance of a denial order within 90 days (or 150 days if the department issued an extension order) to avoid being deemed granted. An abeyance order does not change this reopening deadline. A protest received very close to the deadline may not allow enough time for the department to act, and result in a deemed granted order being issued.
The best practice is to act promptly if you are protesting an order granting reopening. If there’s good cause for the delay, L&I may be able to issue a 60-day extension order and it’s OK to ask for one as well.
Trainer Trivia
Answer to January’s trivia: Arthur Conan Doyle based Sherlock Holmes on Scottish physician Joseph Bell. Doctor Bell was a surgeon at the University of Edinburgh. He prized close observation to make diagnoses. Like Holmes, he would often deduce the professions and recent activities of strangers just by observing them, to prove this point.
This month’s question: What gemstone is linked to Valentine’s Day? [Answer: Amethyst. It is said that St. Valentine wore an amethyst ring depicting Cupid, the Roman god of love.]
More Reading/Resources
Claims Adjudication Guidelines, Reopenings Chapter -
Claims Adjudication Guidelines, Protests and Appeals Chapter
Application to Reopen Claim Due to Worsening of Condition (F242-079-000)
September 2024 CAT-U: Reopenings
Reminders/tips from the SI teams
If you receive anything from the worker or a provider that looks like they want a claim reopened, you must forward the document to L&I within five working days, per Washington Administrative Code (WAC) 296-15-470. Consider also sending the worker an application to reopen their claim.
Only L&I can resolve a worker’s request for reopening. The department may direct the employer to arrange examinations, imaging, or gather other information to make its decision.
For more information, send an email to the SI trainer inbox.
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