Washington Workers' Compensation: Understanding the 'Medical‑Only' Coverage Option

What Is 'Medical‑Only' Coverage?

In Washington state, workers' compensation offers a tiered benefits structure. 'Medical‑only' refers to a coverage level where an employee receives compensation for medical treatment related to a work injury but does not receive wage replacement or other benefits. It is the lowest benefit tier and is available to employees whose injuries are not severe enough to qualify for higher benefit levels.

Eligibility Criteria

To qualify for medical‑only benefits, the injury must meet specific conditions:

• Injury is work‑related and documented by a medical provider.
• Injury does not result in permanent impairment that would qualify for permanent partial or total disability.
• Employee's wages are not reduced by more than 25% of their average weekly wage.

What Benefits Are Covered?

Medical‑only benefits cover:

• All medically necessary treatment (doctor visits, surgeries, physical therapy).
• Prescription medications.
• Diagnostic tests and imaging.
• Hospital stays, if required.

They do not cover:

• Lost wages or income replacement.
• Rehabilitative services beyond standard medical care.
• Vocational rehabilitation unless the injury meets higher benefit thresholds.

How to File a Medical‑Only Claim

1. Report the injury to your employer within 7 days.

1. Obtain a medical assessment from a licensed provider.
2. Submit a completed Workers' Compensation Claim Form (Form W-2) to the Washington State Department of Labor & Industries (L&I). Include medical reports and any supporting documents.
3. L&I will review the claim and determine the benefit level. If approved, you will receive a payment schedule for medical services.

   Comparison with Other Benefit Levels

   Benefit Level	Key Features	Typical Eligibility
   Medical‑Only	Medical care only, no wage replacement.	Minor injuries, <25% wage loss.
   Temporary Total Disability (TTD)	Medical care + wage replacement.	Injury prevents work for >6 weeks.
   Permanent Partial Disability (PPD)	Medical care + permanent wage reduction.	Permanent impairment.
   Permanent Total Disability (PTD)	Medical care + full wage loss.	Total permanent incapacity to work.

   Common Misconceptions

   Some workers assume medical‑only means no compensation at all. In reality, they receive full coverage for all medically necessary services. Another myth is that medical‑only claims are automatic; employers can deny the claim if the injury does not meet the required criteria.

   Resources and Contacts

   • Washington State L&I Workers' Compensation – https://www.lni.gov/wc
   • Local L&I office: Call 1‑800‑775‑0068 for assistance.
   • Employee rights groups: Washington Employees Union provides guidance on filing claims.