In the State of Washington, compensation for workplace personal injuries and on-the-job injuries is governed by a sometimes-confusing series of rules promulgated by the Department of Labor and Industries (specifically Title 51 of the Revised Code of Washington). The rules and regulations that injured workers must follow involve a complex and specific process.
It is highly recommended that anyone who is injured at work – or anyone who develops a disability, disease, or impairment at the workplace – consult an attorney. An experienced Washington workers comp attorney will help maximize your recovery and ensure that your rights are protected. Our Seattle and Tacoma workers compensation attorneys can represent you before the Board of Industrial Appeals and through the administrative and court hearings.
Emerald Law Group attorneys are experienced and knowledgeable in handling the complex maize of rules that govern workers compensation claims. If you suffer a personal injury at work, you are no less deserving of compensation than someone who is injured elsewhere. But the rules you must follow are much more complicated. Furthermore, if you think a disability, sickness, or handicap was caused by your job, you may be subject to Labor and Industries rules.
Our attorneys will make every effort to help you recover: lost wages, long-term health care coverage, physical or vocational rehabilitation, or perhaps a final settlement to compensate you for permanent injury. Washington State workers compensation laws involve strict deadlines and filing requirements. It is imperative that an injured worker abides by these deadlines or an otherwise-valid claim could be permanently denied. Call Emerald Law Group and we will provide a free consultation to help you decide if you need an attorney and make sure your rights are protected.
If you have been injured on the job in Washington, you should file a workers’ compensation claim with the Department of Labor & Injuries (L&I), or with your employer if your employer is self-insured. A workers’ compensation claim provides you with a number of benefits, including medical treatment for your workplace injury, wage-replacement benefits if you are unable to work, and possibly job retraining benefits or a disability award.
You can also open a workers’ compensation claim if you develop an occupational disease from your work. An occupational disease is a medical condition that develops over time as a result of the type of work you do. For example, carpal tunnel syndrome, tennis elbow, or bursitis can all result from repetitive motion. Hearing loss can result from prolonged exposure to noise. An occupational disease claim qualifies you for all the same benefits as an injury claim.
In theory, Washington’s workers’ compensation system provides “sure and certain relief” for injured workers. However, in practice, many injured workers encounter repeated obstacles when trying to obtain their workers’ compensation benefits. At Emerald Law Group we can help you get the benefits that you are entitled to under Washington’s workers’ compensation system.
If you have been injured on the job, you should see a doctor as soon as you can. You may go to any doctor you choose. Your employer may suggest a certain doctor or clinic, but you can go to any doctor you wish. You and your doctor will fill out some paperwork, which will be submitted to the Department of Labor & Industries or your self-insured employer. It is also possible to file your claim online.
Once you have submitted your application for benefits, the Department of Labor & Industries will issue an order either allowing or denying the claim. If the claim is allowed, you are entitled to a number of benefits.
However, the Department of Labor & Industries denies many claims, for a number of reasons. For example, the Department may conclude that your injury or occupational disease is not work-related, that it was pre-existing, that you were not actually injured, or for some other reason. Many times the Department of Labor & Industries denies a claim despite strong evidence that the claim should be allowed. Fortunately, nearly all orders that L&I issues can be either protested or appealed. There are strict deadlines for appeals and protests (usually 60 days), so if L&I has denied your claim for your workplace injury or occupational disease, you should contact an attorney promptly to discuss your options.
Once your claim is allowed, you are entitled to treatment. The length of treatment you will receive varies greatly. Some injuries are resolved within weeks or months; other injuries require years of treatment. It is important that you attend your doctors’ appointment regularly and are compliant with recommended treatment. Your workers’ compensation claim will cover treatment until you are at Maximum Medical Improvement, or MMI.
If you are unable to work due to your industrial injury or occupational disease, you will receive time-loss. If and how long you receive time-loss benefits is also quite variable. Some injured workers miss very little or no work at all. Other injured workers are out of work for months or years.
If you miss work due to your on-the-job injury, L&I will assign a vocational counselor to your claim. Generally, the vocational counselor will not be assigned until you are at or near Maximum Medical Improvement. The vocational counselor’s job is to determine whether you can return to work—either at an old job or a job you can perform based on your transferable skills—or whether vocational retraining is necessary to return you to work. If the vocational counselor determines that you need retraining to return to work, you have the option of undergoing retraining, or receiving six months’ of time-loss benefits instead.
Once your medical condition is stable and any vocational assessment or retraining is completed, your claim will be closed. If you have a permanent impairment as a result of your on-the-job injury, you will receive a Permanent Partial Disability award when the claim is closed.
If your condition due to your workplace injury objectively worsens, you can apply to reopen your claim. “Objective worsening” requires measurable or visible evidence of reopening. For example, if a recent MRI shows that your herniated disk has become more severe, or your rotator cuff tear has become more significant, your claim may be reopened. If there is no objective evidence of worsening and your condition is simply more painful than it was at the time your claim was closed, it is unlikely that L&I will allow you to reopen your claim.
There is no time limit on reopening your claim for further treatment. However, if your claim is reopened more than seven years after the date it was first closed, then you may not be able to obtain other benefits, such as time-loss, vocational retraining, pension, or PPD.
Medical care for your on-the-job injury or occupational disease is covered under your claim. However, this does not mean that all treatment you request or your doctor recommends will be automatically be covered. There are regulations governing what types of treatment will be allowed on workers’ compensation claims. In addition, some procedures or treatments require authorization before L&I will pay. If your claims manager is denying you treatment that your doctor recommends, we may be able to help you.
Time-loss benefits are cash benefits you receive while you are unable to work due to your on-the-job injury. The amount of your time-loss benefits depends on your wages at the time of injury, and your marital and family status. If you are single and have no dependent children, your time-loss benefits will be 60% of your wages at the time of injury. If you have a spouse and/or dependent children, your benefits will be higher. Injured workers often find that their wages are not correctly calculated, resulting in incorrect payment of time-loss.
For you to receive time-loss, your doctor must complete an Activity Prescription Form stating that you are completely disabled from performing any work. In addition, you must complete a Worker Status Form that certifies you have not worked during the time in question. Once the Department of Labor and Industries has both these documents, you should receive your time-loss benefits. Both of these documents need to be completed regularly to keep your time-loss going.
Occasionally an injured worker will qualify for vocational retraining under an L&I claim. Vocational retraining is provided if the injured worker can no longer do his or her old job, and doesn’t have the job skills or physical ability to do other kinds of work. If you qualify for vocational retraining, you will work with a vocational counselor to identify a job retraining goal. During your retraining period, you will continue to receive your time-loss benefits.
A Permanent Partial Disability (PPD) award is given to claimants who have a permanent impairment as a result of their workplace injury. The award is made at the time of claim closure. If you have made a complete recovery from your injury or occupational disease, you will not receive a PPD. If you do have a permanent impairment, a doctor will will determine how much of an impairment you have. That then translates into a specific dollar amount set by statute. Because different doctors can reach different conclusions about the extent of impairment, you should talk to an attorney if you think your impairment rating or PPD is too low.
Structured settlements are available to workers over the age of 50 who wish to wrap up their workers’ compensation claims and are not interested in pursuing a pension. By accepting a structured settlement, you waive many benefits that you might otherwise be entitled to. It is a good idea to talk to an attorney before deciding to accept a structure settlement.
If you are permanently unable to return to work as a result of your industrial injury or occupational disease, you are entitled to a workers’ compensation pension. This pension pays wage-replacement benefits for the rest of your life, and may provide benefits for your beneficiaries upon your death.
L&I is required to issue written orders advising you of decisions made on your claim. If L&I issues an order claim that you don’t agree with, you can submit a protest or appeal. A protest is sent to L&I, and requires L&I to take a second look at its decision and either affirm or deny that decision. An appeal is sent to a separate agency, the Board of Industrial Insurance Appeals. At the Board of Industrial Insurance Appeals, you may have a hearing with a judge who will then decide your case. If you are not satisfied with the Board’s decision, you have the option of further appeals to Superior Court.
You are not the only party who can protest or appeal orders. If your employer does not agree with an L&I order, they can protest or appeal. For example, your employer might appeal the order allowing your workers’ comp claim.
Examples of orders that you may wish to protest or appeal are: orders denying a claim; orders incorrectly setting your wages at the time of injury; orders segregating certain medical or psychiatric conditions; orders terminating time-loss; and orders closing your claim.
If you are injured due to the negligence of your employer or one of your coworkers, your only remedy is your workers’ comp claim. However, if you were injured due to the negligence of someone else (i.e., not your employer or a coworker), you may have a third-party claim too. For example, if you were driving as part of your job and you were rear-ended, you can bring a claim against the person who rear-ended you.
A third-party claim allows you to get compensation beyond what your workers’ comp claim provides. For example, general damages for pain and suffering are not available in your workers’ comp claim, but are available in a third-party claim. If you miss work due to your injuries, you can seek full compensation for wage loss, rather than the partial compensation that time-loss benefits provide.
If your workplace injury appears to be caused by a third-party, you should speak with an attorney about a third-party claim. If you don’t pursue the third-party claim on your own, L&I may pursue it on your behalf.
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