Have you ever wondered what was going on with your claim file? Do you sometimes think your claims manager is not telling you everything? Or, did you just get a written notice in the mail and cannot understand why it was sent? Then, you need to look at your official L&I claim file.
About 10 years ago, I was appointed to a committee to design a web site that would let injured workers (as well as doctors and employers) see the same information that Labor & Industries claims mangers see. After a long process, L&I launched its “Claim and Account Center,” known as CAC. It is a web site that allows any injured worker to look at the same information that L&I uses to administer the claim.
The web site was designed to be easy to use without any real computer skills or training. It was tested on random workers, who all felt it was a great tool. It is easy, it is free, and it will answer many of your questions.
In addition to representing individual clients on a daily basis, we also try to protect the rights of all injured workers, whether we represent them or not. That is why each of the attorneys in our office is an Eagle member of the Washington State Association for Justice (WSAJ). This is a state wide group of trial lawyers who attempt to protect people’s rights within the civil justice system and the rights of injured workers.
Effective January 1, 2013, the Department will launch a statewide Medical Providers Network (MPN) for treating injured workers and expand the Centers of Occupational Health Education (COHE). Doctors who want to treat injured workers will have to apply to be part of the MPN. The Department predicts these programs will improve quality of care and save the State over $200 million over the next four years.
After January 1, 2013 you can only treat with a non-network (MPN) provider for the initial office or emergency room visit. For additional care, the worker must transfer to a network provider. Workers should ask their regular doctors to enroll in the network. Currently, out of state medical providers are not required to be part of the network (MPN.)
As of August 31, 2012 the Department had received 340 applications for state fund claim settlements. The majority of these, 264, involved workers without legal representation. Of the 340, so far 13 applications led to final settlement contracts approved by the Board of Industrial Insurance Appeals. Others are in various stages of consideration, which can be a lengthy process.
A recent Court of Appeals decision, Joy v. Department of Labor and Industries, held that as a matter of law, an injured worker is unable to obtain medical procedures that are precluded by the Health Technology Clinical Committee (HTCC). The HTCC is a committee of 11 practicing health care professionals who review scientific, evidence based reports about whether certain medical devices, procedures and tests are safe and work as promoted. The HTCC determines whether certain types of treatment will be covered under a State purchased health care program, regardless of the individual facts and circumstances. This includes workers compensation claims. Read a review of their health technology assessment findings here.
In the Joy case, the injured worker sought review of a decision of the Board of Industrial Insurance Appeals to deny payments for a spinal cord stimulator to treat her workplace neck injury.
Our general election ballots are set to be mailed soon for the November election. We want to take a moment as your counsel to share our recommendations with you on the most important contests on your ballot.
The open seat on the Supreme Court is Position Nine. This is an open seat, vacated by Justice Tom Chambers, who was a champion for the rule of law and citizens’ rights. The final two candidates both have good records on civil justice. However, I want to recommend that you join us in voting for Sheryl McCloud.
Sheryl McCloud is a true champion of individual rights, and true believer in Constitutional rights, and we believe will fight hard for many years to come to protect those rights for all of us. She has received a huge range of endorsements, from organizations and newspapers across the political spectrum. We urge you to support Sheryl.
We want to share our views on two statewide offices of great importance to citizens and civil justice: Governor and Attorney General. In the Governor’s race, Jay Inslee is the clear civil justice candidate. Prior to public office, Jay was a prosecutor and then an attorney representing injured persons as a lawyer in Selah and Yakima. He then began a long career of public service where he has diligently protected citizens’ constitutional and civil rights, and has been a champion of worker and consumer protections.
In contrast, his opponent Rob McKenna has fought to remove or reduce citizens’ ability to hold government accountable through the court system. His first request legislation as Attorney General would have taken away right to hold the government or any government contractor accountable - whether from poisoned food in schools, faulty bridge construction, or any other of the most reckless or careless acts that lead to serious injury and death. He wants to let private insurance companies provide workers’ compensation, even though every county in the state voted against Initiative 1082, which would have allowed that.
We strongly support Jay Inslee as the candidate to protect our rights and our civil justice system, and we respectfully suggest that this is the most important race for protecting our civil justice system this year.
The second race is for Attorney General. The Attorney General is the chief legal officer for the State of Washington and its citizens, and 95% of the office’s job is representing the state in civil cases. We believe it is necessary that the Attorney General believe in a government accountable to the protection of its citizenry and who shares a commitment to going after the powerful special interests that harm the public by abusing our laws.
We strongly recommend Bob Ferguson for this job. Bob is a lawyer and King County Councilman, who has committed his campaign to protecting public safety, going after fraudulent actors like mortgage lenders and servicers, prosecuting polluters, and protecting taxpayers against fraud and abuse. Bob would be a champion for us all as Attorney General.
We hope you have found this information helpful. We are sharing our views because of the strong belief and commitment in our office, that every client who walks in our door seeking a chance for justice through the court system should have a fair shot. We depend on these public servants to make sure our rights are protected. The outcome of this year’s election will have a huge impact on our rights and our civil justice system. These candidates will fight to protect all of our rights.
Please, feel free to share this, if you think it’s helpful, with family and friends. Regardless of your views on these races, though, please make sure you vote on or before November 6th. We owe it to each other to participate and have our voice heard in our electoral process.
All parties have the same appeal rights. Any party (employer or injured worker) can appeal an Order from the Department of Labor and Industries (Department) to the Board of Industrial Insurance Appeals (Board.) This is a general outline of the definitions and procedures which govern these appeals.
BOARD OF INDUSTRIAL INSURANCE APPEALS
The Board is a state agency which is separate from the Department of Labor and Industries. The Board’s only job is to hear appeals from decisions of the Department. The Board is composed of three members, one a representative of business, one a representative of labor, and one who is the chairperson.
I was fortunate to be able to go on a couple of weeks of safari in Africa, recently. I found that, like most everything else, the sights, sounds and animals in Africa are much more stirring and impressive in person than they are in photographs or on television.
Having had a chance to look a wild lion in the eyes from very close range, I now understand why impalas have large ears, big eyes and are willing to start running at the drop of a hat. I imagine the lion looks upon the impala somewhat like a self-insured employer’s attorney looks at an un-represented claimant.
The Department’s Stay at Work Program - A new program to help employers keep injured workers on the job - pays half the wage plus expenses.
The Department of Labor and Industries’ Stay at Work program provides a strong financial incentive for employers to offer medically approved light duty jobs. The Department will reimburse the employer for 50% of the base wages, for up to 66 work days, with a maximum amount of $10,000. The Department will also reimburse employers for expenses designed to assist the worker’s return to work, including the cost of necessary training, tools or clothing. To obtain reimbursement, the employer must create a job description outlining the job duties and physical demands and provide it to your doctor.
At a Continuing Legal Education class I attended some time ago, a spine specialist noted he often provided a copy of a New Yorker’s article called “A Knife in the Back” to patients who were interested in a spinal fusion to treat their chronic pain. The article can be found here.
This article takes a cautionary tone towards fusion to resolve chronic pain issues, as opposed to fusions that are (according to the article) “necessary” such as “when vertebral bones that have been dislocated or damaged by diseases are endangering the spinal cord or the nerves.”
The Department and employers often suggest an injured worker is employable, or can be retrained, as a Security Guard and/or Surveillance-System Monitor (watching video monitors), which they frequently view as a sedentary unskilled job. However, frequently these jobs are more physically demanding and require more skills than suggested by the Department and employers.
From a Workers Compensation perspective, employers may
(arguably) return injured workers to light duty at a different job, wage,
schedule and location. Any light duty job offer must be within a
Common sense says a long commute might be reasonable for a
high-paying job, but not so reasonable for a minimum wage job. After
taxes, $4 a gallon gas and automobile wear and tear, an injured worker may end
up losing money. Many injuries limit a worker's ability to drive or sit
in a car. Consequently, a worker may frequently need to stop and stretch
or lay back in the seat, thereby doubling the commuting time.
Have you ever tried to cook pork chops only to suffer the sad result of a piece of meat that is tasteless and as tough as shoe leather? Well, it is not your fault. Help is on the way.
Prior to the 1950s, most pork chops were marbled with fat, much like beef steaks. That was because the pigs were mostly raised for their lard. With the introduction of oleomargarine and other vegetable oil products, farmers started breeding more lean pork meat. The pork industry successfully rehabilitated the reputation of pork, marketing it as “The Other White Meat.” The result, although healthier, created problems for the cook.
Recently, I came across a great new magazine called Horns
and Hooks which focuses on outdoor adventures in the western states. Many
of the articles are geared toward fishing and hunting trips right here in
This magazine contains a broad range of articles with many
useful tips and practical advice on how and where to fish and hunt for the big
ones. The layout is very easy to read and includes a lot of eye popping
As Primary election ballots are set to be mailed next week
for the August 7th election, I wanted to share our recommendations
with you on the Supreme Court races and three other very important races for
consumers and citizens.
Election statistics show that about twenty percent of voters
skip the judicial races on their ballots.
We know it is critical to have the right men and women leading our
judicial system. We want to share with
you the candidates we support and some reasons why.
When you are able to return to work, and have reached maximum medical rehabilitation (meaning you are as good as you are going to get) your claim will close. Sometimes it closes with an award of Permanent Partial Disability. This is an award for loss of function of your body.
When your claim closes, it is thought you are capable of obtaining and performing reasonably continuous gainful employment, and unless you intend to retire you should probably look for work after the claim is closed. If you do not look for work you may be considered voluntarily retired and not eligible for future time loss or pension benefits.
Anyone who has experienced ringing (buzzing, clicking, etc.) in the ears, for any period of time, knows how irritating this problem can be. This ringing, known as tinnitus, can cause significant problems including concentration difficulties, irritability, sleep disturbances, difficulty following conversations, anxiety, depression, interference with personal relationships and fatigue. Frequently, the Department simply ignores these functional problems.
Starting July 1, 2012, the amount of money available for retraining costs will increase from $15,713.49 to $17,599.11. This applies to any plan approved on or after July 1, 2012. This increase is the result of an annual adjustment due to rising tuition costs. The injured worker still has up to two years for retraining.
Prior to 2008, injured workers had up to one year and $4,000 for retraining purposes. Fortunately, the Legislature passed laws increasing this amount to two years and originally $12,000 for retraining purposes, along with yearly adjustments to reflect rising tuition rates. Unfortunately, these laws have a "sunset provision" and will end June 30, 2013, unless legislation extends the "sunset" date or makes them permanent. Otherwise, it is back to one year and $4,000.
Recently, I attended a daylong seminar on Workers Compensation. One of the speakers was a Vocational Rehabilitation Counselor (VRC). She had conducted an informal survey of other VRCs about what they do when there is "conflicting medical information." Frequently, there are disagreements between the attending physician and the Department’s so-called Independent Medical Examiners (IMEs) regarding an injured worker’s work restrictions and treatment plans.
There are two very interesting judicial races that will be on the ballot in our area. Two of the candidates are my son and son-in-law, respectively.
My son, Brendan Williams, is running for the Court of Appeals Position Number 2. Division 2 is a Court of Appeals which hears appeals from lower courts in Grays Harbor, Mason, Thurston, Kitsap and Jefferson counties. Brendan is a former three term State Representative from the Olympia area, and is currently a Deputy Insurance Commissioner. He previously clerked for retired Chief Justice Gary Alexander on the Washington State Supreme Court. Brendan has a Master's degree in Criminal Justice, has authored three law review articles in criminal law, and while a legislator served on the House Judiciary and Criminal Justice committees. Brendan lives in Olympia with his wife Nicole and my 9 year old grandson, Blake. I urge you to support and vote for Brendan. Please visit Brendan’s website at: http://brendanwilliams2012.com
My son-in-law, Jim Johnson, is running for Thurston County Superior Court Position Number 2. He is a lawyer who is currently an Assistant Attorney General representing the Department of Labor and Industries. Over many years, I have had a chance to litigate cases against him (not since he married my daughter) and I have found him to be extremely intelligent, a talented attorney, and a pleasure to work with. Jim has worked and lived in Olympia for many years, raising his children and my grandchildren here. Curiously, one of his opponents, Christine Schaller, lives in and is registered to vote in Pierce County. Jim graduated from the University of Michigan Law School with high honors in 1991. He is on the Executive Board of the Government Lawyers Bar Association, and serves on the Board of Directors of South Sound Parent to Parent, a local non-profit that helps families with children with special needs get the services to which they are entitled. Jim is a great guy and a valuable member of the community here in Olympia, and I urge you to vote for him for Thurston County Position Number 2. Please visit Jim’s website at: http://jimjohnsonforthurstoncounty.org
Medical providers frequently send patients, particularly those who have been out of work for a while, to work conditioning and hardening to prepare them for returning to work or retraining. Work conditioning and hardening are performed in succession and are designed to meet a specific return to work or retraining goal. Usually an injured worker starts with work conditioning for 2 hours a day, 3 days a week, progressing to 5 days a week, over a 4 week period. Hours, days and weeks may vary.
Work conditioning involves intense exercises designed to increase strength, flexibility, coordination and conditioning to help prepare an injured worker for certain job duties.
Physical Capacity Evaluations (PCEs)* are scientifically designed to determine an injured worker’s physical limitations. PCEs typically last 3 to 6 hours over a 1 or 2 day period. Generally, they include a series of tests involving lifting, carrying, sitting, standing, walking, and material handling. The end result is a comprehensive report providing a very detailed analysis of physical abilities over a 40 hour work week. These reports are very important since they are used to determine ability to work for time loss, pension, return to work and retraining purposes.
How to file a complaint against an Independent Medical Examiner (IME):
The Department’s website states “IMEs should provide unbiased, accurate and comprehensive information and be carried out with dignity and respect for the worker.” Unfortunately, many IME providers have not read the Department’s website.
I frequently review the Department’s files on IMEs and I am always surprised how few complaints are filed, particularly for some of the more notorious IMEs.