Blog

COVID-19

Washington State, like many states across the nation, continues to grapple with COVID-19.  Here are some key things to know about how the Department of Labor and Industries is attempting to protect the states’ workers in the midst of this crisis.

Who can file a claim for Coronavirus workplace exposure/quarantine

The Industrial Insurance Act allows for treatment of COVID-19 when work-related activity has resulted in probable exposure to the virus and certain criteria are met. In these cases, the worker’s occupation must have a greater likelihood of contracting the disease because of the job (examples include first responders or health care workers). There must also be a documented or probable work-related exposure, and an employee/employer relationship.

Health care workers and first responders will receive wage-replacement benefits (timeloss compensation and loss of earning power benefits) and have all related health care expenses covered under the state’s workers’ compensation program when quarantined by a physician. Other essential workers in Washington who test positive for COVID-19 will be considered on a case-by-case basis.

Workers do not need to be examined by a physician for a COVID-19 exposure claim to be submitted when they are quarantined. L&I is handling medical documentation for these claims differently than other workers’ compensation claims. However, the Department does require a positive test to allow a claim for the disease when a worker has actually contracted the virus.

Criteria for claim allowance

The state has established three criteria for evaluating COVID-19 claims:

  • Was there an increased risk or greater likelihood of contracting the condition due to the worker’s occupation (such as a first responder or health care worker)?
  • If not for their job, would the worker have been exposed to the virus or contracted the condition?
  • Can the worker identify a specific source or event during the performance of his or her employment that resulted in exposure to the new coronavirus (examples include a first responder or health care worker who has treated a patient with the virus)?

When will a claim likely be denied?

When the contraction of COVID-19 is incidental to the workplace or common to all employment (such as an office worker who contracts the condition from a fellow employee), a claim for exposure to and contraction of the disease will be denied.

Benefits available

For allowed claims, time-loss payments for lost wages during a quarantine period may be available for up to 14 days. As with all wage replacement benefits under the Industrial Insurance Act, the first 3 days are not paid unless the worker is medically required to remain off work on the 14th day following exposure.

Once a claim is allowed, the insurer will pay for treatment of COVID-19. Currently, the only treatment for this new coronavirus is supportive care to help relieve symptoms.

The Industrial Insurance Act allows the insurer to pay for testing before someone is ill when there has been a documented, work-related exposure. If the diagnosed condition on the original accident report form is contraction of COVID-19 and the 3 criteria under when to file a claim are satisfied, the claim will be allowed, and treatment authorized.   When a claim is filed for probable exposure and the criteria under when to file a claim are satisfied, the claim will be allowed for the quarantine period regardless of whether the worker actually contracted COVID-19.

Let us know how we can help

The situation with the pandemic continues to develop. If you would like to know more about how we can assist you in filing or navigating your claim for coronavirus exposure, please Contact Us and let us know how we can lift the weight off your shoulders!

2021 Legislative Update

Legislative News 2021

Last updated February 18, 2021

Washington state legislators are currently working on 3 bills that could impact injured workers in our state.

Senate Bill 5046

https://app.leg.wa.gov/billsummary?BillNumber=5046&Year=2021&Initiative=false

*As of 2/15/2021 this bill is currently passed in the Senate and is being discussed in the House. 

Currently some injured workers are able to settle their claims with a process called “Claim Resolution Structured Settlement Agreement” or  CRSSA,  commonly referred to as a Structured Settlement.

With the current version of the law, structured settlements consist of a large down payment and one or more monthly periodic payments until the balance of the settlement is paid in full.   SB 5046 will change this to allow a one-time lump sum payment.

As it currently stands under federal law, Structured Settlements are considered periodic payments and are therefore subject to an offset (or reduction) in benefits if the injured worker is also receiving social security benefits.   Since SB 5046 would allow structured settlements to be a one-time lump sum payment,  a  CRSSA under a lump sum settlement agreement would not be subject to a social security offset or reduction.

Senate Bill 5137

https://app.leg.wa.gov/billsummary?BillNumber=5137&Initiative=false&Year=2021

*As of 2/15/2021 this is still in the Senate with the last recommendation being to “ Do not pass”. 

This bill has seen some significant changes from the original bill to the current version.

This bill changes the Cost of Living Adjustment (COLA) for time-loss and pension benefits.    Currently, cost of living increases are based on the increase of the average monthly wage in Washington State.   In 2020, the average monthly wage increased by 6.7%, therefore the cost of living increase for time-loss and pension benefits was 6.7%.

The original version of this bill would have made COLA based on a change in the “consumer price index”, up to a maximum of 3%.     The current substitute version of this bill (as of 2/17/2021)  removes this change,  but it would suspend the COLA for 2021.

* Injured workers who also receive social security benefits do not automatically receive COLA increases.

Senate Bill 5102

https://app.leg.wa.gov/billsummary?BillNumber=5102&Initiative=false&Year=2021

As of 2/15/21 this bill is still in the Senate with a majority of senators recommending  “Do Pass”

This bill also has changed since its original version.   The information below is regarding the current version only. 

This bill concerns Independent Medical Examinations ( IME) and makes several key changes to the IME process including:

  • Removing the right for the department or self-insured employer (SIE) to request an IME for case progress or to resolve an appeal.
  • Allowing department or SIE to request the attending physician arrange a consultation instead of an IME to resolve disputes with regard to treatment.
  • Limiting the number of times and circumstances in which an IME can be requested
  • Requiring a 28 day advanced notice of IMEs for self-insured employers.
  • Allowing for injured workers to record the audio and/or video of IME examinations, as long as the injured workers follows specific rules. These rules include providing advanced notice of intent to record and not interfering with the examination itself.

To contact your local state representative and state senator, visit https://app.leg.wa.gov/DistrictFinder/

Office Careers

KING5 News in Seattle is currently investigating Office Careers, an unaccredited online training course for injured workers.

Here are links to their stories:

Washington investigating unaccredited school that retrains injured workers. 

Washington State regulators launch investigation into Office Careers

Judges slam Washington’s use of unaccredited school to retrain injured workers.

State paid millions to retrain injured workers at unaccredited school. 

If you are currently enrolled in Office Careers, involved in Vocational Rehabilitation services, or need any assistance with your industrial injury claim,  please contact our office.  

New Website

After months of design and planning, Atlas Law is proud to announce an all new website at AtlasLawPS.com.     Our new site is redesigned on an all new platform, and will better integrate with our Social Media platforms.  There’s also a contact page, and our texting information.    We will soon be adding more content and more information.

Post Office Delays, Checks

Over the last several weeks, we have seen an increase in delays from our post office.  Unfortunately this is beyond our control.   We do understand that this unnecessary delay is stressful to our clients, and we are increasing our efforts to minimize and reduce these delays.

Currently it takes a minimum of 2 business days, sometimes 3-4, to receive checks from the department.   We are working to shift to electronic payments from the department.  Many self-insured employers use administrators from out of state.  It can take several days to receive checks from these administrators.  There are currently no alternatives.

If you have, or establish, an account with bank with Columbia Bank, we can deposit your time-loss or pension benefits into your account the same day we receive them.  All you have to do is provide us with your account number.

Additionally, we offer text alerts for all of our clients.    You may sign up today with our office to receive free text messages when your check arrives in our office.

We understand it is frustrating when checks are delayed.

Texting

Did you know that AtlasLaw offers text messaging?

Do you pick up your check in our office?   Sign up for text alerts and receive a free text message* when your check is available!
Get text reminders for vocational appointments, IME’s, and other claim related appointments.

Stop by our office, or contact us today to sign up!

*Neither Atlas Law, or our texting provider will charge you.  Messaging and data rates may apply per your carrier, please contact them if you have questions. 

 

New Pilot Program by Labor and Industries

Posted on: 28 September 2017

By: Atlas Law

Beginning October 1, Labor and Industries is beginning a pilot program for acupuncture treatment.
If you have low back pain, associated with an accepted condition related to your Industrial Injury claim, and your attending provider believes that acupuncture may be a curative treatment option, the department may pay up for up to 10 visits to see an acupuncturist.
Additional rules apply. For more information see the department’s page at:

http://lni.wa.gov/acupuncturepilot

New Pilot Program for Accupuncture

Beginning October 1, Labor and Industries is beginning a pilot program for acupuncture treatment.
If you have low back pain, associated with an accepted condition related to your Industrial Injury claim, and your attending provider believes that acupuncture may be a curative treatment option, the department may pay up for up to 10 visits to see an acupuncturist.
Additional rules apply. For more information see the department’s page at:

http://lni.wa.gov/acupuncturepilot

PTD after PPD

Generally, if an injured worker received a Permanent Partial Disability (PPD) award for an injury and is then later found to be Permanently Totally Disabled (PTD) due to the same injury, the Department may recover payments made on the PPD award from the PTD award. However, a worker who is injured and is later found to be permanently and totally disabled (PTD) is entitled to a full pension, even if that injured worker had previously received a permanent partial disability (PPD) award from a prior, unrelated industrial injury.

In a recently published opinion( Michael L. Sims v. Department of Labor and Industries), the Court of Appeals determined that if an injured worker is found to be permanently totally disabled, they are not entitled to a permanent partial disability award for a subsequent injury.

The Court of Appeals found that the effective date of PTD is the determinative date for deciding what benefits an injured worker is entitled to under any subsequent injury claims and not the date of the Department’s decision to classify a worker as PTD. Since the injured worker in the Sims case had been classified as PTD starting at a time prior to sustaining the second injury, the Court decided that the Department’s order that denied Mr. Sims additional PPD benefits under his second claim was correct. For more information regarding PPD and PTD, please contact us for a free consultation.