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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.

Recent court of Appeals Case clarifies an injured worker’s responsibility to file a claim within one year of workplace accident.
The Washington State Court of Appeals recently issued an unpublished decision that reinforces the importance of filing a report with the Department of Labor and Industries within one year of a workplace accident. The case involved an injured worker who sustained two head injuries at work. He received first aid and then continued to work. Unfortunately, the injured worker never filed a claim with the Department of Labor and Industries. The injured worker later developed migraines, eye pain, and hearing loss. He was diagnosed with a traumatic brain injury approximately two years after the initial injuries. With the assistance of his doctor, the injured worker submitted a claim with the Department of Labor & Industries. However, the Department denied the claim because the injured worker submitted his claim more than one year after the date of injury. The Court of Appeals upheld the Department’s denial, finding that the injured worker’s failure to file a claim within one year of the date of injury precluded him from recovery under the Industrial Insurance Act. [Please see our Blog article on Filing a Workers’ Compensation Claim.] link to that article as well.
Workers injured on the job may avoid filing a claim with the Department of Labor and Industries or downplay their injuries for a number of reasons. Those reasons may include a fear of causing their employer “problems,” a desire to avoid “paper work,” not wanting to loose pay or a job assignment they enjoy, as well as a number of other reasons not listed here. However, many falls, cuts, and sprains can become serious injuries later if they are not treated promptly. Unfortunately, the law is strict regarding the amount of time an injured worker has to file a claim following an incident. Sadly, there is no consideration given to the many hurdles an injured worker must go through to establish a claim.
We invite you to contact us if you have had an accident at work and are not sure whether you should file a claim.

In 2015, 58 people died from work-related causes. Among those are truck drivers, construction workers, a firefighter, a bookkeeper, a pilot, and loggers.
Those who died were someone’s sibling, child, parent, or grandparent, spouse, or a close friend.
This Thursday, April 28, 2016 is Washington State’s annual Worker Memorial day. Governor Inslee, Director Sacks from Labor and Industries, and other government leaders will memorialize those lost in 2015.
This year, we remember those workers who lost their lives. Among those killed in 2015 include:
A police officer, who died of complications from surgery related to an injury he sustained while arresting a suspect.
Three forest service workers who became trapped while fighting the Twist River fire in Eastern Washington.
A construction worker and business owner who was crushed by a wall that collapsed.
We at Atlas Law extend our best thoughts and wishes to the families of anyone who has lost a loved one as the result of a work related injury. If your loved one is killed or injured as the result of a workplace injury or exposure, and you want more information on potential benefits, please contact our office.

No one ever wants to be the victim of horseplay, an assault, or altercation. Fortunately, in many cases, an injury sustained as the result of horseplay, and assault, or altercation, is allowable if certain criteria are met.

An injury needs to occur during the course of employment in order to be allowable. In order for an injury to occur during the course of employment, it must occur while the injured worker is providing some benefit to the employer.

Horseplay: According to the Department of Labor and Industries’ internal policies, horseplay that minimally interrupts work is usually covered as long as it does not take the worker significantly away from the course of employment. Several factors are considered, including the extent and duration of deviation, if the horseplay was mixed with work activities, if the employer was aware of the practice, and where the injury occurred.

Assault/Altercation: The same factors above also apply to injuries that are the result of an assault or altercation. If the dispute arose from work related issues, then it is likely any resulting injury would be determined to be work related (if the other criteria are met). If the dispute arose solely out of non-work related issues, then it is likely the injury would be determined not to be work related. Additionally, if a worker leaves the jobsite to fight, they are typically no longer in the course of employment.

If your injury is the result of an assault, altercation, or horseplay and you have questions or concerns about your claim, please contact our office.

Generally speaking, if you are injured while participating in social, recreational, athletic activities, or events, even if your employer pays for them, you are not “acting in the course of employment” and therefore your injuries are not covered under Washington State’s industrial insurance act. However, there are a couple of exceptions to this rule.
1) If you participate during normal working hours
2) If you are paid by the employer to participate
3) Are directed, ordered, or reasonably believe that you are directed or ordered by the employer to participate.

Goodwill actions:
According to the Department of Labor and Industries policies, you may be determined to be in the course of employment if you go to the aid of someone in a life-threatening emergency IF:
1) Your employment brought you in contact with the emergency situation
2) The situation in some way was proximate to your job, even if the person in need was not a coworker
3) Your employer derives some benefit, even if its only goodwill to the community.

If you have a claim resulting from an act of goodwill or while participating in a recreational activity, and you have questions or concerns about your claim, please call our office.

Washington State Court of Appeals decision in re:
Crabb versus Labor and Industries

Typically in July of each year, Labor and Industries provides a Cost of Living Adjustment (aka COLA), which is based on the rate of inflation. COLA’s are not implemented until the 2nd July after the claim is open. (for example a claim opened in August of 2011 would not see a COLA until July of 2013)

Washington State also has minimum and maximum Time Loss amounts, based on the average monthly state wage.

In 2011, Washington State Labor and Industries instituted a freeze on COLA adjustments based on a lack of inflation in our state. While there was an increase in the minimum and maximum Time-Loss rates, those injured workers that were receiving the maximum time-loss benefits, were paid at the 2010 maximum rate and not 2011.

In the recent decision by the Court of Appeals, the court ruled that essentially, injured workers who were receiving the maximum time-loss rate in 2011 were entitled to the 2011 rates and not 2010 rates. The department is now paying out adjustments to many injured workers.

Vocational Rehabilitation Changes!

Earlier this year, the Department of Labor and Industries, at the direction of our state’s legislature, made some significant changes that impact injured workers when they enter vocational rehabilitation.

Travel Reimbursement for Vocational Retraining

Effective August 1, 2015, all mileage incurred by an injured worker for vocational retraining, will be reimbursable by the department. The department will no longer deduct the first 30 round-trip miles. This change only applies to miles for vocational retraining, and does not affect mileage for medical appointments.

Vocational Option 2

When an injured worker is found to be medically stable and unable to return to their job of injury, they begin the vocational process. One component of this process is determining if a retraining program is necessary for an injured worker to return to gainful employment. If an injured worker is found to be eligible for retraining, Labor and Industries will cover up to 2 years of retraining costs, during which the worker will receive time-loss compensation benefits.

When an injured worker is found eligible for retraining an injured worker may have the option of choosing “Option 2”. Option 2 allows an injured worker to opt out of the formal retraining program, and receive the equivalent of 6 months of time-loss benefits, and funds to choose their own retraining. (Subject to restrictions and monetary caps).

Effective with all plans approved on or after August 1, 2015:

• Option 2 benefit increases to the equivalent of 9 months of time-loss benefits.

• Workers that enter a formal retraining program may elect to choose “Option 2” during their first academic quarter. Their option 2 retraining funds will be offset by any tuition or expenses incurred, and their option 2 monetary award will be offset by any time-loss received during this first quarter.

If you have any questions about these benefit changes, or are in need of assistance with your claim, including vocational rehabilitation, please contact our office.

In Fiscal Year 2014, Labor and Industries reported nearly five thousand new industrial insurance claims that involved injuries to the shoulder. Most shoulder injuries are caused by lifting.

In a recent report published, Labor and Industries examined compensable injury claims from 2002 to 2010. Of over 400,000 allowed compensable injuries, over 29,000 claims were for shoulder injuries. Of those 29,000 injuries, over 12,000 were for “rotator cuff syndrome”. Shoulder related claims cost the department on average over $74,000, and resulted in an average of 428 days of time loss paid.

The top 10 industries for shoulder injuries include Construction, Nursing Care Facilities, and Transportation.

If you have any questions, or would like help filing a claim for an industrial injury or occupational disease claim, please contact us here at Atlas Law.

In Fiscal Year 2014, Labor and Industries reported over eleven thousand new industrial insurance claims that involved injuries to the back. This includes over one thousand spinal cord injuries. These injuries account for 13% of accepted industrial injury claims, costing Labor and Industries nearly $100 million.

Washington State has many industries in which back-injuries are common:
• Semi Truck Drivers
Over 200 claims costing over $4 million in FY 2014
• Farmworkers and Laborers
Over 200 claims costing over $3million in FY 2014
• Carpenters/Construction Workers
Nearly 400 claims, costing over $7.5 million in FY 2014
• Warehouse and production workers
Over 300 claims, costing nearly $2.5 million in FY 2014
• Landscapers
Over 80 claims, costing nearly $1 million in FY 2014
• Nurses, nursing aids, and hospital orderlies
Over 100 claims, costing over $1 million in FY 2014

If you have any questions, or would like help filing a claim for an industrial injury or occupational disease claim, please contact us here at Atlas Law.

*Fiscal year 2014 (FY 2014) are injuries sustained from July 1, 2013 to June 30, 2014. These figures are for state-fund claims only and do not include data from self-insured employers.

How do you file:

The most common way to file a workers’ compensation claim is to see a medical provider (MD, ARNP, DO, DC) and complete a Report of Accident. This could be an emergency physician, a general practitioner, or a specialist. If your employer is self-insured, most employers will have a Self-Insured Accident Report available (also referred to as an SIF2). If your employer is not self-insured, you also have the option of filing a claim online at http://www.lni.wa.gov/ORLI/ECS/FileFast.asp. Your employer may attempt to direct you to a provider of their choosing. However, according to RCW 51.36.010(2)(a), you are entitled to see a provider of your own choosing.

How long do you have to file a claim:

Under RCW 51.28.050 and 51.28.055, a report of accident must be received by Labor and Industries within one year of the date of injury, or within two years of being diagnosed in writing with an occupational disease.(1) Even though the statute provides time to file a claim for an industrial injury or occupational disease, it is important to report an injury or a diagnosed work related condition as soon as possible.

If you have any questions, or would like help filing a claim for an industrial injury or occupational disease claim, please contact us here at Atlas Law.

(1)An occupational disease, under Washington State Labor and Industries rules and regulations, is an infection or disease that occurs over a period of time and arises naturally and proximately out of the distinctive conditions of employment. An injury under Washington State Labor and Industries rules is a sudden and tangible happening that produces an immediate result. The event must be external and it must proximately cause the physical condition that the worker complains of.