Workers Compensation - Washington

Tara Reck, Managing L&I Attorney at Reck Law PLLC - Workers' Compensation Attorneys

Workers Compensation Attorney and L&I Lawyer

Thank you for visiting my blog. My name is Tara Reck and I am a managing attorney at Reck Law, PLLC. Our Workers’ Compensation and L&I attorneys are dedicated 100% to representing injured workers in Washington State. We have several offices in the Puget Sound area and we represent injured workers all over the state.

If you need help with your L&I claim, self-insured employer claim, or any other workers’ compensation or work injury claim, please give us a call to schedule a free consultation. We help with claim management, appeals and litigation with L&I and the Board of Industrial Insurance Appeals, Washington State Superior Court, Court of Appeals, and Washington State Supreme Court, as needed.


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Reck Law, PLLC – Office Locations
Seattle & Bellevue

2731 77th Ave SE #203
Mercer Island, WA 98040

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(206) 395-6141

2367 Tacoma Ave S #110
Tacoma, WA 98402

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(253) 999-9828

707 S Grady Way #600 Suite R
Renton, WA 98057

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(425) 800-8195
Port Orchard

219 Prospect St
Port Orchard, WA 98366

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(360) 876-4123

L&I Claim for Radiculopathy

I’ve been thinking a lot about radiculopathy lately. That’s because I have several clients that have issues with radiculopathy in their L&I claim in Washington State.


Radiculopathy in your workers’ compensation claim

Radiculopathy is a condition that comes up fairly frequently in a workers’ compensation claim. Understandably, people with a work injury claim tend to be nervous when they learn they may have radiculopathy. It’s a challenging condition. On top, it can be difficult to decide which treatment to pursue. Therefore, I think it’s important for people to understand radiculopathy. What it is, how it occurs, and what treatments are available under the L&I guidelines. The general information in this article isn’t a replacement for medical advice. Rather, it’s a way to help work injury claimants that don’t have medical training to learn about the condition.


Why is the spine important?

The first step to understanding radiculopathy is to look at the structure of the spine. Medical doctors sometimes refer to the spine as the backbone. It’s the central structural support for the entire body. The spine connects different parts of the musculoskeletal system, which enables body postures. For example, postures like sitting, standing, walking, bending, twisting, crouching, squatting, and lifting are all possible because of the spine. Therefore, the spine has a critical role in many types of employment. Consequently, it’s also susceptible to workplace injury or disease at work.


The spine is made up of 33 bones or vertebrae in a stack. Together, they form 3 curves or a S-shape. These vertebrae connect to each other by bony structures and intervertebral disks. The disks act like jelly-filled shock absorbers. Muscles, ligaments, and tendons also help hold the spine’s shape. Furthermore, in addition to providing structural support, the spine also protects the nerves of the spinal column. Hence, any damage to the spine means the nerves of the spinal column might be susceptible to damages as well.


What is radiculopathy?

In general, radiculopathy refers to a pinched or impinged nerve in the spinal cord. A pinched or impinged nerve is when there’s excessive pressure on the nerve. The cause for the pressure can be bones, cartilage, muscles, or tendons near the nerve. On top, this condition can produce a variety of symptoms. These symptoms may include weakness, radiating pain, muscle spasm, numbness, and tingling.


How does radiculopathy happen?

Structures of the spine (or surrounding tissues) can experience an injury, displacement, or even abnormal growths. For the latter, reasons can include bone spurts, tumors, or calcium deposits. Any of these occurrences can cause excessive pressure on nerves of the spinal column resulting in radiculopathy. Personally, from my experience and observations, radiculopathy cases usually involve: (1) A significant traumatic injury to the spine resulting in an acute fracture or disc herniation; or (2) A disease causing the areas where the nerves exit the spine to narrow.


Radiculopathy from work injury and causal relationship

There are several challenges with radiculopathy diagnosis in L&I claims. For one, some can argue that the cause for radiculopathy is the natural aging process rather than work-related conditions. Therefore, I commonly see the Department of Labor and Industries (L&I) deny coverage. For denials, they often base decisions on a medical opinion that the condition relates to the person’s age and not to a work injury or work illness.


Remember, we rely on medical evidence and medical opinions to show causation. Hence, if a medical provider feels that radiculopathy relates to your workers’ compensation claim, then it’s important for them to have a clear, logical, and medically-appropriate basis for the opinion. If you were diagnosed with radiculopathy or if it’s a suspected diagnosis, don’t be afraid to talk to your doctor about the condition. Moreover, ask them to explain why they think you have the condition. Also, ask whether they think it’s connected to your workplace injury or work-disease. Finally, take your time. Make sure you’re understanding the various treatment options so you can choose the one that suits you best.

L&I Claim Interpretation Services in Washington State

The Department of Labor and Industries (L&I) oversees work injury claims in Washington State. Every L&I claim is unique. Moreover, L&I claims can be very challenging to work injury claimants. Some of the challenges are even more frustrating for workers who do not speak English well.


Interpreting services for L&I claims

L&I offers a variety of interpretation services for people with a workers compensation claim. Previously, interpretation services were available primarily for in-person appointments. For example, appointments or meetings such as a medical consult and vocational provider conversations. To set them up, providers go through the InterpretingWorks online system.


With COVID, L&I announced that interpreters who provide in-person services must be vaccinated. This is in line with the Washington State Governor’s mandate. In fact, the mandate requires most state employees, healthcare workers and long term care workers to be fully COVID-19 vaccinated by October 18, 2021. Moreover, under the mandate – employees, contractors, volunteers, and providers of goods and services in a healthcare setting must also get the vaccine. Hence, the mandate includes L&I interpreters.


L&I interpretation services for online meetings

With COVID-19, we’ve seen a surge in virtual, video, and telephonic appointments in L&I claims. Obviously, these kinds of appointments also have interpreting needs. Consequently, L&I provides telephonic and video interpretation services through CTS LanguageLink. The services are available whenever in-person interpretation services are impossible or unnecessary. Interestingly, CTS LanguageLink has been providing statewide interpretation services for Washington State agencies since 1999. They offer over-the-phone interpretation as well as video services.


Setting up interpretation services for your L&I claim

As before, it’s up to the service provider to set up interpretation services when they need them. Providers can use the phone numbers below to set up CTS LanguageLink services. More explicltly:


First, service providers need to set up an account with CTS LanguageLink in order to access the services. For signup, providers can establish an account by emailing their L&I provider number or ID, name, and email address to ClientRelations@Language.Link. Then, the company will verify your provider information before they activate your account. Once active, you can utilize the services whenever you need them.


The viewpoint of an injured worker

I’m a workers’ compensation attorney in Washington State representing work injury claimants. I’m always concerned that people understand what’s occurring in their L&I claim. Also, it’s imperative for injured workers to be able to communicate effectively with service providers. Therefore, it always encourages me to see service providers utilizing interpreter services. Furthermore, I am very grateful to L&I for making these services easily accessible.


L&I Claims and Causal Relationship Challenges: Diagnoses That Come “Later”

If you have a work injury or work-related illness in Washington State, then you can file an L&I claim. Your L&I claim should cover all conditions that arise from the work injury or disease. We refer to these conditions as “causally related”. However, in some cases, it can be challenging to determine which conditions are causally related.


Work injury medical condition: Causation and aggravation

Under the law, a condition relates to the workplace injury if: (1) The work injury caused or aggravated the condition; or (2) The cause or aggravation was a result of medical treatment for the workplace injury. Clearly, when a diagnosis comes late, it can be difficult to establish the causal connection.


There are many cases where conditions arise in later stages of a workers’ compensation claim. Often, these conditions come up late due to valid and logical reasons. Common reasons include overlooking a diagnosis, or failure to obtain necessary diagnostic studies early. Another reason can be a minor injury at first, which progresses into a severe one later. Moreover, there are other reasons such as new medical conditions that develop during (or as a result of) treatment. Either way, it’s important to ensure that the Department of Labor and Industries (L&I) covers these conditions. Therefore, it’s imperative to show causal relation to the workplace injury under your L&I claim.


Missing diagnosis in a workplace injury

It’s very common for initial work injury or workplace disease diagnoses to be simple soft tissue issues. For example, sprains or strains. These diagnoses should heal quickly within weeks or months. However, when symptoms persist, it may be necessary to take a second look. For whatever reason, more significant diagnoses may not surface up for months or even years. When doctors make the “new” diagnosis so much later, it can raise serious questions about causation. Moreover, it can be particularly challenging if treatment wasn’t consistent, or if it continued over time. This is one reason I always stress the importance of having an attentive attending provider on your L&I claim. In my experience, if your L&I claim medical provider is attentive, then you have lower likelihood for missing diagnoses.


Failure to obtain necessary diagnostic studies

Another common reason for “new” diagnosis that comes in late is when doctors do not request diagnostic studies early. Many work injury claimants I represent experience the frustration of authorization denials for diagnostic studies. For example, when requesting an MRI. In the most egregious cases, I’ve seen IMEs opine there is no diagnosis because there are no “objective” findings for it. However, there are no objective findings because the attending provider’s request for an MRI is denied. Sometimes, it requires litigation to finally get the MRI. Then, when we finally get the MRI, it objectively documents a more severe diagnosis. Here, these may include disc herniation, muscle, tendon or ligament tear. In some cases, it can reveal a fracture or nerve impingement.


Progression of the initial work injury

Occasionally, a diagnosis may not occur until later in your L&I claim because it doesn’t progress until later. For instance, a person may experience a muscle, tendon, or ligament strain as a result of a specific injury at work or work activity. Over time, the damage may progress and become worse. For example, a shoulder stain may become a partial or full thickness tear. The same goes for knee strains that can become meniscus tears. Alternatively, back injuries that turn into full disc herniation. Here, the question we ask if whether a more severe condition developed out of the original work injury? If the answer is “no”, then the more severe injury is not causally related.


New injury during treatment

In Washington State, under the law, injuries that occur during treatment also fall under your workers’ compensation claim. Unfortunately, these kinds of injuries are more common than you’d expect. No one ever intends for them to happen. However, additional injuries can occur during massage therapy or physical therapy. Furthermore, they can even happen as a side effect of an authorized treatment such as surgery.


In my experience, the most critical thing is to ensure there’s a medical report. The report should document the injury – when and how it happened. Workers’ compensation is not about fault. Therefore, it doesn’t matter how the new injury occurred. However, we still need to establish causation. Hence, it’s important to document the fact that the injury happened during treatment.


Final remarks and conclusion

Causal relationship of medical conditions is always an important issue in a workers’ compensation claim. Often, challenges can arise, especially when diagnoses come later. Yet, regardless of the reason for the late diagnosis, it’s important to establish the connection. Explicitly, the chain of connections between the “new” diagnosis and the original workplace injury or occupational disease.


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