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

Map and directions

(206) 395-6141

Tacoma

2367 Tacoma Ave S #110
Tacoma, WA 98402

Map and directions

(253) 999-9828

Renton

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

Map and directions

(425) 800-8195
Port Orchard

219 Prospect St
Port Orchard, WA 98366

Map and directions

(360) 876-4123

L&I Claim Closed – Who is Paying for Future Medical Expenses?

What happens after my L&I claim closes? I get this question all the time. It’s one of the biggest points of stress for people after a work injury in Washington State. Moreover, this stress is particularly high for people that know they will incur additional medical costs after their L&I claim is closed.

 

Paying for medical expenses after L&I claim closure

Under WAC 296-20-124, the Department of Labor and Industries (L&I) will not pay for services after a workers’ compensation claim closes. However, L&I and self-insured employers are responsible to pay for services that relate to the claim reopening application. Furthermore, there are a couple of other important exceptions.

 

Workers’ compensation claim closure and payment exceptions

The first exception is for certain periodic medical exams. Here, L&I and self-insured employers must pay for certain periodic medical surveillance examinations. For example, these exams are very common in cases involving asbestos diseases. Generally, doctors recommend these exams under the medical protocol whenever they need to perform routine medical monitoring or maintenance.

 

Another exception is for medical equipment replacement. Under WAC 296-20-1102, L&I may cover repair or replacement of prosthetics, orthotics and other special equipment. However, after L&I claim closure, you need to get pre-authorization from the prescribing medical provider. Explicitly, your doctor needs to provide a document to L&I to explain the need to replace or repair the item. For example, your doctor will have to explain that the medical device incurred damages, broke, or is worn out. Finally, note that crutches, cervical collars, and lumbar and rib belts (as well as other low-cost orthotics) don’t require preapproval. Of course, there are also limitations on the kinds of items that L&I will cover. As an example, L&I will not cover inversion traction equipment, vibrators or heating pads. They will also not cover home furnishings, hot tubs and exercise equipment.

 

Personal recommendation

In my opinion, I always think it’s a good idea for people with a work injury claim to plan for their L&I claim closure. In part, they should discuss medical expense (and other) concerns before claim closure becomes final. On top, there are special considerations when medical surveillance exams or equipment repair applies in your L&I claim. In such cases, I recommend that claimants, medical providers and L&I get on the same page regarding process and procedure after claim closure.

L&I Claim Mental Health Treatment Options and Master Level Therapists

I’ve been serving as a workers’ compensation attorney in Washington State for over 15 years. One of my biggest challenges is to find mental health treatment for clients with an L&I claim. I will go a long way to help my clients. However, it’s sometimes impossible to find treating psychiatrists who are medical doctors. Yet, there are some good news from the Department of Labor and Industries (L&I) concerning this matter.

 

Mental health treatment in a workers’ compensation claim

In the past, it has been easier to find treating clinical psychologists. Recently, all that changed, and it’s become more challenging than before. But there’s some good news. A little over a year ago, L&I started a 4-year pilot project. The project authorizes and pays Master’s Level Therapists (MLT) to treat people with a work injury claim.

 

Interestingly, under current L&I medical treatment guidelines, the system doesn’t permit MLTs to provide mental health treatment in L&I claims. However, L&I is conducting the pilot program to provide structure. In the process, L&I is collecting data on behavioral and mental health services that MLTs provide to work injury claimants.

 

L&I program for mental health professionals

The enrollment for the 4-year pilot program began back in November 2019. L&I said it will allow up to 300 MLTs into the program. Initial signups include licensed independent clinical social workers (LICSW), licensed marriage and family therapists (LMFT), and licensed mental health counselors (LMHC).

 

Therapists and counselors that wish to apply for the L&I pilot program must meet some requirements. For one, every therapist must complete an L&I training module and submit a completion certificate with their application. In addition, each mental health therapist must submit a Non-network Provider Application. Finally, L&I requires mental health counselors to also submit the MLT Pilot Supplemental Application.

 

L&I claim and mental health treatment coverage

Once L&I approves an application, the MLT can treat work injury claimants under their workers’ compensation claim. Of course, you have to meet certain criteria for treatment coverage. For example, the attending provider on the L&I claim must refer the work injury claimant to the MLT. The referral should be for appropriate psychotherapy treatment, for a mental health condition that L&I previously accepted under the claim.

 

An MLT cannot diagnose mental health conditions or perform mental health evaluations following a workplace injury. However, in cases with accepted mental health conditions, the mental health therapist in the pilot program can provide eight treatment sessions. Importantly, these sessions do not require treatment pre-authorization or going through the utilization review process. After that, additional sessions beyond the first eight require a utilization review authorization.

 

The impact of mental health services after a work injury

Mental health conditions can seriously (and very negatively) impact your recovery after a workplace accident or work-related illness. As an L&I attorney representing work injury claimants, I hope this pilot program becomes permanent. It’s important to provide people that have a workers’ compensation claim with early and easy access to mental health treatment. I strongly believe this program will result in much better outcomes compared to the current status quo.

 

For more information, please refer to the Master’s Level Therapists pilot program on the L&I website.

 

L&I Claim Expense Reimbursement and Refund

The Department of Labor and Industries (L&I) in Washington State provides reimbursement for some expenses under your workers’ compensation claim. Expense reimbursement may include travel costs as well as personal property losses. However, if you want L&I to refund these kinds of expenses, you must first meet certain requirements.

 

Workers’ compensation claim and refund for travel expenses

Under an L&I claim, L&I doesn’t usually cover travel expenses to and from medical treatment. Yet, there are some exceptions. Reimbursement for traveling to (or from) treatment is contingent on the following requirements:

(1) Travel reimbursement must be pre-authorized by your L&I claim manager;
(2) The medical provider must be more than 15 miles one way (30 miles round trip) from the home address of the work injury claimant;
(3) There can’t be other medical professionals that can provide the treatment closer to the home address of the work injury victim; and
(4) The work injury claimant must complete a Travel Reimbursement Request form and provide copies of all receipts to L&I.

If the requirements are met, then L&I might also reimburse for parking over $10 and for toll road payments.

 

L&I claim property reimbursement

In some cases, L&I may also reimburse the work injury victim for property lost (or damaged) during a workplace accident. Here, you can get a refund only for certain kinds of personal property. For example, property can include prescription eyeglasses, contacts, clothing, shoes, boots, and personal protective equipment (PPE). To be eligible, the person that suffered the work injury should complete and submit a Statement for Miscellaneous Services to the claims manager.

 

Final remarks

Workplace injury and work-related diseases have some serious negative financial impact on workers. The goal of the Industrial Insurance Act in Washington State is to minimize the suffering and economic losses for people with a work injury claim. These types of expense reimbursements are one good way for L&I to try and uphold the purpose of the Industrial Insurance Act.

 

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