Did you know that many injured workers have difficulties obtaining an “attending physician” for their claims?
The role of attending physician (AP) is incredibly important. The AP certifies entitlement to benefits and makes treatment recommendations. APs also make appropriate referrals and their opinion is given special consideration.
While injured workers may choose their own AP, those physicians must be in the Department’s Medical Provider Network (MPN). On top, the physician must be willing to see and treat the injured worker.
For older or more complicated claims this can be a significant issue. This week I worked with three injured workers whose APs retired or left the area. Some of them have been searching for a new AP for months, but providers aren’t willing to accept them. As a result my clients are receiving letters demanding that they identify a new AP. Moreover, they are receiving threats of termination of benefits if not certified by new AP.
For these injured workers it is a dire situation. There’s a reason members of the MPN don’t want to get involved in these cases. Those reasons should be identified and addressed! I’m disappointed that this issue isn’t more widely recognized and that no one is taking steps to ensure that injured workers can find willing attending physicians when needed.
If an injured worker cannot physically return to their job prior to the injury in Washington State, he or she can be retrained. I feel very conflict about retraining injured workers because, in my opinion, some of the cases we see are unrealistic.
Retraining has a cost cap and cannot take more than two years. We see good loyal workers with lifelong heavy labor work histories, relegated to desk jobs. While still grieving over the loss of a career and collapse of retirement dreams, they are enthusiastically presented with retraining plans for basic “clerical work”. Introduction to computers, basic keyboard typing, phone etiquette, intro to Microsoft software products, and so on.
The goal is entry level, minimum wage, clerical or office work. When the worker voices concerns or doubts, they are frequently brushed off and ignored. This week one client started a plan and failed, and was being presented with a new skeleton plan. The new plan includes terms of repeated classes on the assumption he would fail the first time around. Another client’s plan included one handed basic keyboarding. Does the term “hunt and peck” sound familiar?
I am supportive of retraining, but I cannot ignore the legitimate frustrations and fears my clients express. There must be a better solution. I am very grateful to live in a state that cares about its employees and labor force. However, I know I am not the only person feeling this conflict in the retraining process. These are people’s lives we are talking about. They cannot be taken lightly. How do we work together and find a better solution?
This week I met with a prospective new client who was at an emotional breaking point. Her L&I workers compensation claim for benefits was rejected, but she has a significant medical condition and currently cannot work. Because her appeal of claim denial was already before the Board of Industrial Insurance Appeals, she had consulted with a number of attorneys that declined to get involved. She had an upcoming conference, and the Judge had given her an ultimatum to either obtain representation or prepare to present her case pro se. Or in plain English, to represent herself.
It was impossible for me to make any informed recommendations and I really don’t know whether there is a medical basis for the allowance of her claim. This is a very difficult spot for me to be in, because unlike many other cases, it is difficult to apply proper judgement. However, when I told her I’d come on board to help satisfy the ultimatum and conduct some discovery in order to better advise her about her chances of prevailing, she broke into tears.
It made me realize that she truly had no support network and that I was her last hope for getting some help to navigate this situation. She had no one to help. Can you believe that? How can we foster better support networks for injured workers or disabled people, and how do we promote better access to justice?