Workers Compensation - Washington

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

Month: February 2019

L&I penalizes self-insured employer King County Metro

Today we’re going to talk about L&I penalizing self-insured employers such as King County Metro. There is more to the Department of Labor and Industries (L&I) than administering workers’ compensation cases. It is a very big administration charged with many other tasks including workplace safety issues. After all, safe workplaces are a first step towards reducing the number of industrial injuries that occur.

 

In today’s local news we learned that L&I has fined King County Metro $20,100 for safety violations involving employees working around high voltage. This isn’t the first time that King County Metro has been cited for safety violations by L&I. Approximately 2 years ago KIRO 7 news investigated incidents of Metro employees getting shocked while working on busses. Two years after a KIRO 7 investigation into employees getting shocked while working on buses in 2016, Metro was fined $10,800 for not implementing training programs for high voltage work and failing to periodically review and evaluate improper energy control procedures. Metro has also been fined for issues associated with bathrooms for bus drivers and assaults of Metro employees while working.

 

King County Metro is a self-insured employer. That means for injured Metro employees, Metro (or their third-party administrator insurance) handles claim paperwork and pays for the claim. According to WAC 296-15-310 Every employer certified to self-insure is obligated to comply with the provisions of the Industrial Insurance Act and the rules and regulations of L&I, and to have the necessary administrative processes in place to manage its self-insurance program. Each self-insurer is ultimately responsible for the sure and certain delivery of Industrial Insurance Act benefits to its injured workers and is accountable for all aspects of its workers’ compensation program. For an employer to be certified to be self-insured, the employer must meet the requirements set forth in WAC 296-15-001.

 

If an injured worker whose claim is being administered by a self-insured employer believes that the self-insured employer has unreasonably delayed benefits, the worker can ask L&I to penalize the self-insured employer according to WAC 296-15-266. If the self-insured employer’s actions are even more egregious than mere delay of benefits, under RCW 51.14.090 the Department may withdraw the self-insured employer’s certification. WAC 296-15-255 sets forth the hearing process for corrective action or withdrawal of a self-insured employer’s certification.

L&I workers compensation claims and acupuncture

Did you know that the Department of Labor and Industries (L&I) has an acupuncture pilot project? Until very recently, acupuncture as a treatment was not covered on L&I claims. Recently L&I decided to launch a pilot program designed to collect information about the use of acupuncture to treat low back pain, including treatment provided by East Asian Medicine Practitioners (EAMPs). During the project L&I will pay qualified providers participating in the project to provide acupuncture treatment to injured workers with low back pain that is related to an accepted condition under their claim.

 

For treatment to be covered, it must focus on helping inured workers heal and return to work. Furthermore, the treatment must be ordered by the attending provider (AP) and documentation must show clinically meaningful improvement in pain and function with the acupuncture treatment. If these conditions are met, up to 10 acupuncture treatments over the lifetime of the claim may be authorized. As treatment progresses, participating providers are required to use the Oswestry Disability Index and 2-item Graded Chronic Pain Scale score to assess the improvement in pain and function and send reports to the Department continuing this data.

 

As an attorney representing Washington State injured workers, I am very excited that the Department is finally exploring acupuncture as a treatment option under L&I claims. For years, acupuncture has often been recommended to assist injured workers in overcoming painful conditions and dependence on pain medications like opioids. However, injured workers were often disappointed to learn the recommended treatment would not be covered by the Department. It was not uncommon for me to represent individuals so desperate for pain control they were willing to cover the cost of acupuncture treatment out of pocket. However, for struggling injured workers, paying out of pocket is often not possible. In my experience, many injured workers have had very positive results from acupuncture.

 

Are you an injured worker that has been able to take advantage of the L&I acupuncture pilot project? If so, I’d love to hear from you about your experience.

Vocational Dispute Resolution (VRDO) – Disputing vocational decisions in L&I workers’ compensation claims

Vocational services in L&I claims

Continuing with vocational services articles for L&I workers’ compensation claims, yesterday I posted general information and thoughts about the Plan Development phase in vocational services. Today, I’d like to focus on disputing vocation decisions and Vocations Dispute Resolution (VDRO).

 

While vocational retraining can be a tremendous benefit under the right circumstances, I don’t believe enough emphasis is placed on a holistic analysis of the injured worker’s ultimate ability to become employed… Continue to read the full article.

 

Vocational counseling in workers’​ compensation and L&I claims: A deeper dive

Yesterday I posted a simplistic summary of vocational benefits, which is my typical way of trying to simplify and explain the general process. However, when vocational services are provided in actual workers’ compensation L&I claims, it becomes a much more dynamic than can be captured in a simple summary. Over the next few posts, I’m going provide a deeper explanation of the various phases within the vocational process. Today, I’m going to focus on “Early Intervention”.

 

Early intervention services are outlined in WAC 296-19A-050, which states that these services are intended to help injured workers return to work or continue to work for the employer of injury or the current employer. Early intervention services may include:

1) Discussing early return to work options with the employer, worker, and attending physician;

2) Identifying return to work goals and barriers that may interfere with or prevent the injured worker from returning to or continuing to work;

3) Assisting employers with offers of employment;

4) Planning and working with the referral source on necessary job modifications and pre job accommodations;

5) Performing job analyses; and

6) Assessing the injured worker’s need for preferred worker status and educating about that benefit.

 

In a publication titled “Getting Back to Work: It’s Your Job and Your Future”, L&I states that getting back to work is a “team effort” requiring the injured worker, attending provider, employer and the Department of Labor and Industries to all work together on returning to work. However, as an injured workers’ representative, I believe this is one of the biggest failures in the early intervention process. Rarely, if ever, do I see these entities working together towards a common return to work goal. More commonly I see the members of this “team” each working separately on the issue most pertinent to them at the time.

 

This can be problematic for early intervention success since fees to vocational counselors for early intervention services are limited to 20 hours of professional costs, are allowed only once per claim, and extensions cannot exceed 12 weeks for graduated return to work and 4-6 weeks for work hardening. If possible, during that time the vocational counselor will typically explore the following return to work options:

a) Graduated return-to-work by increasing the number of hours until the worker is back up to the work pattern at the time of injury;

b) Transitional return-to-work in a temporary job where the injured worker is expected to be able to go back to the job of injury during early intervention;

c) Light-duty work in a job with less physical demands than job of injury; and

d) Temporary work in a job that isn’t ongoing.

 

However, because the team approach frequently does not occur, injured workers are often surprised to receive an unexpected job offer when they are focused on other aspects of their workers’ compensation claim. This often creates stress and anxiety because injured workers feel isolated and alone as they struggle to figure out how to meet the demands of a job while simultaneously attending necessary medical appointments and meeting other claim related requirements. This is one place where injured workers’ representatives can make a big difference.

 

Not only do we provide support for injured workers who feel alone in the process, skilled representatives know how to address the issues that arise in early intervention and can help to effectuate the team approach (assuming an early intervention return to work conversation is appropriate given the facts and circumstances of the claim).

Wrapping up a very busy January in our workers’ compensation law firm

I am very busy these days. While the past few weeks have handed me no shortage of professional challenges, and while I’ve certainly had my moments of frustration, I’m not complaining. A lot has changed since I came on board at Casey & Casey P.S. and founded Reck Law, PLLC. Changes are going to continue as we improve and grow in our exemplary representation of injured workers throughout the Peninsula and across the State. I’m going to continue being busy for a long time to come.

 

I’ve received compliments lately on my work ethic and accomplishments since taking the helm at Casey & Casey. While I appreciate the compliments and the sentiments behind them, sometimes I feel like people think this is nothing more than a gamble. It is very early, and time will only tell how my business will grow and evolve, but my decision to take the lead at Casey & Casey, P.S. and to launch Reck Law, PLLC was no gamble. It was a calculated and deliberate decision I made because I was ready to take the next step in my career, because I believe in my representation of injured workers, and because this is exactly what I want to do.

 

Tonight, as I reflect on what has been a very full day, I am grateful for everything I was able to accomplish. I started my morning by having a great strategic conversation with an incredible client. I met an injured worker who is not my client, but who is finishing up a retraining plan under his claim and about to start a new career as a paralegal after sustaining a career ending industrial injury. I participated in a vocational meeting that provided my client with hope for a fulfilling future after years of struggling following a catastrophic injury. I participated in several conferences, and finally made some forward movement in a case that has been standing still. I participated in a conference with an injured worker, her attending physician and the medical director to try and develop a treatment plan for a complex condition. Finally, I took testimony from an attending physician as part of an ongoing Board hearing. In other words, I enjoyed an incredibly busy day doing the work I am passionate about doing.

 

As the first month of 2019 comes to an end, I want to thank my wonderful clients and everyone who has encouraged and supported me at Casey & Casey, P.S. | Reck Law, PLLC. You are the best family, friends, staff, colleagues, and clients I could ask for. There is a lot of work to do and I’m ready to do it.