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
 

PPD Rating in L&I Claims (and Why Most Doctors Won’t Do It)

After a workplace injury or work illness, some people are left with some sort of permanent disability. In legal terms, we call it permanent measurable residuals. Usually, these work injury claimants are eligible to a permanent partial disability award (or PPD award in short). Timewise, the Department of Labor and Industries (L&I) provides the PPD award when an L&I claim closes. Furthermore, the same goes for self-insured employers and insurance companies, like Sedgewick.

 

PPD rating

L&I doesn’t decide the amount of the PPD award arbitrarily. In fact, it’s based on PPD rating and the L&I PPD award schedule. First, your L&I claim doctor must consider the area of the body involving the work injury or industrial disease. The body parts in question determine the methods they are going to use to decide the PPD rating. Here, there are 2 different categories.

 

If the industrial injury or workplace illness affects a body part that doctors can amputate, then doctors base the PPD award on the American Medical Association guides. However, if amputation is not an option, then the doctors base the PPD award on various categories in the Washington Administrative Code (WAC).

 

Amount of PPD award

The PPD award schedule is the official term for calculating the PPD payout. The monetary amount of the PPD award depends on the PPD rating. For reference, L&I maintains a PPD awards table. The table shows the payment amount versus the PPD rating decision. Interestingly, the award rate also depends on the date of the work injury (or the manifestation date for a workplace disease). Once the L&I doctor makes the PPD rating, L&I looks up the award schedule to find the PPD award value. Furthermore, additional information about this process can be found under the PPD section of the L&I website.

 

I’ve been representing work injury claimants for many years. Over time, I came to realize that many L&I attending doctors don’t do PPD ratings. Consequently, when your L&I claim is getting ready to close, L&I usually sends you to an independent medical exam (IME). There, the IME panel confirms your maximum medical improvement and gives a PPD rating. However, the methods for finding the PPD rating are relatively straightforward and simple. Therefore, I’m confused as to why more attending doctors don’t provide PPD ratings regularly.

 

Recommendations and personal thoughts

Personally, I think (and hope) that many more attending providers should perform PPD ratings. First, in general, attending doctors are in the best position to know their patients’ permanent residuals. Hence, it should be fairly simple for them to determine the appropriate rating method and measurements. Second, it would allow work injury claimants to feel more confident that their PPD rating and compensation are fair and proper. I get so many calls from injured workers who are concerned that IME providers didn’t take accurate measurements. Unsurprisingly, PPD readings by attending physicians are bound to limit these types of concerns. Finally, if more attending doctors perform PPD ratings, we wouldn’t need so many IME doctors and appointments. That way, we can keep L&I claim costs down. Moreover, we could reach L&I claim closure more quickly and efficiently, once workers reach maximum medical improvement (assuming no further vocational issues).

 

I often ask L&I doctors why they don’t perform PPD ratings. Sadly, the most common answer I get is that they don’t feel competent and lack training. For me, it seems that this is a relatively easy problem to fix. All we need is little education, some training, and someone within the L&I ranks with enough energy to push for change.

L&I Claim and Arthritis Around the Spine – A Challenging Medical Condition

Recently, I’ve encountered an interesting diagnosis in several L&I claim matters in Washington State. The name of the condition is diffuse idiopathic skeletal hyperostosis (or DISH in short). It relates to arthritis mostly around the spine. Sometimes, we encounter the condition in the context of work injury involving the lower or upper back.

 

Arthritis in the spine area

Diffuse idiopathic skeletal hyperostosis is an arthritic condition. It happens when various musculoskeletal structures such as ligaments and tendons harden overtime. The condition is most common around the ligaments and tendons of the spine. However, it can also manifest itself in the hips, knees, shoulders, feet, and hands.

 

Some of the most common symptoms include stiffness, decreased mobility, and pain. After a work injury, many people report experiencing the symptoms especially upon waking in the morning. Over time, diffuse idiopathic skeletal hyperostosis can cause bone spurs around the affected areas. Then, if bone spurs form, they can also cause additional inflammation and impact nerves in the area. Unfortunately, depending on the areas in question, bone spurs that impact nerves can become quite dangerous. Moreover, they require surgical intervention. However, it’s important to note that many people do not experience any symptoms. Frequently, medical doctors diagnose the condition after performing imaging studies following an acute workplace injury.

 

A unique arthritis condition

Interestingly, diffuse idiopathic skeletal hyperostosis is largely an asymptomatic condition. On top, it’s an interesting condition for other reasons. First, medical professionals still do not fully understand its causes. In fact, various medical sources suggest that causes include genetics and the aging process. Some studies imply causes such as inflammation, metabolism, and possibly body mechanics. Furthermore, another interesting feature of the condition is that it impacts certain types of people. For example, it’s more frequent in men, especially over 50 years old.

 

Individuals who have diabetes or conditions that raise insulin levels also have higher likelihood of developing the condition. Additionally, researchers found some connections to certain acne medication and excessive vitamin A intake or production. Finally, other sources found that diffuse idiopathic skeletal hyperostosis might relate to repetitive heavy lifting.

 

Challenging condition in the workers’ compensation claim setting

We can all agree that this type of arthritis has unusual features. Also, it can be very difficult to diagnose the condition. Hence, it’s also difficult to handle diffuse idiopathic skeletal hyperostosis under an L&I claim. Personally, in the cases I encounter, the individuals didn’t know they had the condition. Surprisingly, doctors discovered the condition while treating clients after an industrial injury or workplace accident.

 

Naturally, the discovery of the condition raises questions about the origins of the symptoms that these individuals are experiencing. Do their symptoms originate from their work injury? Do their symptoms originate from diffuse idiopathic skeletal hyperostosis? Is it a combination of the two? Would the condition become symptomatic if it wasn’t for the industrial injury?

 

Conclusion

We have to leave these questions to the medical experts to answer. However, the difficulty is that there’s a lack of consensus amongst medical professionals. Therefore, it is common to have differing opinions in response to each of these questions. Consequently, it means that there’s much higher likelihood to run into disputes when encountering the condition in an L&I claim or self-insured employer claim. Should L&I cover the condition under the claim? If not, why not? And so on.

 

Some work injury claimants intend to pursue acceptance of the condition under their workers’ compensation claim. Therefore, it’s important to have strong medical opinion. These medical opinions must explain the causal connection in light of the unique nature of this condition.

Consulting with L&I Attorney in Washington State: Don’t Wait Too Long!

Many L&I attorneys in Washington State that represent work injury claimants offer free consultation. Personally, I’d much rather talk to a work injury claimant early in the claim. For me, it’s far better to tell people they don’t need an attorney rather than wait until their work injury claim gets completely out of control. Therefore, I think it’s a good idea to talk to a knowledgeable L&I attorney whenever you feel there are red flags in your workers’ compensation claim. This applies to both L&I claim matters or self-insured employer claim as with a Sedgewick claim (and others).

 

Should I consult with an L&I attorney?

If you have an upcoming consultation with a workers’ compensation attorney, you can take steps to make it more productive. Explicitly, these steps include preparing for the meeting, answering questions that the attorney asks you, and listening carefully with an open mind. The first step is to prepare for the L&I attorney consultation. Often, a free consultation with a workers’ compensation lawyer is approximately 30 minutes long. Therefore, the L&I lawyer needs to collect important information in a short time. To help, make sure to equip yourself with basic information. For example, your claim number, date of injury, and current claim status. It’ll help the L&I attorney get information quickly. That way, you and the attorney can spend most of the consultation discussing more pertinent issues.

 

L&I attorney consultation and answering questions

In my experience, work injury claimants often want to describe the abuses they experience in their L&I claim. For instance, people often complain about poor communication, excessive delays, and employer misconduct. Furthermore, many people are upset about negative or aggressive comments from their treatment provider, claim manager, and vocational counselor. L&I claims are hard for everyone. I know. We see these misbehaviors towards injured workers all the time. However, is this the best use of your consultation time while speaking to an L&I attorney?

 

Remember, the main goal of the L&I claim consultation is to identify legal issues that need attention. By far, the easiest way to do it is to ask work injury claimants very specific questions. Make sure you’re carefully listening to every question. Then, provide complete but concise answers to enable the L&I attorney to cover more issues. This way, it’ll help the attorney make a better assessment regarding representation.

 

Speaking with L&I attorney while keeping an open mind

Unfortunately, there’s a lot of misinformation out there regarding L&I claims. It’s difficult for people after a workplace injury to digest the fact that things may be different than they thought. However, you must remember that the Industrial Insurance Act provides many benefits and protection after a workplace injury or work sickness.

 

An L&I attorney with proven experience will be looking at your claim from all angles. The goal for a good workers’ comp attorney is to ensure that the system is treating you fairly after your workplace injury. Therefore, it’s important to maintain an open mind. Do not get upset with new information or questions. Answer questions directly, and the best of your ability. Things aren’t always exactly as you expect them. Recall, the attorney’s job is to help you. Therefore, be open and let the L&I attorney find the best way to navigate the conversation.

 

L&I claim consultation – Get ready

In summary, I strongly believe that it’s a good idea to consult with a workers’ compensation lawyer any time you have concerns. If you don’t understand what’s happening in you claim, or if something is going wrong, then call an L&I attorney. Most worker’s comp attorneys offer free consultations. However, it’s important for consultations to be efficient. For that, be sure to prepare for your consultation by following these simple steps:

  • Don’t wait too long to speak to an L&I attorney
  • Come prepared with information such as claim number, date of injury, and claim status
  • Listen to the attorney’s questions
  • Answer the questions directly to make best use of your consultation time
  • Listen and keep an open mind
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