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

Category: LNI Benefits (Page 12 of 21)

Light Duty Work in L&I Claims and Workers’ Compensation Claims

After a work injury or occupational disease, people with an L&I claim or workers’ compensation claim might have medical conditions that impact their ability to return to work. We refer to workers incapable of working during their recovery as temporarily and totally disabled. These workers receive time-loss compensation benefits, which is a type of wage replacement. When the Department of Labor Industries (L&I) pays time-loss compensation benefits, it negatively impacts L&I insurance rate for the employer. Consequently, L&I created alternative programs and incentives to help employers improve their rate. In this article, we cover the topic of light duty work. It’s one such incentive program for employers.

 

Light duty work and job offers

For one, L&I offers cost reimbursement to employers. Here, employers are eligible to recoup costs when they accommodate employees after a work injury and offer them a light duty job.  L&I refers to this program as Stay at Work (WA-SAW).  Explicitly, if a work injury claimant has limitations because of claim-related conditions, the employer can offer a job that fits within those limitations. Interestingly, L&I considers a light duty job as valid if it meets the following criteria:

1) The work injury claimant must have limitations because of conditions that relate to their workers’ compensation claim. These limitations must impact their ability to work.

2) The employer must submit a written (and detailed) job description for the light duty job to the attending physician.

3) The attending provider must approve the light duty job in writing.

 

After the criteria are met, the employer can make a light duty job offer to the worker. Light duty job offers vary significantly between employers and industries. For example, grocery stores frequently offer stockers or checkers light duty jobs as door greeters. Also, another good example is sedentary office work. Furthermore, if the wages for the new job are 5% less (or lower) than the worker was making before, then the worker can apply for loss of earning power benefits.

 

The economic incentives of this program are advantageous to employers. In fact, the program has many other benefits too. For one, after a work accident, it helps keep employers and employees connected during the recovery process. Furthermore, it creates less ambiguity concerning the work status of the employee. These advantages are only realized when the program is used for the right reasons. Unfortunately, too frequently, that is not the case.

 

The reality of light duty jobs in some L&I claims

I have seen employers offer light duty “jobs” such as watching safety videos for the entire work shift. I’ve also seen light duty “job” offers that involve sitting at a desk doing nothing. Clearly, these are not legitimate light duty jobs and the sole intention behind them is to save costs. Sometimes, employers ask workplace injury claimants to perform duties outside the details in their job description. Other times, employers require the worker to perform tasks contraindicated by explicit medical limitations. Realistically, many complain about harassment and intimidation while trying to perform light duty jobs.

 

Some employers tell light duty job employees to schedule medical appointments and treatments outside work hours. This can be difficult if not impossible. Finally, many workers are placed under a performance microscope while doing light duty work. For example, when the employer writes them up for clocking in a minute late. Another example is when the employer writes them up for playing a game on their cell phone out of sheer boredom because the light duty work was a do-nothing desk job. Yet another, is writing up the employee because he or she places their swollen foot on a desk shelf to reduce pain and swelling, while performing a do-nothing job. These are all real-life examples. Surprisingly, when you inspect personnel records, one must wonder why this excessive performance oversight didn’t happen prior to the work injury or occupational disease.

 

Advocating for people with a workers’ compensation claim

In the past, employers and administrative workers called me out for my criticism of L&I programs like WA-SAW. Proponents of the program cite studies, charts and data showing that early return to work (even in light duty capacity) dramatically reduces long term disability. I don’t dispute these findings.  I too, want workers I represent to regain their quality of life, including their full wage-earning potential, as quickly as possible.  However, I believe that the WA-SAW program is often misused and fails to accomplish its intended goals.

 

Too often, when employers use the program solely for cost savings without any regard to the feelings or needs of the work injury claimant, I see workers sour towards their employer. I see work environments become hostile, mental health conditions develop, and L&I claims become unnecessarily contentious. It’s for that reason that I will continue to advocate for a more worker centric overhaul of these incentive programs.

 

L&I Claim Court Decision Prompts Changes to the Stay at Work Program in Washington State

The Stay at Work (WA-SAW) program in Washington State is an incentive program for employers.  The Department of Labor and Industries (L&I) offers this program to help employers save costs. Specifically, the program allows employers to apply for cost reimbursement after a worker or an employee suffers an injury at work. To get reimbursements, the employer must provide temporary light-duty job to workers while they heal from their work injury.

 

What is the L&I Stay at Work program?

In short, the WA-SAW program helps employers avoid compensable claims. From my perspective, it’s designed purely to offer cost-saving measures to employers. However, it’s a short-sighted program. Practically speaking, it ignores several real-life challenges for work injury claimants. Furthermore, it often causes more long-term harm than good.

 

In my opinion, one important issue is that L&I exercises very little oversight of employers that take advantage of WA-SAW.  Upon returning to work, many work injury clients face hostile work environments and excessive work performance criticism. Many work injury victims report difficulty maintaining treatment schedules resulting in progress setbacks. Yet, these issues are largely overlooked. In fact, work injury claimants are usually blamed and frequently penalized for various issues that arise. For example, when the employer blames the worker after a light duty job is not working out. This situation can result in termination of time loss compensation benefits.

 

Making the program more fair for people with workers’ compensation claim

L&I recently announced changes to the WA-SAW program following a Court of Appeals decision. Previously, employers could ask for reimbursement back to the date they sent a light duty job description to the L&I claim doctor for consideration.  The Court of Appeals ruled this was not appropriate.  Now, employers can only ask for reimbursement as of the date the attending provider approves the light-duty job.

 

Personally, I believe this is a step in the right direction. However, it does not go far enough. In order for employers to be eligible for WA-SAW incentives, the work injury claimant must be: (a) Limited and unable to perform their regular job due to claim related conditions, and (b) Medically released to perform light-duty work by the attending physician.  Both the light duty job description and the attending provider approval must be in writing.

 

Personal perspective

When done the right way and for the right reasons, the WA-SAW program can benefit employers and workers alike. But, from my standpoint, I often see cases where the employer wants to take advantage of WA-SAW by making a light duty job offer. Frequently, employers fail to follow the steps that they need to take, which are necessary to make the offer valid.

 

The decision by the Court of Appeals is a good step. It helps ensure that employers that follow the rules and provide appropriate job offers enjoy the WA-SAW benefits. Nonetheless, the program still needs a more worker-centric overhaul to make it fair and maximally beneficial to all parties.

 

L&I Pension – Permanent Total Disability

An L&I pension is an important benefit after a serious work injury. For example, a catastrophic work injury or occupational disease can make work injury victims unemployable.  Here, unemployable means that the person is unable to “perform or obtain a gainful occupation with a reasonable degree of success and continuity”.  If medical treatment or vocational services cannot make the person employable, then the work injury claimant is permanently and totally disabled.  If you have an L&I claim or workers’ compensation claim, and you are permanently totally disabled, then you are entitled to “L&I pension” benefits under your claim.

 

L&I pension payments

When the Department of Labor and Industries (L&I) places a work injury claimant on L&I pension, then their L&I claim is closed. However, the injured worker receives L&I pension benefits for the rest of their life, so long as they remain unemployable.  L&I pays out pension benefits monthly, around the 15th of each month.  The amount depends on the worker’s salary and wages at the time of injury.  Furthermore, if the worker is married, then he or she can choose for their spouse to get survivor benefits. Simply put, “survivor benefits” means that if the work injury claimant passes then their spouse will receive the pension benefits. Under certain circumstances, this choice may also impact the monthly L&I pension amount.

 

Permanent total disability and L&I pension

There are many factors to consider when determining whether a work injury claimant is permanently and totally disabled.  These factors include the following considerations, among others:

1) The worker’s work pattern at the time of injury – part-time employment, full time, seasonal worker, and so on.

2) Whether the work-accident, injury, or work-related illness cause the permanent physical or mental limitations.

3) Were there any preexisting permanent (physical or mental) limitations?

 

 

4) The person’s wage-earning capacity.

5) The local labor market.

6) The worker’s strengths and weaknesses.

7) The work injury claimant’s age, education, training, and experience.

 

Based on these factors, L&I may consider the workplace injury claimant as permanently and totally disabled.  Even if a person is not physically or mentally helpless, they can still fall under the qualifications. However, we have to remember that an injured worker doesn’t have permanent total disability just because they cannot return to their former job. In fact, if the worker can perform or obtain any gainful work with success and continuity, then they are employable.

 

Employability: Are you employable?

The Department of Labor and Industries places great value on employability, for a variety of reasons.  From my perspective, there are some issues with how L&I views and evaluates employability. In my opinion, saying that someone is employable on paper is not the same as how things manifest themselves in the real world. Furthermore, it’s not uncommon for employability determinations to be based on erroneous or insufficient medical or vocational evidence.

 

Getting L&I pension help from an L&I attorney

As I see it, most people with a workers’ compensation claim recover from their injuries or illness and return to work. However, there are many individuals with L&I claims that need assistance to return to work.  Comparatively, only a small number of workplace injury claimants have permanent and total disability. If you have an L&I claim or a workers’ compensation claim, and the claim administrator is saying you are employable when you are not, then you should immediately speak with a workers’ compensation attorney.

« Older posts Newer posts »