Category: LNI Benefits (Page 18 of 21)

Can I Collect Unemployment While My Workers’ Compensation Claim is Open?

I’m often asked if injured workers can collect unemployment benefits while their workers’ compensation claim is open. In general, the short answer is – usually no. Injured workers cannot collect unemployment benefits and time-loss compensation benefits at the same time. Unemployment benefits are for individuals who are willing and able to work but are unable to get a job. Time-loss compensation is for people who are unable to work because of work injuries or occupational diseases.

Examples when injured workers can collect unemployment benefits

There are some circumstances whereby injured workers can collect unemployment benefits. The best example I can think of is when an injured worker is declared as capable of working but haven’t obtained a job yet. Usually, once a vocational counselor determines that an injured worker can return to work, then time-loss compensation benefits are immediately terminated. However, finding that an injured worker can return to work doesn’t mean they have a job to return too. When this happens, unemployment benefits can be a saving grace. They can provide the injured worker with some income and access to job search resources through WorkSource.

The takeaway

In summary, it is important for injured workers to know they cannot simultaneously collect unemployment and time-loss compensation benefits. However, under certain circumstances, it is fine to collect unemployment benefits. For example, when searching for a job or for options to return to work after an industrial injury or occupational disease. Additionally, WorkSource can provide many useful resources. These resources include help writing a resume, searching for available positions and work opportunities, and others.

Non-Cooperative Injured Workers Are At Risk of Claim Closure and Loss of Benefits

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When you have an open and active L&I claim, it is imperative that you remain claim compliant. Injured workers who become non-compliant or non-cooperative, are likely to have their benefits suspended.

Non-cooperative injured worker behavior according to L&I

Behavior that L&I considers to be non-cooperative includes:

1) Failing to attend or not cooperating with medical examinations or vocational evaluations. These appointments are requested by the Department of Labor and Industries or self-insured employer;
2) Failing to attend scheduled appointments or evaluations with attending providers or vocational counselors;
3) Engaging in unsanitary or harmful actions that could jeopardize or inhibit recovery;
4) Refusing to accept medical or surgical treatment that is considered reasonably essential for recovery;
5) Refusing to transfer care to an attending provider within the Medical Provider Network; or
6) Failing to follow the accountability agreement in a vocational retraining plan.

If the Department or Self-Insured Employer believes that an injured worker is engaging in non-cooperative behavior, they will typically attempt to correct the issue. They normally do so by contacting the injured worker (or their attorney) to discuss the behavior and potential consequences. Additionally, they will send an informal letter recapping the discussion. If the non-cooperative behavior continues, a formal non-cooperation letter is sent to the injured worker (or their representative). The letter will outline the behavior believed to be non-cooperative. The letter will also request an explanation form the injured worker for the behavior. This letter must contain notice that benefits may be suspended under RCW 51.32.110. Under WAC 296-14-410, the injured worker has just 30 days to submit a response explaining the reasons for the behavior.

Claim closure and suspension of benefits

In some cases, injured workers fail to respond within 30 days. Alternatively, even if they respond, L&I may not believe the injured worker’s explanation. In either case, L&I may issue an order suspending the injured workers right to further benefits until cooperation resumes. If non-cooperation occurs during vocational retraining, the retraining plan must be salvageable despite the lack of cooperation. For retraining plans that lack additional time or funding, non-cooperation can result in plan failure. Plan failure due to the worker’s own actions usually results in swift claim closure.

The penalties for non-cooperation are very severe. Therefore, I always advise injured workers to remain cooperative and communicative throughout their claims. If benefits are suspended and the injured worker lacks good cause for the behavior deemed non-cooperative, it is difficult (if not impossible) to secure benefits while non-cooperation continues. However, in my experience, the analysis of whether good cause exists for non-cooperative behavior is very subjective. I do not always agree with the Department’s position regarding what constitutes good cause and what does not.

L&I Claims and Free Interpretation Services for Injured Workers

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What language do you speak? Español? русский? Tiếng Việt? Qué idioma hablas? на каком языке ты говоришь? Bạn nói tiếng gì? Did you know that L&I pays for interpreters during medical or vocational services to injured workers and crime victims who have open and allowed claims?

How to get an interpreter for my L&I claim?

Medical practices receiving Federal funding are legally required to provide interpretation services to patients who need it. Consequently, when medical or vocational providers feel an injured worker needs interpretation services, they can reach out to the Department of Labor and Industries (L&I). In turn, L&I will arrange interpretation services and will also cover those costs. L&I does not decide whether an injured worker needs an interpreter. Instead, L&I leaves that determination to medical and vocational providers. If a medical or vocational provider determines that interpretation services are warranted, L&I will provide those services without pre-authorization.

If injured workers feel they may experience language barriers or that they can facilitate claim-related communications better with the help of an interpreter, then I strongly encourage injured workers to ask their medical and vocational providers for help with interpretation. In my experience, it is not uncommon for injured workers with difficulties communicating in English to ask a friend or family member to assist. Yet, it is important to note that L&I does not require the medical provider or vocational providers to use the interpreter that arrives with the injured worker.

Video and phone interpretation for workers’ compensation claims

The L&I website contains helpful information to assist providers in understanding how to arrange video, over-the-phone, or face-to-face interpretation services. Video interpretation is a relatively new service from L&I and their current vendor offers video interpreting for most commonly used languages. Phone interpretation is a versatile service with interpreters in over 200 languages available within minutes via a toll-free number. Each toll free number may be different based on the type of claim. Finally, for face-to-face interpretation, L&I provides an Interpreter Lookup Service on their website. All face-to-face interpreters are expected to adhere to a professional code of conduct. The code governs what they may and may not do, and requires them to maintain strict confidentiality, impartiality, accuracy, completeness, and competency.

Recommendations and conclusions

To ensure appropriate case and optimal resolution of the L&I claim or self-insured workers’ compensation claim, it is important that injured workers are able to communicate effectively with treatment and vocational providers. The interpretation services offered by L&I are versatile, useful, and important for ensuring that claims are progressing appropriately. They also help injured workers understand recommendations and requirements for remaining in compliance with medical treatment and forward progress of the claim.