Category: LNI News (Page 2 of 22)

Falling From a Roof – Why We Must Take Work Safety More Seriously

The Department of Labor and Industries (L&I) governs work safety matters in Washington State. Recently, L&I published a news bulletin showing that not all employers are taking workers’ well-being seriously. Unfortunately, some employers continuously ignore very basic safety precautions. In this article, we cover specific issues in L&I claims involving roofers. Unfortunately, falling from a roof is something we see often in L&I claims. It’s no joke. If you fall from a roof, it can cause serious injuries. In fact, roof falls lead to many workers compensation claims.

Roofing Work Injury Examples and Hazards

In its publication, L&I reported that Allways Roofing Inc and United Roofing Solutions Inc are severe safety violators. The two roofing companies are in Western Washington. What makes these companies severe violators? Ongoing safety inspection failures resulting in repeat citations. In fact, the two companies racked over $3M in penalties, combined.

Interestingly, L&I says it inspected Allways Roofing 11 times in the past 3 years. The company repeatedly violated fall protection regulations. Consequently, L&I considers the company’s behavior egregious and willful. These recurring safety violations resulted in high numbers of work injury occurrences. In detail, at least seven employees sustained serious workplace injuries. They include five falls from heights and two eye injuries from nail guns. Furthermore, Allways Roofing appealed its past citations.

Falling from a roof is a serious work injury

In addition, L&I inspected United Roofing Solutions Inc more than 6 times since 2009. L&I issued them citations for repeat safety violations. Per L&I, the most recent citation was for repeated, willful, serious violations of not using fall protection. Unsurprisingly, the company appealed this determination.

L&I and federal workplace safety programs track statistics for roofing accidents. They concluded that falling from heights is one of the leading causes of workplace deaths and serious injuries. Wake up people! These statistics alone justify fall protection and safety regulations. Not to mention inspections and citations for failing to follow regulations.

L&I claims that come through my office

Every day, I see the very real and devastating effects that serious workplace injuries have on workers. And, the horrific impact of catastrophic work injuries on families. EVERY-SINGLE-DAY! Companies that repeatedly ignore safety regulations. Placing profits over people. These companies deserve to receive citations and penalties. In fact, they deserve the extra scrutiny that comes with the Severe Violator Enforcement Program.

When it comes to L&I claims, there’s so much disagreement regarding claim administration and processing. However, there’s one thing I think we can all agree on. Preventing work injuries is the single best outcome in the L&I setting. In my opinion, both employers and employees should take measures to increase workplace safety. We cannot tolerate willful safety violations. Personally, I am grateful for L&I for prioritizing workplace safety.

Self-Insured IME Exams: L&I Implements New Rules in Washington State

/ L&I attorney / 0 Comments

The Department of Labor and Industries (L&I) implemented new rules for self-insured independent medical examinations. In short, we call this exam a self-insured IME exam. These rules passed the legislative section during 2019-2020. I’m happy to share that the new rules officially kicked in on April 23, 2022.

Self-insured IME exams – The rules

There are several changes under the new regulations. The most significant updates are summarized below. The first change relates to IME scheduling and notices. Previously, self-insured claim administrators provided injured workers a 14 days notice before an IME. However, under the new rule, the new time window is 28 days.

The second major change has to do with the notice form. Moving forward, self-insurers must include a standard form to notify workers’ compensation claimants of an upcoming IME. The form is available on the L&I website (although I wasn’t able to find it). More importantly, the form mandates insurers to provide critical information to workers. For one, it has to include the reason for the IME request.

Disputing independent medical exams in self-insured claims

The third rule change focuses on IME disputes. Here, workplace injury claimants can dispute upcoming IME exams. Moreover, the worker’s attending provider can also dispute an IME. Either way, it’s important to file the IME dispute at least 15 calendar days before the exam. The dispute must specify the reasons why the IME is inappropriate. In turn, L&I may postpone the IME. Moreover, there’s a very interesting case when an IME exam is under dispute yet the claimant attends it. If L&I determines the IME was in violation of RCW 51.36.070, then the IME report can’t be part of claim administration.

No more infinite IME exams

The fourth area of change is around the number of IME exams. From here on, there’s a limit on the number of independent medical exams that self-insurers can request. The actual number depends on the underlying issues and the reason for the IME. For example, IME doctors can perform only one exam when contending a new medical issue. The purpose of the one-time IME is to resolve the new medical issue before issuing a final order.

The fifth and final change I wanted to cover is for case-progress IME criteria. This happens when self-insured claim managers request an IME for accepted conditions. More explicitly, L&I considers IME exams for accepted conditions as case-progress exams. Self-insurers can only request these exams when:

1) The worker is not receiving necessary and proper treatment; or

2) Treatment stalled without any real improvement to physical or mental conditions.

So – what’s next?

The new rules are fresh out of the over. They are so new that it isn’t clear how they’ll impact the claim administration process. However, I applaud L&I for adopting the new rules. Clearly, they help protect work injury claimants. The changes eliminate excessive and inappropriate IME requests. These unnecessary IME exams tend to impede and inhibit productive claim progress.

The L&I Double Standard: Workplace Safety vs Medical Coverage

/ L&I attorney / 0 Comments

I regularly applaud and give praise to the Department of Labor and Industries (L&I) when praise is due. In particular, I’m always impressed with L&I’s workplace health and safety programs. L&I dedicates tremendous resources to studying and improving safety for workers. Moreover, the L&I website contains helpful information for employers and workers alike. On top, people can sign up to health and safety newsletters. These email-newsletters comprise valuable and important information.

A recent L&I safety publication

Recently, L&I sent a newsletter with the subject “Be Kind to Your Neck and Shoulders”. It caught the attention of workers’ compensation attorneys like me who represent work injury claimants. The reason it caught our attention is because it lists causes of neck and shoulder injuries. However, the newsletter’s safety topics are ones that L&I often ignores when it comes to medical coverage.

L&I’s own guideline not covered by workers’ comp insurance

According to the publication “working with your hands overhead can cause neck and shoulder problems. Disposition can reduce blood flow to your neck and shoulders causing you to tire out quickly. Problems can begin after 30 minutes of overhead work per day”. I concur.

Now, say that workers perform overhead lifting only 30 minutes out of an 8 hour workday. That’s less than 7% of the day. Yet, according to L&I definitions, an activity that’s done for 1-10% of the day is a “seldom” activity. In my experience, when a person suffers a work injury from seldom activities, there’s higher likelihood for questioning causation. In fact, chances for doubting causation increase when L&I asks IME doctors to weigh in on causation.

Industrial insurance coverage in the L&I claim settings

I’m a workers’ compensation attorney representing work injury claimants. The L&I double-standard in this example is extremely frustrating to me. It appears that L&I acknowledges that 30 minutes of daily overhead reaching can result in shoulder injury. However, as it turns out, it only applies to safety procedures. It doesn’t apply to actual L&I claim coverage. I don’t think it’s fair. It would only be fair if L&I applies the same standard when evaluating causation for industrial insurance coverage.