Category: LNI News (Page 9 of 22)

Work Injury and Workplace Accident Heroes: Nominate Workers That Saved Lives

A workplace can be dangerous. It can even be deadly. When disaster occurs, many workers respond heroically to help coworkers and others, and save lives. Nominations for work injury heroes are now open.

Coworkers rushing to save fellow employees in a construction work accident

I recently posted about the heroic efforts of several workers in a trench collapse at a wind farm near Rainier, Washington. The Department of Labor and Industries (L&I) cited and fined several employers for the incident. Most importantly, we must remember that several construction workers risked their own lives. Those brave workers jumped into the trench to try and rescue their fellow workers.

Police officers heroes save lives after public shooting

Similarly, three police officers were recognized in the news and other media outlets for lifesaving efforts in Des Moines, Washington. Very recently, on July 13, 2020 there was a shooting incident near a Metro stop in Kent, Washington, injuring six people. An off-duty Des Moines K-9 police officer, Doug Weable, was in his patrol car. The police dispatcher flagged him down to help. Immediately, the officer went to work using a shirt to apply a chest seal to 15-year-old victim. In parallel, Officer Weable directed a bystander to move another 16-year-old victim onto his side to aid in his breathing.

Two other officers, Johnny Tyler and Shay LaMarsh responded to the scene and used advanced medical training to assist with other victims. Luckily, these officers were trained in combat first aid alongside Army Rangers and Special Forces medics at Joint Base Lewis McChord near Lakewood, Washington. Consequently, following their quick actions, the officers saved the lives of the shooting victims. There’s no question that these officers acted heroically to save the life of others.

There are many work-injury heroes among us

While these officers received public credit, there are many workplace heroes that did not. For example, those fearless construction workers that helped after the trench collapse accident. However, that’s why every year, the Washington State Governor honors workplace heroes at the Governor’s Industrial Safety and Health Advisory Board (GISHAB). This year, the Governor is presenting the awards at the virtual GISHAB conference occurring September 21-25, 2020.

Workplace hero nominations

If you know of live-saving incidents that occurred between June 1, 2019 and May 31, 2020, then you can nominate your fellow workers. All workers of a state-funded or self-insured employers are eligible for nomination. Here, the most important nomination criterion is that a nominee performed hands-on aid. This is especially important for law enforcement officers, firefighters, and emergency medical technicians (EMT). To qualify for consideration, those and other similar professions must perform a lifesaving action beyond the call of duty.

This year, the deadline to nominate is July 31, 2020. Furthermore, the Governor will give out a humanitarian award to workers who tried to render lifesaving assistance to others, unsuccessfully. Workplace hero nominations can be submitted on the GISHAB website. Finally, the registration for the Virtual Governor’s Industrial Safety & Health Conference opens in August.

L&I and Workers Compensation Claim Fraud

/ L&I attorney / 4 Comments

The Department of Labor and Industries (L&I) takes L&I claim fraud very seriously. Under the Industrial Insurance Act, the letter of the law refers to fraud as “willful misrepresentation”. Under the law (WAC 296-14-4121) it says:

“[I]t is willful misrepresentation for a person to obtain payments or other benefits in an amount greater than that to which he or she would have otherwise been entitled. Willful misrepresentation includes making a willful false statement or the willful misrepresentation, omission, or concealment of any material fact.”

In fact, if L&I finds willful misrepresentation, they can demand repayment and assess a 50% penalty. If the willful misrepresentation is egregious, it can lead to criminal charges.

L&I claim fraud and scam

Recently, there was a story about a who pleaded guilty to a first-degree theft felony, in Renton, Washington. The man used his wife’s name and social security number to obtain work. He worked in multiple delivery jobs as a driver while collecting L&I time-loss and pension benefits. To receive pension benefits means he contended that he was incapable of working on a permanent basis. Moreover, in addition to the criminal sentence, he must repay $340K in benefits. Ultimately, this is one of the largest L&I scams in history. This story received a lot of media coverage.

Receiving time-loss or pension benefits under a workers’ compensation claim

A work injury claimant may not be able to work while recovering from an industrial injury or occupational disease. Therefore, to support injured workers during their recovery, they should get time-loss compensation. Here, to be paid, the time-loss compensation must be “certified”. Under a state-funded L&I claim, basic time-loss certification requires:

(1) Chart notes and forms from the attending provider, or the treating or consulting provider;

(2) An accompanying Activity Prescription Form (APF) from the examining provider; and

(3) A Work Status Form (WSF) completed by the workplace injury claimant.

Generally, L&I makes every injured worker complete a WSF approximately every 30 days. If the work injury claimant fails to complete a WSF, then L&I might stop time-loss payments. The WSF is the best tool that L&I employs to prove willful misrepresentation. Explicitly, the WSF specifically asks the work injury claimant if they are working. It is not ambiguous. In fact, the bottom of the form must be signed by the injured worker, as shown in the image below. Signing serves as confirmation that the form contains truthful information.

L&I claim fraud while on pension

If you receive pension payments because of your workplace injury, you must complete and file a form once a year. The name of this annual form is Declaration of Entitlement. Remember, when completing this form, it must also be notarized. The form clearly asks whether the work injury claimant worked since submitting their last declaration. If the form is not complete within 30 days of its due date, L&I may suspend pension payment.

Final remarks

To summarize, dishonest people can hide work activity while collecting time-loss compensation or pension payments. Consequently, they are causing real and measurable damage to the workers’ compensation system. This behavior is unspeakable and is not tolerated. As L&I said in a recent announcement, this kind of willful misrepresentation is not a victimless crime.

Fraud in workers’ compensation claims and L&I claims hurts honest people trying to get better after a work injury. Recall, employees (and employers) pay L&I insurance premiums out of their pocket. They (and other stakeholders) are obvious victims. And, with that in mind, it’s important that victims of workplace accidents must be honest about their work status. That way, the system can continue to help those who really need help and assistance.

L&I Cost of Living Adjustment (COLA) and the Washington State Accident Fund

/ L&I attorney / 0 Comments

The Department of Labor and Industries (L&I) recently announced the 2020-2021 benefits schedule. Every year, around July, L&I determines if a Cost of Living Adjustment (COLA) applies to workers’ compensation benefits. Sometimes COLAs are not applied. However, this year, there are adjustments to monetary benefits.

Cost of living adjustment under an L&I claim

In short, L&I benefits are going to increase by a little over 6% this year. This is a historically high increase. Last year, the cost of living change of 5.5% was also historically high. COLAs are based on the average annual wage of all workers in Washington State. In order for the increase to be over 6%, average annual wages of employees must also increase in a similar amount. For work injury claimants, this news could not come at a better time. If you would like to review more information about the COLA this year, please refer to the 2020-2021 Benefits Schedule.

However, we must also think ahead considering our current reality. Businesses, workers and employees have been severely impacted by the COVID-19 pandemic. Consequently, unemployment rates are very high. And, many businesses have been forced to close. Some of those closures are temporary. However, many are permanent. This is especially true in certain industries such as hospitality and retail. Both are industries that previously employed many workers. The Corona virus is going to negatively impact our economy for quite some time.

What is the L&I accident fund?

The Department of Labor and Industries administers the Accident Fund. Say that you had a workplace injury. Moreover, say that you are receiving payments and financial benefits under your workers’ compensation claim. Then, it’s important to know that the money is coming from the Accident Fund.

Previously, economic downturns had negative impact on the financial health of the Accident Fund. Specifically, during economic waves in the early and mid-2000s, Washington State businesses experienced L&I rate increases. In other words, employers had to pay higher worker’s injury insurance rates towards the fund. In 2003, the rate increase was an astonishing 28.8%.

Starting in 2007, we saw four straight years of L&I rate increases. Unfortunately, these rate increases were necessary. Businesses received significant rate rebates that left the Accident Fund nearly empty. In fact, there were $200MM in workers compensation rebates for employers in 1999 and 2000, and $315MM in rebates in 2007. It isn’t a coincidence that L&I rates had to increase after those employer rebates.

L&I workplace injury insurance rates in Washington State

The employer rebates depleted the Accident Fund. Therefore, L&I implemented an increase to the work injury insurance rate to repair it. Business and labor stakeholders on the Worker’s Compensation Advisory Committee (WCAC) decided to do something about it. Explicitly, the WCAC established targets to ensure that the reserves in the Washington State Accident Fund will be sufficient to withstand the next recession. Thanks to COVID-19, that next recession is already knocking on our door.

Currently, the Accident Fund is healthy enough to sustain the upcoming recession. Interestingly, recent forecasts estimate that the Washington State government faces $8.8B revenue shortfall through 2023. That kind of shortfall is going to require cuts. Because the Accident fund is healthy, the workers’ compensation system is going to be an easy target for tax cuts. Therefore, now more than ever, it’s important to focus and monitor the financial health of the Accident Fund.

Cost of living adjustment: Viewpoint of a workers’ compensation attorney

Our (currently) healthy workers’ compensation ecosystem provides a critical safety net for working families. That safety net prevents financial ruin when catastrophe strikes. For that reason, we must actively resist the kinds of Accident Fund depletion that we saw in 1999, 2000, and 2007.

As a society, we cannot afford to empty this workers’ compensation insurance fund and hope to save it with rate-increases later. For more information about this issue, please read this recent article. It was written by The Stand, which is a publication for workers in Washington State.