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

Category: LNI Pension (Page 1 of 6)

Workers’ Compensation Vocational Rehabilitation – Who Gets Them and Why?

After a work injury, some workers may no longer be employable. To address this, the Department of Labor and Industries (L&I) can provide workers’ compensation vocational rehabilitation services. However, L&I doesn’t have to offer vocational rehabilitation. In fact, it’s up to L&I to choose who gets these services.


Who gets workers’ compensation vocational rehabilitation benefits?

In Washington State, the Industrial Insurance Act governs the workers’ compensation system. Under the law, some workers’ compensation benefits are entitlements. What does that mean? It means that L&I must provide these L&I claim benefits to workers when they meet certain conditions. For example, if a worker has temporary total disability, then L&I must provide time-loss compensation.


Another example is when workers require medical treatment. After a workplace injury, L&I must provide proper treatment for conditions that relate to the work injury. Whenever a work injury claimant has permanent partial disability, L&I must give a PPD award. However, if workers are unable to return to work, nothing mandates L&I to provide vocational rehabilitation services.


Who decides to give L&I vocational rehabilitation services?

There are many types of vocational services under an L&I claim. Early return-to-work in one example. Vocational retraining and vocational counseling are also important services. However, all workers’ compensation vocational rehabilitation benefits are discretionary. L&I decides who receives vocational services and who doesn’t.


Yet, on many occasions, L&I does provide workers’ compensation vocational rehabilitation. Interestingly, it’s up to the Director of L&I to decide who receives them. Although, on occasion, the Director of L&I can designate others to assist with these decisions.


Why does L&I provide vocational services?

If there’s no requirement for L&I to offer vocational services – why do they provide them? That’s a good question. The answer is – it boils down to cost. Say that L&I doesn’t provide vocational services to a work injury claimant. Then, ask yourself: Can the worker go back to work without receiving vocational benefits? If the answer is No, and if L&I denied vocational services, then L&I may be on the hook to provide them with an L&I pension.


L&I awards a workers’ compensation pension when the worker has permanent total disability. In fact, a workman’s compensation pension is one of L&I’s most significant monetary benefits. It’s a lifetime annuity. With an L&I pension, L&I pays the worker twice per month, for life. Therefore, it’s very costly (to L&I). Consequently, vocational benefits are one way for L&I to ensure employability. By doing so, L&I can avoid long term disability and pension payments.


What can I do if L&I doesn’t provide vocational services?

However, L&I sometimes declines vocational benefits. Unfortunately, if L&I decides to not award vocational rehab services, it’s nearly impossible to reverse their determination. The only way to change the decision is to prove that the Director of L&I abused their discretion. Then, to prove abuse of discretion, you must show that no reasonable person would make the same decision.


What if I receive workers’ comp vocational rehab services?

Some workers end up receiving vocational benefits from L&I. If you are one of those workplace injury claimants, then I strongly recommend you follow the below.


First, if you want to return to work and you receive vocational benefits – be thankful. Some L&I vocational programs are very good! In fact, my office often hires paralegals straight out of retraining programs.


Second, you must cooperate with your vocational service providers. Here, cooperation means you must meet with your vocational counselor and adhere to their guidance. You’ll have to provide them your education history and work experience. Moreover, they’ll expect you to collaborate and explore options to return to work.


Final takeaways

You must cooperate with vocational services. If you fail to cooperate, then L&I can suspend all benefits under your L&I claim. Don’t do it. It’s not worth it. Navigating the vocational process can be simple. However, in some cases, it can also feel confusing, hostile, and scary.


From my perspective, the most important thing is to fully engage in the process. If you want to return to work, then give it all you got. Workers’ compensation vocational rehabilitation can be an incredible benefit. Take full advantage of it. Pay attention to what’s happening around you. Track the actions and various recommendations throughout the vocational process.


Finally, as always, problem can arise along the way. For some, the vocational process seems hostile. For others, there can be lack of transparency. If that’s the case, it’s always a good idea to speak with a workers’ compensation attorney.



L&I Survivor Benefits After Death: How Does L&I Survivor Pension and Other Benefits Work?

After a work injury or occupational disease, workers with permanent total disability can receive an L&I pension. An L&I pension is like a lifetime annuity. Workers receive pension payments every month. Moreover, L&I pension benefits continue for the life of the worker. Sometimes, work injury claimants ask what happens after they die. Does L&I provide survivor benefits? Are there L&I death benefits? Will their family members receive an L&I survivor pension? Or, can workers pass their L&I pension to their spouse or children? In general, the answer is Yes. However, every situation is different. It always depends on the facts and details.


L&I survivor benefits when death is not related to the L&I claim

Say that the Department of Labor and Industries (L&I) gives you an L&I pension. Additionally, at the time you receive the pension, say that you have a spouse or domestic partner. Then, L&I will provide you with survivor benefits options. In fact, L&I sends you a form so you can choose the L&I survivor benefits you want. The form explains all the different options. It also details the financial implications of each option.


You, the injured worker, can select your L&I survivor benefits. The most common options are:

(1) Full survivor benefits

(2) Partial survivor benefit

(3) No survivor benefits.

In other words, the pensioner can choose to have all, or a portion of their pension benefits pass on to their surviving spouse. These options apply when the pensioner dies from causes unrelated to their L&I claim. Furthermore, when death that is not related to the claim, you can only pass survivor benefits to your spouse (or partner). You cannot pass them to your children or dependents.


Option 1: Full L&I pension survivor benefits

Let’s say you choose full L&I survivor benefits. Furthermore, before death, you receive a certain pension amount every month. The surviving spouse or domestic partner continues to receive the same amount after you die. This option is good for the surviving spouse. However, this option usually results in the lowest monthly payout amount. That’s because L&I stretches your pension payments over the remaining life of both you and your spouse.


Option 3: Partial L&I survivor benefits 

Now let’s assume the injured worker chooses partial survivor benefits. As before, the pensioner receives a certain monthly payout during their lifetime. Upon death, the surviving spouse or domestic partner continues to receive approximately 50% of the pension. Here, again, the payments continue for the rest of the spouse’s life.


Option 2: No claim survivor benefits

Work injury claimants can decline L&I survivor benefits. In this case, the spouse must sign and notarize an L&I option form. The form acknowledges that they understand and agree to not receive benefits after the pensioner’s death. Importantly, this option typically results in highest monthly payout. That’s because L&I only pays the pension funds over the life of the pensioner.


Survivor benefits when death is claim-related

Sometimes, a work injury or occupational disease is the cause of death. We refer to these cases as fatal claims. Fatal claims can occur when a worker dies while on the job. However, they can also happen later. For example, when an L&I pensioner dies from claim-related conditions.


Legally speaking, L&I survivor pension benefits for work injury cases that result in death are usually straightforward. While tragic, in most such cases, the work injury is the cause of death. With fatal injuries on the job, employers must report them to L&I. Alternatively, they can report them to the Department of Occupational Safety and Health (DOSH) within 8 hours. DOSH will prepare a fatality memo. Also, under RCW 68.50.103, if the cause of death is uncertain, then they must order an autopsy.


If a worker receives L&I pension payments and dies later, then L&I survivor benefits can be more challenging. That’s because you must show causation. In other words, there must be medical evidence connecting the cause of death to the work injury or occupational disease. Typically, you’ll have to hire a medical expert. Sometimes, it’s even necessary to get an opinion from a forensic pathologist. This entire process can be sad and frustrating for survivors.


How to apply for L&I survivor benefits

Surviving beneficiaries who want to collect L&I survivor benefits must submit a beneficiary application. For work injury, they must submit the L&I survivor benefits application within one year from the date of the death. The rules for occupational disease deaths are different. For those, you must submit within two years of receiving notice from a physician that death was due to an occupational disease.

When applying, you’ll have to provide additional documents. These documents include:

1) Marriage certificate or declaration of domestic partnership

2) A copy of the death certificate

3) Birth certificate for dependent children

4) Letters of guardianship or custody orders (when applicable)

5) For children 18-22 years old – Proof of full-time enrollment in an accredited school.


What happens after L&I approves survivor benefits?

After L&I approves survivor benefits, L&I makes a one-time payment upon death. The amount of this immediate payment is 100% of the average monthly wage in Washington State. On top, L&I provides burial benefits up to %200 of the same average monthly wage. After that, L&I pays monthly survivor benefits when due. The amount of the monthly payments varies. In fact, it depends on who receives the L&I survivor benefits. The payout amounts are different for spouses, children, or other dependents.


L&I survivor benefits payments to a spouse, domestic partner, or children

The first category of payments is when the survivor is a spouse or a domestic partner. Here, the L&I claim entitles the survivor to receive 60% of the worker’s wages. Furthermore, for reference, L&I calculates the worker’s wages at the time of injury. On top, there’s a statutory maximum limit. If 60% of the wages is greater than the statutory maximum, then payments are capped at the limit.


Sometimes, worker’s that die in fatal claims leave behind children. With surviving children, L&I pays an additional 2% of wages per child. This extra benefit also has a maximum limit. Here, the limit is up to 10% of wages. That’s equivalent to paying survivor benefits for up to 5 children.


Survivor benefits and L&I survivor pension for other dependents

On occasion, there is no eligible spouse or domestic partner. Yet, there are surviving minor dependents. In these unfortunate situations, L&I pays monthly survivor benefits of 35% of wages. As before, L&I calculates the wage rate at the time of the work injury. Also, it’s important to note that L&I makes the payments to the guardian of the minor dependents. Plus, the fatal L&I claim pays an additional 15% for every additional child. Once again, this is up to a maximum limit. In this case, the limit is set at 65% of the injured worker’s wages. Finally, if there’s more than one child, then L&I divides claim benefits equally among them.


Moreover, an L&I claim resulting in the worker’s death pays out benefits to other recipients. However, these recipients only qualify if they depended on the worker’s earnings. For instance, dependents such as parents, grandparents, or grandchildren. These dependents can also be brothers, sisters, nieces, and nephews. Here, dependents may receive a benefit equal to 50% of the average monthly support during the year before the injury. This L&I benefit limit caps out at 65% of the worker’s wage. Or, at the maximum benefit level. Whichever is less.


When will my L&I survivor benefits end?

For dependents, L&I payments for survivor benefit may end. More explicitly, L&I stops payments when the dependency naturally ends, had the injury not occurred. Also, for minor dependents, their L&I survivor benefits end when they turn 18. If they are full-time students in an accredited school, then it’s when they turn 23.


For spouses, or domestic partners, the L&I survivor pension benefit is an annuity for life. However, L&I terminates benefits when the surviving spouse remarries. Similarly, L&I stops payments when the domestic partner enters another partnership. When this happens, the surviving spouse or partner has 2 options.


Option #1 – they can choose to receive a lump-sum settlement payment. Either 24 times the monthly compensation, or 50% of the remaining value of the pension. Whichever is less. Or, option #2 – they can decline the settlement. With option #2, the spouse maintains their right to reinstate L&I survivor pension benefits when the new relationship ends. For example, when the new marriage ends because of death or divorce. Or, when the new domestic partnership is over.



In summary, spouses, domestic partners and dependents may receive L&I survivor benefits. These benefits start upon the death of the work injury claimant who’s eligible for an L&I pension. L&I survivor benefits vary depending on the cause of death. Some benefits are appropriate when the death relates to the workers’ compensation claim. Other benefits apply regardless. Furthermore, the extent of the L&I survivor benefits varies depending on the status of surviving dependents.


It’s important to remember that survivors must file an application for benefits. It’s critical to file the application on time. One year for death after a work injury, and 2 years for occupational disease deaths. Unfortunately, if you don’t file on time, you’re giving up all your rights for benefits.


Can I retire when I have an open L&I claim in Washington State?

Figuring out when to retire is always a big decision. Even if you don’t have an open workers’ compensation claim. However, retiring with an open L&I claim is even more complex. In fact, if you voluntarily retire while you have an open L&I claim, it can have serious impact on your L&I benefits.


Retirement during an L&I claim

The term Voluntary Retirement has a special meaning in workers’ compensation claims. Under WAC 296-14-100, you are “voluntarily retired” if:

  • You are not getting salary or wages from gainful employment; and
  • After your retirement, you don’t show any real attempts to go back to work.

Voluntary retirement can have negative effects on your L&I claim benefits. Specifically, under RCW 51.32.090(10), if L&I “determines that the worker is voluntarily retired and is no longer attached to the workforce”, then they won’t pay temporary total disability benefits. Moreover, under RCW 51.32.060(6), the same rule applies to permanent total disability benefits. That means, if a person voluntarily retires, they won’t receive L&I pension benefits.


Can I retire because of a work injury?

There are important nuances to the rules above. For one, a work injury claimant isn’t “voluntarily retired” when a proximate cause for their retirement is a workplace injury or occupational disease. What does it mean? If at least one reason for your retirement is directly because of your work injury, then your retirement isn’t “voluntary”.

Some people have severe disabilities because of their industrial injury or workplace illness. They can never return to work. These people may be eligible for an L&I pension. A pension is essentially a lifetime annuity. People that receive pension benefits under their L&I claim can also collect retirement money. Therefore, it’s usually better to make retirement decisions after L&I decides if you have permanent total disability.


Documenting your retirement reasons

However, delaying retirement isn’t always possible. Also, sometimes, it’s not practical. There are many reasons why people retire before L&I decides on permanent total disability. Unfortunately, in my experience, L&I usually assumes the retirement was “voluntary”. That is, if it happens while the claim is open and active. Yet, this assumption is often wrong. Many times, it’s not easy to decide if the retirement fits the legal definition of “voluntary retirement”. This is especially true when the retirement facts and circumstances are not well-documented.

Some people choose to retire while their claim is open. If the retirement has nothing to do with your work injury or disease, be ready to lose your time-loss benefits. Furthermore, you will not receive an L&I pension. But, if your decision to retire is based (at least in part) on the work injury or workplace illness, then you must document all claim-related reasons.


In summary…

If you retire with an open L&I claim, you’ll probably be giving up some benefits. You should seriously think about whether to retire while your workers’ comp claim is open. Make sure you understand the rules and consequences. I tried to explain some of the considerations in this article. However, retiring during an L&I claim is not a simple matter. Hence, I always recommend speaking with an experienced workers’ compensation attorney before making any retirement decisions.


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