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

Category: Medical Conditions (Page 14 of 19)

L&I Claim and IME Exams During COVID

Workers’ comp claim administrators can ask people with a work injury claim to attend an Independent Medical Examination (IME).  The IME exam is a standard procedure and an integral part of your L&I claim. This fact remains true during COVID.  The Department of Labor and Industries (L&I), self-insured employers and their third-party administrators continue to request IME tests during COVID. If a work injury claimant refuses to attend without good cause, they may receive a penalty. Here, penalties might include a missed-appointment fee or even suspension of benefits under the workers’ compensation claim.

 

Concerns for people with a workers’ comp claim

Many people with a workmans comp claim raised concerns about this issue. In fact, here’s a short list of question I heard people ask about their IME exam during COVID-19:

1. If I am “at risk” when it comes to COVID, or if one of my household members is “at-risk”, must I attend the test in person?

2. Say that I live in a county with low Corona-virus infection rate. Do I have to travel to another county with higher infection rate for my medical exam?

3. What if I have an L&I claim but I live outside of Washington State? Must I travel to Washington State and attend the IME in-person?

4. Are there telemedicine IME exams as an alternative?

5. I have an IME exam for my workers’ comp claim. Can I bring an observer with me to the test?

Overall, claim administrators have been reasonably accommodating (so far) during COVID. If a work injury victim has a valid reason for not attending an IME, then you can usually reschedule without penalty.

 

Valid reasons to reschedule an IME exam under your L&I claim

In my experience, L&I claim managers accept several reasons for rescheduling medical exams. For example, if you are at an age that’s higher risk for COVID complications. Also, if you have health conditions that can put you, or people that live with you, “at-risk” for Corona-virus complications. Moreover, another good reason is feeling unsafe leaving home or traveling to areas with higher infection rates. Finally, when applicable, feeling uncomfortable with interstate travel to attend an IME.

 

 

Virtual IME exam

Telemedicine is another alternative. L&I indeed permits online virtual IME tests through telemedicine.  However, as of the date of writing this article, L&I didn’t offer online IME exams to any of my clients. Therefore, I can’t say how successful such tests might be.

 

Additionally, it’s important to note that some medical panels refuse to allow workplace injury victims to bring an observer. This isn’t right because work injury claimants have the right for an observer, regardless of COVID. In fact, L&I recently reminded the IME panels that work injury claimants have this right.  Consequently, some providers now require people to call in advance if they plan to bring an observer.

 

Final remarks and notes

In summary, IME tests are occurring during COVID.  Often, workplace injury claimants with a good reason can request to reset the exam without penalty. On top, L&I authorized telemedicine IME providers as an alternative to attending in-person. Most importantly, if you have an L&I claim, know that you have the right to bring another person to observe the exam. You may need to let the IME panel know in advance, however that is your right!

 

If the panel doesn’t permit you to bring an observer, you should report the incident to L&I right away. If this happens, it’s probably a good idea to consult with a workers’ compensation attorney as well.

 

Medical-Only L&I Claim and Workers’ Compensation Claim in Washington State

Sometimes claims for workplace injury are called “medical only” claims. Often, work injury claimants do not understand what it means to have this kind of claim. Yet, it’s important to understand the difference between “medical only” workers’ compensation claim versus “compensable claim”. It is important because the type of claim impacts the benefits you might receive. Hence, if your L&I claim has the wrong type, then you might miss out on important benefits.

 

What is a “medical only” workers’ comp claim?

As the name suggests, when an L&I claim is medical-only, then L&I or the self-insured employer only pays for medical expenses. Therefore, you don’t receive other benefits such as time-loss compensation, loss of earning power, or permanent partial disability. You also can’t get total permanent disability or death benefits.  When a workers’ compensation claim pays out these other benefits, it is called “compensable claims”.

 

From my perspective, “medical only” claims are appropriate when doctors can treat the workplace injury or occupational disease quickly. Practically, this type of L&I claim works when there’s no interruption to your employment or wage-earning ability. For example, a workplace accident claimant who sustains a cut at work may need urgent medical attention. The person is rushed to the hospital to clean and bandage or suture the wound. If all goes well, the injured worker may miss less than a day of work. The injury will heal, and it will have no limiting impact on the worker’s ability to do their job. Under these circumstances, a “medical only” workers’ comp claim is appropriate. The insurance covers the medical expenses for the work injury. From here, there’s no need for other benefits under the claim.

 

Employer tactics under a workers’ compensation claim

People that suffer an injury at work should know that L&I provides incentives to employers with no claims (or with “medical only” claims). Businesses that prevent workplace injury occurrences earn a “claim-free discount” from L&I. Here, the condition is to not have a “compensable claim” during a 3-year period. Employer discounts range anywhere from 10-40% off the base rate for their business. Consequently, some businesses and employers go to great lengths to ensure zero compensable claims on record.

 

Some employers reduce compensable workers’ comp claim volumes by increasing workplace safety. Others provide employees with accommodations and flexibility to not interrupt the worker’s employment. I applaud such employers because it’s a win for both the worker and the employer.

 

Unfortunately, some employers try to limit compensable claims unfairly, to the detriment of the worker. In these cases, employers can argue that injuries are less significant than they are. Another strategy is when the employer creates a job to keep the work injury claimant working, regardless of their medical condition. For example, some people have been paid their regular salary to watch safety videos while recovering from injuries. This isn’t necessarily a bad thing, unless the employer has ulterior motives.  For example, when employees have a workers’ compensation claim, some employers work hard to find basis to fire the work-injury claimant for cause. When an employer fires a person with a workers’ comp claim for cause, they are not eligible to receive benefits like time-loss compensation benefits.

 

Summary and conclusion

To summarize, a medical-only workers’ compensation claim is appropriate after a simple injury at work. Remember, such workplace injury must not have long term impact on your physical abilities or future employment. However, if you suffered a more severe illness or injury, then the Industrial insurance Act (RCW 51) providers other claim benefits. Moreover, these other benefits are important when your work injury has real impact on your functioning and employability.

 

 

Construction Workers Comp Claim and Roadwork Injuries in Washington State

Anyone who recently traveled through Tacoma in Washington knows that there’s a major construction zone on highway I-5. The construction site is on the road near the Tacoma Dome. The local municipality reduced the speed limit through this area to 50 miles per hour (mph) because of the construction project. Additionally, police officers are assessing double penalties for drivers exceeding the work zone speed limit. Is that enough to prevent construction workers comp claim occurrences?

 

Driving slower to reduce construction work injury in Tacoma road projects

Recently, I noticed that the reader-boards along that area ask drivers to slow down to help construction workers. The city of Tacoma is trying hard to prevent work injury occurrences. Bright orange speed limit signs, penalty warning signs, and reader-board messages are spread across several zones. Sadly, from my observations, all these efforts are not successful. Drivers are not slowing down through this area in Tacoma. To make things worse, most drivers that go faster regularly express their despise to safe drivers. In fact, drivers that obey the new speed requirements draw the ire of local motorists and experience unfriendly tailgating.

 

Road construction work injury and workers’ death statistics

In the US, approximately 3 workers die from traffic-related motor vehicle crashes every day. These statistics come from the Center for Disease Control (CDC) and the National Institute for Occupational Safety and Health (NIOSH). If you think about, it adds up to over 1000 work injury instances that result in the death of the worker.

 

Interestingly, Washington State receives federal funding from NIOSH to track work-related deaths after traumatic work injury.  The program responsible for that data tracking is called the Washington Fatality Assessment and Control Evaluation (FACE). More information about work zone fatalities and the FACE program can be found on the Department of Labor and Industries (L&I) website.

 

According to FACE, motor vehicle accidents accounted for 21% of construction work death incidents in Washington State from 1998 through 2019.  These staggering statistics are for fatalities alone. They do not account for other serious non-fatal workplace injury accidents that happen on the road.

 

All drivers must help prevent roadwork injury and work accidents

To me, work zone speed limits are not an inconvenience or a suggestion.  These lower speed limits are necessary to protect road and construction workers. Consequently, the speed limit signs are there to prevent construction workers’ work injury and death. It’s important. We must do everything we can to prevent construction workers comp claims from happening.

 

In my posts, I often write about the importance of increasing workplace safety.  Frequently, I place that burden on employers. However, in this case it is up to us, the drivers, to prevent work accidents from happening. Road construction zones are one area where we must all do our part to make it less dangerous for road workers. That means slowing down and following signs and directions. If we all stay alert and attentive, we can prevent work injury and help keep our road workers safe.

 

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