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

Category: Medical Treatment (Page 35 of 36)

L&I Threatening to Close Injured Workers’ Claims

If you follow my updates on Workers’ Compensation issues in Washington State, you know that over the past two months I’ve written several posts outlining some of the difficulties injured workers face when trying to obtain new attending physicians within the Medical Provider Network (MPN). To recap, I find it incredibly problematic that injured workers, especially those with older or more complex claims, have extreme difficulty finding MPN providers willing to become attending physicians.

 

This week my feelings regarding this issue have progressed from frustration to outrage. The reason for my outrage has to do with RCW 51.32.110 and WAC 296-14-410. Under these laws, injured workers who are deemed to be non-cooperative may have their claims suspended and benefits stopped. Non-cooperation is when an injured worker and/or their representative obstructs or delays the progress of the claim. RCW 51.32.110(2) specifically identifies behavior that is considered non-cooperative: (a) refusing to submit or obstructing medical examination, (b) persisting in unsanitary or injurious practices which tend to imperil or retard recovery, or (c) refusing to submit to medical or surgical treatment reasonably essential recovery or refusing or obstructing evaluation or examination for the purpose of vocational rehabilitation or not cooperating in reasonable vocational rehabilitation efforts.

 

Nowhere in the statue does it indicate an injured worker should be considered non-cooperative, have their claim suspended, and their benefits stopped because they cannot find a willing attending physician. Yet, in two separate cases involving injured workers I represent, this week the Department of Labor and Industries (L&I) has sent letters threatening to find the injured workers non-cooperative because they cannot find willing attending physicians.

 

This kind of punitive behavior on behalf of L&I is a travesty and an injustice to injured workers. The Department of Labor and Industries should be ashamed this kind of claims management practice exists. I will certainly be addressing the inappropriateness of this practice under the Industrial Insurance Act.

Injured Workers Trying to Find Attending Physicians

Last Friday, my work week ended on a familiar note. Trying to reassure injured workers who can’t find attending physicians (APs). In my opinion, we have a real problem in Washington State finding willing APs. Particularly for older L&I claims or for injured workers with multiple claims.

 

The law allows injured workers to designate an AP of their choosing. This is important since an injured worker needs to be comfortable enough with their AP to place full trust in that provider and their medical advice. Having multiple providers decline the AP role is upsetting for injured workers. When the Department of Labor and Industries starts sending letters directing them to designate an AP, the situation only gets worse.

 

Attorneys should not meddle in the patient physician relationship, so I don’t have a list of doctors in my hip pocket ready and willing to do my bidding. However, when a workers’ compensation claim is in jeopardy, I think it is my responsibility to write letters, forward medical records, and even meet with doctors to help my clients obtain APs. If the matter ends up in litigation, certainly the question will be asked about whether I had any hand in my client establishing care with a particular physician. After conversations like the ones I had today, there are simply no alternative but to do what is best for my client.

L&I Medical Providers and Personal Experiences

Ever since January 2013, any medical providers treating injured workers in Washington State have been required to be part of the Medical Provider Network (MPN). This includes physicians, chiropractors, naturopathic physicians, podiatrists, ARNPs, PAs, dentists and optometrists.

 

Over the past few days I’ve spent some time introducing myself to local MPN members that treat the injured workers I represent, and it has been a wonderful experience. I have really enjoyed meeting other professionals who are equally committed to helping injured workers successfully navigate through their claims.

 

What I’ve learned from these conversations is that I share many of the same concerns, frustrations, and challenges as the medical providers treating injured workers. As a result, I’m looking forward to continuing collaborative dialogues with these providers in an effort to find solutions for our shared concerns, frustrations and challenges, as we work together to achieve productive claim progress and appropriate outcomes for the injured workers we help.

« Older posts Newer posts »