Category: Retraining Vocational (Page 1 of 5)

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.

Vocational Recovery and Early Return to Work After a Work Injury

/ L&I attorney / 0 Comments

Some people can recover quickly and return to work after a workplace injury. For me, that’s the best L&I claim outcome. However, these are two separate topics. I genuinely believe that they must go together. First and foremost is the recovery. Then, it’s all about returning to work.

Return-to-work program

Sometimes, I worry that the Department of Labor and Industries (L&I) is cutting corners. I’m concerned that they lost sight of the importance of recovery. Instead, it feels like L&I focuses on early return to work. That’s because of academic studies. More specifically, they researched the length of time before returning to work.

If more time passes, it’s more likely that work injury claimants suffer longer term disability. Personally, I believe that if more time goes by, it’s certainly harder to start working again. However, I don’t think it’s a good idea to return people to work without proper recovery.

Vocational counselors and early intervention

It’s obvious that L&I is trying to return work injury claimants to work as quickly as possible. Evidently, they started assigning vocational counselors to claims earlier. Before, we used to call this “early intervention”. But now they call it “vocational recovery”.

Vocational counselors work with employers during the vocational recovery phase. They collaborate to get the injured worker back to work fast. Usually, the employer must decide if light duty or modified duty work is available. In other words, they consider any jobs that people can do within their activity prescription according to the attending provider.

Light duty job and modified duty jobs

Employers receive financial incentives from light work or modified duty work. In my experience, some employers are surprised to learn about these incentives. When they do, they find accommodating options. Even when they previously said none were available.

Light duty work doesn’t have to be a job that’s generally available in the workforce. Unfortunately, to take advantage of incentives, L&I permits employers to create jobs that don’t really exist. For example, one light duty job was having workers watch safety videos the entire day. Ridiculous, isn’t it?

Made-up light duty job offers

Often, Work injury claimants often receive offers for light duty work they never expect to do. For instance, additional examples for light duty jobs include polishing silverware and dusting computer equipment. I’ve also seen workers scanning documents and greeting customers all day long.

Don’t get me wrong. There are cases where light jobs or work modifications serve the purpose perfectly. They keep work injury claimants attached to the workforce during recovery. Moreover, they help maintain good employer-employee relationship through the recovery process. However, sometimes these light or modified jobs are insulting and impractical. They can even interfere with getting proper treatment and recovery.

Is this helping injured workers?

When workers perform impractical jobs, it leads to frustration, stress, and anxiety. Furthermore, it doesn’t help the relationship between the employer and the worker. Consequently, it delays recovery. Many work injury claims report various degrees of retaliatory treatment.

Some clients tell me that they brought such issues to their vocational counselor and claim administrator. However, they weren’t given any serious consideration. What’s more, some work injury claimants decide to not accept a light duty or modified job. But then, they close their vocational recovery services. After that, L&I also stops paying time-loss benefits.

Summary and wrapping up

The vocational recovery program and early return to work can be wonderful. However, it doesn’t apply to everyone. We must advocate for proper light duty assignments. Otherwise, early return to work can be unfair to work injury claimants. When improper, it can easily impede and delay the recovery process.

Closing L&I Claim: Do I Need an Attorney?

/ L&I attorney / 6 Comments

I get calls from work injury claimants often. The #1 reason they call is because their L&I claim is closing. Also, the same goes for self-insured employer claims in Washington State. L&I claim closure can be very stressful. To help, I put together this checklist below. You can use it to check for any red flags. If there are some, I strongly recommend you consult with a workers’ compensation attorney.

L&I claim closure and maximum medical improvement (MMI)

Your L&I claim cannot close before you reach maximum medical improvement. Again, the same applies to self-insured employers. Maximum medical improvement is sometimes calls medical fixity. You achieve it when there’s nothing more that doctors can do for you. Unfortunately, it doesn’t mean you’re healed. In short, it means that doctors don’t think you’ll get better with more medical treatment. Yet, many times, it’s unclear if you’re at maximum medical improvement. After all, it’s a doctor’s opinion. Therefore, it’s possible your claim is closing while your medical provider thinks you need more treatment. If that’s so, then it’s a red flag. You definitely want to contact an attorney.

Future employment issues

L&I must address future employment concerns before a claim can close. For example, if you have total disability. That’s one example where L&I can’t just close the claim. At very least, they have to pay for your disability. Total disability means you have physical or mental impairment. It impacts your ability to find or maintain a job. Any type of job within your skills. Not only the job at the time of your work injury. However, total disability doesn’t mean you’re helpless.

L&I has to evaluate and decide if you’re employable. For that, they consider your age, education, skills, and training. They also consider your experience and any previous limitations. Furthermore, they take into account limitations from your work injury. One way for L&I to resolve total disability is with L&I pension. Therefore, you should think if you have total disability. If you do, and if your claim is closing without pension, then call an attorney.

Permanent partial disability

We refer to permanent partial disability as PPD. Some work injuries or occupational diseases cause permanent conditions. For example, a loss of body function can be permanent. L&I has methods to assess your level of PPD. On top, there are several evaluation techniques. For assessments, a PPD rating medical expert must examine you. Many times, an IME performs the PPD rating. Other times, the attending provider can perform the PPD rating. After the rating, L&I decides the amount of your PPD award. One red flag is when you have permanent limitations without PPD rating. Or, when your rating seems low considering your symptoms. Another red flag is when you don’t receive a PPD award. Finally, it’s possible that some doctors disagree with your PPD rating. All these cases are red flags. It’s important you talk to an attorney.

Unresolved problems in your L&I claim

Some L&I claims start to close when there are ongoing issues. That’s a red flag. For example, closing a claim while there are time-loss compensation payment problems. On top, closing a claim with outstanding medical bills. And so on. You know your claim. You can tell if there are any lingering issues. If there are, then it’s critical to resolve them before the claim closes.

L&I claim closing when it should

There are plenty of cases with no red flags. Very often, L&I claim closure is appropriate. However, improper claim closure is also common. When you L&I claim closes, then L&I sends you a letter. If your claim closed and you didn’t receive a letter, then you must speak with an attorney. Usually, the closing letter contains a payment order or notice of decision. After that, the decision becomes final in 60 days. This means you have 60 days to protest or appeal. Personally, I always think it’s a good idea to talk to an L&I attorney if your claim is closing. You can always receive free information and tips that can help.

Reopening L&I claim

Say your L&I claim closes inappropriately. Now, you can appeal and fight claim closure. If successful, L&I will keep the claim open and work to resolve the remaining issues. However, say your claim closes after they fix all remaining problems. In this case, you can still reopen your L&I claim in the future under certain circumstances.

Reopen L&I claim after it closes

These are certain requirements for reopening a claim. They are:

1) There must be an aggravation. This means that a condition in your claim got worse. More explicitly, for physical conditions, there must be objective medical findings. A doctor has to determine that your work injury condition deteriorated. In addition, you must show some medical tests to support the doctor’s opinion.

2) The aggravation requires more medical treatment or justifies higher disability rating.

3) The aggravation occurs between two specific dates. The first date is when the claim closed. It can also be the last date when L&I denied an application for reopening. Then, the second one is the most recent reopening application date.

Reopening due to new medical conditions

Sometimes, L&I can reopen a claim when a doctor finds new conditions. The conditions must relate to the workplace injury or work illness. This is true even if the condition wasn’t known prior to claim closure.

The 7 year L&I claim reopening rule

Many work injury claimants reopen a claim within 7 years of claim closure. If that’s the case, all L&I claim benefits may be available after reopening. This includes medical treatment, time loss compensation, and loss of earning power. On top, it includes increase in PPD, and even L&I pension benefits. But, if you reopen a claim after 7 years, you can only get more treatment. Unless the director of L&I grants you other benefit under their discretion.