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.
L&I has been mishandling my claim so much so that I filed a complaint with the Office of Civil Rights who is now involved. The thing is they are impartial and although they can tell me the rules and what should have happened vs what did- they can’t give any advice or guidance. I do not have an L&I attorney and am managing my claim myself. Can you sue L&I for civil rights violations? Negligent Tort? Slander?
Providers have called and cancelled appointments after they speak to my claim manager. One told me that L&I told them I was refusing treatment and another said they would not see me because they won’t prescribe narcotics. I dont take narcotics and have not taken narcotics for my work injury at any time so Im not sure why my claim manager told them that. L&I then sent a letter saying they would close my claim because they don’t have medical documentation. There are over 1500 pages of medical records in my portal including from my attending provider.
My doctors said I would get better with treatment but over a year later they now say I might never improve because I didn’t get timely treatment. I still don’t have treatment due to L&I.
Since L&I has been intentionally malicious is it possible to hold them accountable I court or is there someone else I should report them to? What kind of attorney should I be looking for to help me with this?
You cannot sue L&I for these kids of issues. The best way to handle this situation is to hire and experienced attorney that can work to ensure your claim is progressing the way it should, and that knows how to use the law to argue for your entitlement to benefits based on the medical evidence in your claim.