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Work Safety and L&I Claim for Fire Fighters Dealing with Fire and Smoke

The Department of Labor and Industries (L&I) has good news for fire fighters and others that expose themselves to fire smoke. Explicitly, Washington State will be among the first states to develop health and safety rules to protect wild fire workers in their jobs. This article covers fire fighter L&I claim issues and special considerations.

Fire fighting and air quality

Wild fire occurrences increase every year. Sadly, over time, the entire West Coast is losing more land and woods to fires. Therefore, every fire fighter in the fire department has greater exposure to more unhealthy air quality during wild fire season. In fact, fire smoke during September 2020 caused some of the worst air quality in the world in Western Washington. The poor air quality lasted a long period of time. As a result, the authorities encouraged residents to stay indoors and avoid breathing the toxic air.

Unfortunately, outdoor workers cannot stay inside to avoid the bad air. If you are a construction worker, mail carrier, farm worker, or firefighter, you must be outside to perform your job. Moreover, we have to consider that wild fire season aligns with harvest time for many crops in Washington State.

Fire fighter L&I claim: Exposure to fire, smoke and chemicals

According to studies, long exposure to this kind of toxic air causes acute health conditions and occupational diseases. The hazards include more than the smoke alone. Fire fighters, for example, expose themselves to not only to fire smoke but also to chemicals and gases. Many other workers also deal with fine particles in the air that can lead to significant health issues. These health effects are expensive, both in terms of treatment costs and lost work time.

Last September, outdoor worker and advocates accused employers (and the government) of not doing enough to protect them from fire and smoke. In response, L&I took steps recently to begin drafting rules to remedy the situation. Here, the goal for L&I is to develop clear health and safety regulations for identifying and controlling harmful exposures. Thus far, we know that the regulation will also include the use of personal protective equipment (PPE).

Conclusion

Personally, I’m proud to share that Washington State will be the second state to develop these safety rules and regulations. Consequently, L&I will work closely with fire fighters and other stakeholders to ensure the new rules are on point. Like always, there will be opportunities for the public to provide comments and weigh in as well.

L&I Claim Medical Aid Rules and Fee Schedule

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With an L&I claim or workers’ comp claim in Washington State, it can be very difficult to understand treatment payments, policies, and procedures. This is a big problem for L&I medical providers in the provider network (or MPN) and for people that have a work injury claim. For doctors, it’s challenging to know which billing codes to use. On top, it’s hard to tell the rates that the Department of Labor and Industries (L&I) pays for services. Finally, it’s unclear if and what services require pre-authorization.

L&I resources for medical questions

L&I created resources to address the challenges mentioned above. Unfortunately, many medical providers as well as work injury claimants don’t know that these resources exist or where to find them. Yet, questions about medical billing and fees arise in every workers’ compensation claim.

The L&I treatment policies are available in the Medical Aid Rules in chapter 296-20 of the Washington Administrative Code, or WAC in short. Reading or referencing the WAC can be frustrating and time consuming. After all, it’s code that people use mostly for legal purposes. Furthermore, not everyone is familiar with the administrative code writing style and language.

The L&I fee schedule reference

Fortunately, L&I has some useful and user-friendly tools on its website. For example, L&I publishes its annual Payment Policies and Fee Schedules, by year. One of the resources within these publications is a Quick Reference Card. Interestingly, this card contains the most common and frequently used codes. However, for services that are not available in the Quick Reference Card, there are several ways to find the fee schedule and payment policies.

Billing code lookup in an L&I claim

If you know a billing code, then L&I has a Fee Schedule Lookup tool that you can use. Here, simply enter the code and a box appears outlining coverage, fees, and authorization requirements. For example, for billing code 10004, we get the following information from the L&I website.

Even better, in cases where you must obtain pre-authorization, you can click the link that writes “Yes – Claim Manager”. After that, it redirects you to the pre-authorization form that you’ll have to use. Finally, it’s worth noting that many providers find it surprising that many treatments and services do not require pre-authorization.

L&I Claim and Workers’ Compensation Claim in Washington State: Common Mistakes and How to Avoid Them

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As a workers’ compensation attorney, the most common question I get is: “What mistakes should I not make in my L&I claim?”. There is no easy answer for this question. Interestingly, while there’s a clear definition for potential L&I claim benefits, there is no list of potential pitfalls.

Every L&I claim is different

Generally speaking, the administration process for every workers’ compensation claim in Washington State follows certain administrative codes. However, every claim is individual and different. Every work injury or work-related disease has its own challenges. Similarly, every claim outcome is ultimately unique to the person that suffered the work injury. However, from my experience as an L&I attorney, here are a few tips I can offer for avoiding common mistakes and keeping your workman’s comp claim on track.

Use common sense to avoid L&I mistakes

Throughout your L&I claim process, you will need to make many decisions and response to communications. Therefore, it’s very important to use common sense. You should do what is logical. Frequently, I see that people get very anxious and worry about not messing up their work injury claim. Meanwhile, they forget to be logical. You must avoid this common mistake. If it helps, take a step back and think about the big picture. If you use common sense and remain logical, that’s probably the easiest way to keep your workers’ comp claim on track.

Recovery first

The first and most important thing in an L&I claim is to focus on your recovery. Let’s be honest: Whether you got hurt on the job or developed an illness at work, you want to recover. Nothing is more important than your health. Realistically, if you let other claim issues get in the way, it can distract or even derail your path to recovery. I sometimes see work injury claimants prioritize the handling of their claim over their personal health, which may lead to unfortunate outcomes.

L&I mistakes: Pay attention

It’s extremely important to pay attention to everything that is going on in your workers’ compensation claim. I am well-aware that keeping track of all the small details can feel like a full-time job. However, it’s not helpful to ignore certain steps or bury your head in the sand. In fact, it’s necessary to know what’s happening in your claim so that you can follow through and take appropriate actions. Monitoring your L&I claim progress will also help you spot red flags early. It’s critical to read notices and decisions from the Department of Labor and Industries (L&I) and address any issues while you still have time.

Ask for help

Most importantly – don’t wait too long to ask for help. Many work injury claimants may never need help from an L&I attorney. However, that isn’t true for everyone. If certain issues arise in your claim, then don’t delay asking for help. Specifically, if an issue in your case is heading to the Board of Industrial Insurance Appeals (i.e., BIIA or Board), it is advisable to speak with a workers’ comp attorney immediately. Appeals before the Board have timelines and certain litigation schedules. Waiting too long to contact an attorney can make it difficult for any lawyer to get involved. Remember, your attorney will need time to get up to speed or to provide meaningful advice. Moreover, if you are looking for a workers’ compensation attorney, it’ll take them time to prepare a winning case.

Final comments

In summary, when you have an L&I claim, there’s no concrete list of black and white rules to follow. However, I always recommend people to remember the key principles above. Use common sense and focus on recovery. Over time, follow closely and pay attention to what is happening in your claim. Finally (and arguably most importantly), do not delay asking for help.

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