Workers Compensation - Washington

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

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L&I Workers Compensation Claims and Acupuncture

Did you know that the Department of Labor and Industries (L&I) has an acupuncture pilot project? Until very recently, acupuncture as a treatment was not covered on L&I claims. Recently L&I decided to launch a pilot program designed to collect information about the use of acupuncture to treat low back pain, including treatment provided by East Asian Medicine Practitioners (EAMPs). During the project L&I will pay qualified providers participating in the project to provide acupuncture treatment to injured workers with low back pain that is related to an accepted condition under their claim.

 

For treatment to be covered, it must focus on helping inured workers heal and return to work. Furthermore, the treatment must be ordered by the attending provider (AP) and documentation must show clinically meaningful improvement in pain and function with the acupuncture treatment. If these conditions are met, up to 10 acupuncture treatments over the lifetime of the claim may be authorized. As treatment progresses, participating providers are required to use the Oswestry Disability Index and 2-item Graded Chronic Pain Scale score to assess the improvement in pain and function and send reports to the Department continuing this data.

 

As an attorney representing Washington State injured workers, I am very excited that the Department is finally exploring acupuncture as a treatment option under L&I claims. For years, acupuncture has often been recommended to assist injured workers in overcoming painful conditions and dependence on pain medications like opioids. However, injured workers were often disappointed to learn the recommended treatment would not be covered by the Department. It was not uncommon for me to represent individuals so desperate for pain control they were willing to cover the cost of acupuncture treatment out of pocket. However, for struggling injured workers, paying out of pocket is often not possible. In my experience, many injured workers have had very positive results from acupuncture.

 

Are you an injured worker that has been able to take advantage of the L&I acupuncture pilot project? If so, I’d love to hear from you about your experience.

Vocational Dispute Resolution (VRDO) – Disputing vocational decisions in L&I workers’ compensation claims

Continuing with vocational services articles for L&I workers’ compensation claims, yesterday I posted general information and thoughts about the Plan Development phase in vocational services. Today, I’d like to focus on disputing vocation decisions and Vocations Dispute Resolution (VDRO).

 

Vocational services in L&I claims

While vocational retraining can be a tremendous benefit under the right circumstances, I don’t believe enough emphasis is placed on a holistic analysis of the injured worker’s ultimate ability to become employed… Continue to read the full article.

 

Vocational Counseling in Workers’​ Compensation and L&I Claims: A Deeper Dive

Yesterday I posted a simplistic summary of vocational benefits. This is my typical way of trying to simplify and explain the general process. However, when L&I provides vocational services in workers’ compensation L&I claims, things become very dynamic. There are many moving parts. In fact, far more than I can capture in a simple summary. Vocational counselors and vocational counseling are part of these moving parts. Over the next few posts, I’m going provide a deeper explanation. More explicitly, I’ll dive into the various phases within the overall vocational process. Here, in this article, I’m going to focus on “Early Intervention”.

 

Vocational counseling and early intervention

From the viewpoint of the law, early intervention services are available in WAC 296-19A-050. There, it states that these services intend to help work injury claimants return to work. Or, continue to work for the employer of injury or the current employer. Early intervention services may include:

1) Discussing early return to work options with the employer, worker, and attending physician;

2) Identifying return to work goals and barriers that may interfere with or prevent the injured worker from returning to or continuing to work;

3) Assisting employers with offers of employment;

4) Planning and working with the referral source on necessary job modifications and pre job accommodations;

5) Performing job analyses; and

6) Assessing the injured worker’s need for preferred worker status and educating about that benefit.

 

Going back to work

L&I recently published the article “Getting Back to Work: It’s Your Job and Your Future”. In it, L&I states that getting back to work is a “team effort”. It involves the injured worker, attending provider, employer and the Department of Labor and Industries (L&I) to work together on returning to work. However, as an L&I attorney representing work injury claimants, I believe this is one of the biggest failures in the early intervention process. Rarely, if ever, do I see these entities working together towards a common return to work goal. More commonly, I see the members of this “team” working separately on issues most pertinent to them.

 

Vocational counselors drive their own agenda

This can be problematic for early intervention success. That’s because there are fee limitations for vocational counselors and early intervention services. The maximum is 20 hours of professional costs. Also, vocational counseling is only applicable once per claim. Then, extensions cannot exceed 12 weeks for graduated return to work. On top, they cannot exceed 4-6 weeks for work hardening.

 

During that time the vocational counselor will typically explore the following return to work options:

a) Graduated return-to-work by increasing the number of hours until the worker is back up to the work pattern at the time of injury;

b) Transitional return-to-work in a temporary job where vocational counselors expect the work injury claimant to be able to go back to the job of injury during early intervention;

c) Light-duty work in a job with less physical demands than job of injury; and

d) Temporary work in a job that isn’t ongoing.

 

Vocational counseling and counselors: Where is the alignment?

However, the team approach frequently does not occur. Consequently, workers are often surprised to receive an unexpected job offer when they are focused on other aspects of their workers’ compensation claim. This often creates stress and anxiety because injured workers feel isolated and alone as they struggle to figure out how to meet the demands of a job while simultaneously attending necessary medical appointments and meeting other claim related requirements. This is one place where injured workers’ representatives can make a big difference.

 

Conclusion

Many work injury claimants fees alone in this entire process. They are sad, angry, and frustrated. This is where resourceful representatives can help. Especially representatives that know how to address the issues that arise in early intervention. Good professionals can help effectuate the team approach. That is, assuming an early intervention return to work conversation is appropriate. After all, it all depends on the facts and circumstances of the claim.

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