Lately I encounter more and more conflict in L&I claims. What I mean by conflict, in the context of this article, is disagreement over work injuries that results in litigation. I attribute the increase in L&I claim conflicts to the Retrospective Ratings program.

 

What is Retrospective Rating program?

According to The Department of Labor and Industries (L&I) the Retrospective Rating program is a safety incentive for employers to reduce the amount of workplace injuries.  Additionally, employers can earn a partial refund of their workers’ compensation premiums. Refunds are available whenever claim costs are lower than expected. L&I calculates employer premiums either 10 months after the coverage period ends, or retrospectively for that 12-month period.

 

L&I created this program to promote workplace safety and lower work injury and accidents. However, it is entirely inconsistent with what workers’ compensation is all about. Workers’ compensation, by definition and by law, is there to provide relief for people with a work injury, without questions of fault or negligence. Instead, the Retrospective Rating program only weakens the most basic principles of workers’ compensation. Furthermore, it created a new set of conflicts in workers’ compensation claims.

 

Retrospective employers and retrospective groups

Under Retrospective Ratings, employers and employer groups hire legal representatives to prevent work injury claims just to keep work injury claim costs low. I recently see an increase in client calls from people with work injury dealing with employers that are forcing them into litigation. In turn, work injury claimants must hire a workers’ compensation attorney and legal representation and mount expensive legal battles just to get their workers’ compensation claim allowed. There is nothing here that increases work safety or reduces work injury occurrences.

 

Employers taking advantage of retrospective groups

One retrospective group advertises that they secured over $600 million in premium refunds for its 1000 employers. Another group has a picture of a work injury claimant on the beach as their cover photo. Others advertise that they assist employers in reducing the number of L&I claim incidents and costs. While some groups appropriately focus on helping employers achieve safe work environments, others could not care less about this objective.

 

While employers are enjoying things like ~$600 million in premium refunds, victims of a work injury are suffering. These days, L&I will reject a claim because the retrospective ratings employer or group convinces them to do so. It can cost work injury claimants $2500-$5000 just for expert medical testimony to prove the decision is wrong. Most people that suffer an injury on the job cannot afford this, and the Department rejects their L&I claim. They are often left on their own to try and obtain treatment and recover from their occupational disease or industrial injury.

 

Summary

The Retrospective Rating program missed its mark. Rather than incentivizing employers to have safer workplaces, it encourages them to engage in sanctions and L&I claim suppression.  From my perspective, with programs like the Retrospective Raring program, L&I is failing in its duty to provide sure and certain relief to work injury victims.