Workers Compensation - Washington

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

Workers’ Compensation Claims and Structured Settlement

Have you ever heard the term “structured settlement” as it relates to workers’ compensation claims or L&I claims? Ever wondered if it might make sense for your case?

 

The Stages of an L&I claim or Self-Insured Employer Workers’ Compensation Claim

I often describe claims as having three phases:

(1) The open and active phase. This is when a claim is open and the injured worker is actively receiving treatment. Here, the goal of the treatment is to cure their condition or improve the overall level of disability;

(2) The employability determination phase. In this stage there is an assessment of the injured worker’s ability to return to work given their permanent limitations;

(3) Claim closure. I usually tell people that all claims must close (with a few very rare exceptions). However, the main question is how they close.

 

Workers’ Compensation Claim Closure

Typically, claims close in one of three ways:

(a) Simple claim closure. In this case, the injured worker completely recovers and returns to work at the job of injury;

(b) Permanent partial disability (PPD) claim closure. This is when an injured worker fails to make a complete recovery but is capable of working; and

(c) Total permanent disability claim closure. This happens when an injured worker is permanently incapable of returning to work.

The description above covers most common cases phases of L&I claims and workers’ compensation cases. However, in general, there is another option for claim resolution through a structured settlement or CRSSA. The Department of Labor and Industries (L&I) describes structured settlement as an alternative to monthly time-loss benefits. Under this outcome, the injured worker and L&I agree to a sum of money that is received as a series of payments over a relatively short period of time. It’s important to note that medical benefits may continue for industrially related conditions.

 

Conditions and Requirements

Certain additional conditions apply for structured settlement. If you are an injured worker over 50 years old, and you have an accepted claim that is at least 180 days old, then you may qualify. Under the right circumstances, a structured settlement can be a very satisfying way of resolving a claim more expeditiously. From my experience, structured settlements make sense for injured workers who have become frustrated or tired of the claim process. They are also suitable for injured workers who have alternative sources of income, and have concrete plans for their financial future.

 

In my opinion, however, injured workers should never enter into a structured settlement because they are frustrated or desperate to resolve a claim. Injured workers should never feel like a structured settlement is their only option. It is only one of many options available under the Industrial Insurance Act and it may involve giving up other benefits. I strongly urge injured workers to consult with an experienced workers’ compensation attorney before agreeing to a structured settlement. In addition, you must remember that before it becomes final, the Board of Industrial Insurance Appeals (BIIA or Board) must review and approve the terms of the structured settlement.

 

Additional Resources

If you are looking for additional information, you can check out the following L&I flow chart. This chart can help injured workers better understand the various steps and process. Also, keep in mind that following Board approval, there is a 30-day revocation period in which any party may revoke consent to the settlement for any reason. L&I will continue to administer the claim and provide benefits during the time the Board reviews the structured settlement. Claim administration and benefits also continue with the 30-day revocation period.

6 Comments

  1. Hi I was injured at work its been 5 months ago

  2. My husband just started working construction, so I wanted tips and advice in case he gets hurt at work. I didn’t know a PPD was a type of claim closure that states an injured worker is capable of working despite not making a full recovery. I’ll have to keep that in mind to find the right lawyer that has a vast knowledge of the law in our state, thanks to this post!

  3. Injured 2017 with a knee injury. 5 surgeries later with a TKA in 2018. I’m eligible for vocational retraining because my injury will prevent me from doing the physical job I used to do.. My disability rating is 50% percent lower right leg extremity …Do I automatically get the choice of a structured settlement or do I have to take the Voc retraining??

    • blank
      L&I attorney

      January 6, 2020 at 4:45 am

      Obviously due to the severity of your injury you are not capable of returning to work unless you are retrained. In my experience, sometimes retraining is a great option and sometimes it makes very little sense. It depends on your age and what the retraining goal is. If you think the retraining goal is unrealistic or sub standard, you should speak with an attorney. However, when you are eligible for a retraining plan you can choose to do the plan (this is called option1), you can opt out of the plan (this is called option 2), and/or you can apply for a structured settlement. In general, I try to steer folks away from Option 2 because I think it gives you very little in exchange for what you give up.

      • I had shoulder repair in 2004, I have been retrained two times. Been throught voc and everything. Was told new voc counseling was turning in papers for structure settlement as Im now 59 almost 60. Today received papers stating continue eligible for plan development for another voc svc spec for training plan. What would be my next step in thus matter. Thank you

  4. I have been on disability since July with my third work related knee injury. I am not sure if I want a third surgery and it was a big reason I chose to retire as I could not safely work as a firefighter, which the doctor stated in his report. I have received time loss benefits and am wondering what my next step should be.

    I can’t go back to my old job, so would vocational training or the 9 month settlement pay out be the better option? And would they be available? I’m not sure what I should do next.

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