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What Is Workers’ Compensation?
Workers’ compensation is a state insurance program for workers who sustain either an industrial injury or an occupational disease while working. This is a no fault system allowing workers to obtain certain benefits without regard to fault.
How Long Do I Have to File a Claim for an Injury or Occupational Disease Sustained on the Job?
For injuries you have up to one year from the date of injury to file a claim with the Department of Labor and Industries. For occupational diseases, you have up to two years to file a claim following the date you receive written notice from a licensed physician or advanced nurse practitioner that you suffer from a disease or infection which arose out of the distinctive conditions of your work.
What’s the Difference Between an Injury and an Occupational Disease?
An injury is defined as a “sudden and tangible happening producing an immediate and prompt result.” Injuries occur at a specific time and place although it isn’t necessary that they occur instantaneously. An occupational disease on the other hand is “a disease or infection arising naturally and proximately out of employment.” Unlike injuries, occupational diseases and infections tend to occur over time. Examples of occupational diseases include carpal tunnel syndrome, conditions resulting from chemical exposure, and asthma caused by smoke and dust inhalation in the workplace. The benefits for injuries and occupational diseases are the same.
What Benefits Are Available Under Washington’s Workers’ Compensation?
The benefits provided under Washington’s laws are limited to medical treatment, wage-loss compensation, permanent disability awards, and vocational assistance. The most common benefits are medical treatment and time-loss benefits. Time-loss and loss of earning power benefits are wage-loss benefits that provide a percent of your income in the event that you are unable to perform your regular job because of your injury. Where the injury or disease coupled with vocational factors such as age, training, and experience render the worker unable to successfully return to work, monthly pension benefits may be available.
Do I Need Medical Support from a Medical Professional in Order to Receive Benefits?
The injured worker must obtain certification from an attending provider certifying that there is a diagnosed condition, caused by an industrial injury, which is in need of further curative treatment. An attending provider includes those licensed to independently practice one of the following: medicine and surgery; osteopathic medicine and surgery; chiropractic; naturopathic physician; podiatry; dentistry; optometry; and advanced registered nurse practitioner.
Can I Go to Any Doctor of My Choosing for Treatment Under Workers’ Compensation?
Some doctors opt not to treat injured workers for a variety of reasons. The Department of Labor and Industries has a network of providers who provide care for injured workers. This list of providers changes regularly and a current list can be found at: http://www.lni.wa.gov/ClaimsIns/Providers/ProjResearchComm/ProvNetwork/. You may also call for providers at (360)902-6823.
Who Decides Whether I Receive Benefits or Not?
Claims are either administered by the Department of Labor & Industries or by Self-Insured employers. Certain employers who apply and qualify to administer their own claims must abide by the rules established by the Department of Labor and Industries. The Department maintains a self-insured employer division whose sole purpose is to ensure the proper administration of worker’s compensation claims. For more information on the self-insured section go to www.lni.wa.gov/selfinsured.
What Can I Do If My Application for Benefits Is Denied?
If you receive an order rejecting your claim, you must protest the rejection in writing within 60 days by filing a protest with the department or an appeal to the Board of Industrial Insurance Appeals. The 60 day period begins tolling from the date you receive the notice of denial.
What Happens If I Can’t Return to the Work I Was Doing When I Was Injured?
If you are unable to return to your job, and if your employer is unable to offer a position that you are capable of performing, the Department or Self-Insured employer will need to determine whether or not you are capable of returning to some other kind of continuous gainful employment. If the worker is found to be incapable of returning to the job he was performing when injured, the Department may complete a vocational report assessing whether or not you would benefit from vocational training for some other line of work.
What Happens If I Can’t Do My Original Job but Am Still Capable of Working a Lighter Job?
In the event that you cannot return to the job you were performing at the time of your injury, but are able to perform lighter job for less pay with the employer at the time of injury, you may be entitled to what is called “loss of earning power” (LEP) benefits. If a reduction in your wages is more than 5% and you’ve been released by your doctor to perform lighter work, you may be eligible to receive a percent of any difference in pay between wages paid for reduced work and wages paid at the time of injury.
Can My Employer Fire Me for Not Being Able to Work After I’ve Been Injured?
Washington is an “at-will” employment state meaning an employer can fire you or let you go for any reason or no reason at all, so long as the reason is not for discriminatory or retaliatory reasons. Washington has protections in place that prevent an employer from firing an employee solely because the worker filed an industrial injury claim. If you have reason to believe you have been fired because you filed a workers’ compensation claim seek the advice and counsel of an attorney who specializes in employment law.
What Are Vocational Benefits?
These benefits may be available to those workers who are no longer able to return to the work they were performing at the time of injury and are likely to become employable with vocational assistance. Vocational services are granted at the Department’s discretion. Vocational services may include early-return-to-work programs, vocational counseling and evaluation, job analysis, job modification, on-the-job-training, and participation in a vocational retraining plan.
Must I Accept Vocational Plan I’ve Been Offered?
The worker is not required to accept the retraining plan and may opt to go with what’s called “Option 2” benefits so long as you submit the retraining election form indicating your desire to select Option 2 within 15 days from the approval of the retraining plan. If the worker selects Option 2, he/she will receive the equivalent of 9 months time-loss compensation made in bi-weekly payments. The worker will also be provided “training funds”, available upon application to the department or self-insured employer, for 5 years after an Option 2 order is issued. These funds can be used towards training at a department approved institution and for tuition, books, fees, supplies, equipment, and tools. The amount available in the training fund will be indicated on the Option 2 order.
For How Long Will I Receive Benefits?
Benefits will continue as long as there is proper and necessary medical treatment which serves to improve the worker’s accepted industrial condition. When a worker’s condition stabilizes, and when there is no longer curative treatment available, the worker will be considered to be at “maximum medical improvement”. At that time the Department or Self-insured employer must determine whether the worker sustained a permanent disability caused by your industrial injury or disease and whether or not the worker is able to either return to the job of injury or return to some other continuous and regular employment.
Can I File a Lawsuit Against My Employer for Causing My Injury or Disease?
Injured workers cannot sue their employer for injuries or occupational diseases sustained on the job, except in limited circumstances where the employer either knew, or disregarded knowing that an injury would occur. If the injury was caused by some other party besides the employer, the aggrieved parties may seek damages against that third party.
Will I Be Able to Afford a Lawyer While I Am Unable to Work and Have Limited Funds Available?
In Washington, you generally only pay attorney’s fees if the attorney helps you to obtain or increase benefits you weren’t otherwise receiving. If the attorney does not win your case or obtain/increase your benefits, you will not be obligated to pay attorney’s fees. You will however be responsible for paying necessary costs in the administration of your claim, e.g. cost of mailing/filing documents, doctor’s fees for time spent corresponding with the attorney, medical testimony, court reporter fees, etc.