The Department of Labor & Industries has created new forms and templates for use by self-insured employers, third-party administrators, and Physical and Occupational Therapists. The new forms are required as of October 1, 2020. Several of the existing templates and forms that were part of the 2019 claim processing changes were updated with minor changes in language. Employers should make sure to update their form library to ensure the most recent version is submitted. Most notably, however, are several forms that are entirely new. There is a new form for starting/stopping/denying benefits, appropriately titled “Start, Stop, or Deny Compensation Benefits.” The new form combined previous forms for starting and stopping compensation benefits. Self-insured employers and claims administrators should use… Continue reading
Course of Employment in Washington: What Factors are Considered When an Employee is Injured While Working from Home?
As the State of Washington slowly implements its four-phase recovery plan, many employees continue to work remotely from home in various capacities due to the social distancing requirements brought on by COVID-19. As employees continue to work from home, many employers are faced with new claims involving injuries sustained away from the employer’s premises. These unique claims can make it difficult for employers and third-party administrators to assess what constitutes a compensable injury or occupational disease. In Washington, workers acting in the “course of employment” are covered by the Industrial Insurance Act. Generally speaking, acting in the course of employment means the employee is acting at his or her employer’s direction or furthering the employer’s business. This is broad definition… Continue reading
The Department of Labor & Industries recently amended the process and published an amended checklist for employers seeking Willful Misrepresentation orders. The Department’s new checklist for reporting Willful Misrepresentation available here. Pursuant to RCW 51.32.240(5), self-insured employers can demand repayment of any benefits induced by willful misrepresentation along with a 50% penalty payable to the Department’s supplemental pension fund so long as the repayment and recoupment of benefits is demanded within three years of the discovery of the worker’s willful misrepresentation. The statute goes on to explain that “willful misrepresentation” includes willful false statements, omissions, or concealment of any material fact. Additionally, Washington Administrative Code 296-14-4121 provides that the term “willful” means a “conscious or deliberate false statement, misrepresentation, omission,… Continue reading