Category: Washington WC Benefits
Changes to the Washington Department of Labor & Industries Loss of Earning Power Compensation Policy
Loss of Earning Power (LEP) under RCW 51.32.090 requires the self-insurer to compensate a worker when the worker’s earning capacity has decreased as a result of the industrial injury or occupational disease. The Department instituted a new LEP policy effective July 1, 2025. Policy 5.81 states that the worker must…
Washington Hearing Loss Claims – Refresh Your Knowledge!
In Washington, hearing loss claims timeframes for filing are governed under RCW 51.28.055. If there is reported hearing loss resulting from a sudden single event, this is considered conductive hearing loss, which is distinguished from an occupational disease claim. For an injury of this nature and to be considered timely,…
In Washington, Can a Worker Successfully Pursue an Occupational Disease Condition under an Open Industrial Injury Claim?
When a claim has been accepted, and compensation has been paid, the self-insurer is required to send the Department the SIF-2, the claim allowance request form, the SIF-5, and an explanation and documentation used to determine the date of manifestation for occupational disease claims. At that point, the Department will…
Washington Department of Labor & Industries Listening Sessions Signal Changes to Claim Process
On January 7 and 23, 2025 the Department held two listening sessions open to attendance by members of the self-insured community regarding The Claims Process Project. These listening sessions were aimed at increasing efficiency and consistency of adjudication and improving accuracy, timeliness, and quality of claim management by all parties…
Washington House Bill 1927 Passed to Adjust Time-Loss Eligibility for Injured Workers
Washington State Governor Jay Inslee signed into law House Bill 1927 which makes it easier for injured workers to qualify for workers’ compensation benefits for the first few days following their injury. This change took effect on June 6, 2024 and impacts all claims with dates of injury or manifestation…
Is that Docket Properly before the Board? Recent Board of Industrial Insurance Appeals Actions Caution Washington Employers to Double Check the Appealed Department of Labor & Industries’ Order
Washington’s Board of Industrial Insurance Appeals has long been deemed one of limited jurisdiction – the Board cannot act if it does not have the proper authority do so. The Board does not have the statutory authority to consider matters not first determined by the Department of Labor & Industries….
Navigating suspension of benefits and claim closure for Washington claims
There are several reasons why a self-insured employer may move the Department of Labor & Industries to suspend an injured worker’s benefits under the claim. RCW 51.32.110 and WAC 296-14-410 provide guidance for when it is appropriate to request suspension of benefits. These reasons include when an injured worker refuses…
Limitations on compensability for treating conditions impeding recovery in Washington
Under the compensable consequences doctrine, the consequences for a compensable industrial injury are considered to be part and parcel of the injury itself. The Board has applied this principle in numerous cases. For example, In re George Gillilan involved a claimant who sustained a right inguinal hernia and a low…
What Came First: The Acceptance or the Authorization? An exploration of Clark County v. Maphet
In 2019, the Washington Court of Appeals issued Clark County v. Maphet, 451 P.3d 713 (2019). The case held that a self-insured employer authorizing treatment of a condition is tantamount to that self-insured employer accepting the condition as part of the claim. A careful understanding of the case is important…
Wage Calculation of H-2A Visa Workers in Washington
The United States H-2A visa program allows employers to bring foreign nationals into the country to fill temporary agricultural positions. Due to labor shortages, it has become common for employers in Washington to hire temporary agricultural workers through the H-2A visa program. Wage calculation in workers compensation cases involving H-2A…
Washington State Announces 2020 COLA Increase; Affects Temporary Disability Payments Starting July 1st
Under RCW 51.32.075 temporary disability benefits are recalculated July 1st of each year to reflect changes in the states average wage. According to the Washington State Employment Security Department, the statewide average wage for 2019 was $69,700. This represents a 6.7% increase from 2018 average wage of $65,301; the largest…
Back to Basics: While easy to overlook during the COVID-19 pandemic, double checking details in Washington Claims is still as important as ever
As the impacts of COVID-19 continue to occur and affect people and businesses, it is easy to get swept up in the breadth of complexities this pandemic has created. While businesses grapple with safety, financial, and personnel issues and decisions, day-to-day business details can get lost in the shuffle. Among…
Department of Labor & Industries Issues New Checklist for Willful Misrepresentation
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…
New Washington Supreme Court “Innocent Misrepresentation” Overpayment Case
The Washington Supreme Court issued a new case addressing whether the Department has authority to issue an overpayment order and an order modifying claimant’s compensation rate based on claimant’s innocent misrepresentation. Claimant was injured at work. He needed assistance to complete the SIF-2 and because of a language barrier and…
WASHINGTON COLA INCREASES ON JULY 1ST
Effective Friday July 1, 2016 the annual cost of living adjustments (COLA) will take effect for the benefit period of July 1, 2016 through June 30, 2017. Washington’s statewide average wage increased from $54,829.00 in 2014 to $56,273.00 in 2015, an increase factor of 1.0263364278. As usual, there will be…
Everything you’ve wanted to know about third-party recovery in Washington (but were afraid to ask.)
Recovering claims costs through third-party litigation in Washington can be complicated. If careless, self-insured employers (SIE) can walk away from third-party claims leaving money on the table. However, with forethought, third-party litigation can be an effective way for self-insured employers to recover the cost of processing a claim. The purpose…
Lumbar Fusion – New Guidelines for DLI
The Department has issued new stricter guidelines regarding when a proposed lumbar fusion is a medically necessity and clinically appropriate. These guidelines, effective March 7, 2016, deny lumbar fusion surgery coverage for patients with uncomplicated degenerative disc disease (“DDD”). An uncomplicated DDD is one where claimant has lower back pain…
Washington Department of Labor and Industries Revises the Interlocutory Process
On July 16, 2015 the Department issued a new set of guidelines for self-insured employers to obtain an interlocutory order. The 60-day period following the self-insured employer’s receipt of notice of a new claim, prior to when the claim is allowed or denied by the Department, is referred to as…
Washington Housekeeping Matters – COLA and Vocational Mileage Reimbursement
COLA Effective July 1, 2015, cost of living adjustments (COLA) will take effect for the benefit period of July 1, 2015 through June 30, 2016. Washington’s statewide average wage increased from $52,635 in 2013 to $54,829 in 2014. The maximum monthly time-loss rate for dates of injury on or after…
