Category: Washington Workers’ Compensation
Washington Significant Vocational Board Decisions
Two significant decisions regarding the vocational process were recently determined by the Board of Industrial Insurance Appeals. In re Michael Killpatrick BIIA Dec., 21 13384 (2023) clarified what qualifies as good cause for an interruption of a vocational plan. Mr. Killpatrick was in the process of going through vocational retraining…
Guidance on a Washington Workers’ Compensation Occupational Disease in a Post-COVID (Presumption) Era
The Washington Department of Labor & Industries lifted its COVID coverage presumption on April 11, 2023. Under the presumption, frontline workers who tested positive for COVID-19 between February 29, 2020 and April 11, 2023 were automatically considered to have contracted the disease at work and the burden was placed on…
New Washington case provides limitations to Maphet
For self-insured employers in Washington, one of the most significant decisions in recent years was the Washington Court of Appeals’ 2019 opinion in Clark County v. Maphet. 10 Wn.App.2d 420 (2019). This decision was significant because it no longer allowed employers to authorize treatment for conditions that held no causal…
Substitute House Bill Passed to Address Surgical Smoke Hazards in Washington
Governor Jay Inslee signed into law Substitute House Bill (SHB) 1779 to address surgical smoke hazards in hospitals and ambulatory surgical centers in hopes to establish workplace safety and health requirements pertaining to procedures producing hazardous smoke. RCW 49.17.500 and RCW 49.17.505 took effect on January 1, 2024. As such,…
When can a Washington self-insured employer issue a closing order?
Generally, when a Washington workers’ compensation claim is ready for closure, a self-insured employer will submit a request for claim closure to the Department and await issuance of a closing order. However, self-insured employers have the authority to close certain claims through a Self-Insured Employer’s Closure Order and Notice pursuant…
Have you or someone you know been negatively affected by the new Washington IME rules? Get help here!
The new Washington Independent Medical Exam (IME) recording and co-recording rules have made obtaining an IME even more difficult than when they were limited by WAC 296-23-309 last year. Here are some alternative options if you can’t get an IME under WAC 296-23-309 or if you can’t find a medical…
All Washington Self-Insured Employers Should Be Aware of (And Attend if Possible) the Department of Labor & Industries “Listening Sessions” Regarding the Newly Enacted “Bad Faith” Laws
The Washington legislature passed one of two pieces of legislation that creates new duties and standards for some self-insured employers. Substitute House Bill 1521 is scheduled to go into effect on July 1, 2024, and the new laws are set to apply to worker’s compensation claims regardless of date of…
Limitations for self-insured employers in Washington recouping overpayment benefits
During the administration of a workers’ compensation claim, it is common for the self-insured employer or the Department of Labor and Industries to pay the injured worker benefits and later realize it was in error. Sometimes this occurs from the unveiling of new facts, changed medical opinions, or subsequently identifying…
Washington L&I may add nurses to PTSD presumption
On September 7, 2023, the Department of Labor and Industries issues a notice of proposed rulemaking seeking adding a new section to WAC 296-14-300 adding direct care registered nurses to the posttraumatic stress disorder (PTSD) presumptive law. The Department has announced that it is soliciting comment and holding a public…
What Decision? Washington requirements on Communication and Mailing.
RCW 51.52.060 sets forth the Department’s rules regarding the timeline to appeal a decision. It explains that any party (with the exception of certain enumerated parties) aggrieved by an order, decision or award of the Department must file with the Board within sixty days from the day on which a…
New Notice Requirement for Independent Medical Examinations in Washington Effective July 23, 2023.
Substitute House Bill (SHB) 1068 was adopted into law by the legislature effective July 23, 2023. This legislation amends RCW 51.36.070, giving workers the right to record independent medical examinations ordered under that section, RCW 51.32.110 or by the Board of Industrial Insurance Appeals. A worker can record the audio,…
New PTSD Presumption for Registered Nurses in Washington
On May 9, 2023, Governor Jay Inslee signed SB 5454 into law further expanding the number of presumptions under the Washington Industrial Insurance Act. SB 5454 provides presumptive coverage under the Industrial Insurance Act to Registered Nurses for Post Traumatic Stress Disorder (PTSD). The new presumption is limited to Registered…
Washington’s Department of Labor & Industries Announces Changes to Covid-19 Presumption and IME Rules
As the saying goes, change is constant. Never, it seems, has this saying been more applicable to Washington workers’ compensation laws and claims administration. The past few years have seen drastic changes in how employers process and manage Washington workers’ compensation claims (the ramifications of Maphet continue to unfold), and…
When can a worker reclassify a Washington industrial injury claim to an occupational disease claim?
In Washington, workers’ compensation claims are bifurcated and categorized as an industrial injury or an occupational disease. An “industrial injury” involves a sudden and tangible happening of traumatic nature, producing an immediate or prompt result, and such physical conditions result there from. See RCW 51.08.100. An “occupational disease” involves a…
New Washington Board Decision Addresses Closure of Claims When Worker Deceased
The Washington Board of Industrial Insurance Appeals recently designated a new significant decision addressing the situation where a worker dies for unrelated reasons with an open claim, and before their ability to work within their industrial restrictions has been established. This decision holds that employers cannot defeat a pension claim…
Washington Board of Industrial Insurance Appeals Makes In Re Michael Reed a Significant Decision
On March 7, 2023, the Washington Board of Industrial Insurance Appeals published its Significant Decisions from 2022. Each year the Board classifies a small number of decision and orders as “significant”, meaning they contain an analysis or decision of substantial importance. The Board originally published In re Michael Reed, BIIA…
Washington Legislature Considers Bills to Drastically Increase Penalties and Impose Standard of Care on Self Insured Employer’s/TPAs
As part of the current session, the Washington State legislature is considering bills in the House and Senate which impose a duty of good faith and fair dealing on self-insured employer and their administrators. Both bills include unprecedented penalties for violations of the duty they create. HB 1521 Amends to…
No Doctor, No Problem? Rule 904 & Washington State Claims
There are many reasons, despite the best efforts of adjusters, adjudicators, and attorneys, that a workers compensation claim may take a while to resolve. Long courses of treatment, symptom improvement followed by aggravations and setbacks, intervening injuries or even disappearing claimants can all leave claims languishing without resolution. After years…
When to request a segregation order on a newly contended condition in Washington
The Department of Labor and Industries recently addressed when it believes a request for a segregation order is appropriate on newly contended conditions. A condition is “contended” if it is diagnosed and coverage is being sought due to a causal relationship. If the worker or provider is contending that a…
Is that a protest?
The Washington Industrial Insurance Act allows parties aggrieved by Department orders to request in writing reconsideration, known as a protest, of the order within 60-days of it being communicated to the aggrieved party. RCW 51.52.050. However, it is not always easy to determine whether a claimant intended their letter to…
Washington L&I Proposed Changes to Presumptive Coverage of PTSD as an Occupational Disease – Feedback Due by January 13
On November 22, 2022, the Department of Labor & Industries filed a Notice of Proposed Rulemaking seeking to amend WAC 296-14-300 to clarify coverage of posttraumatic stress disorder (PTSD) under workers’ compensation law in Washington state. WAC 296-14-300 currently excludes mental health conditions caused by stress and repeated exposure to…
Washington’s Board of Industrial Insurance Appeals Limits Workers’ Ability to Add Occupational Disease Conditions to Industrial Injury Claims in Tentatively Significant Decision
In some Washington workers’ compensation cases, a significant hurdle can be determining whether a condition in a worker’s claim resulted from an industrial injury or an occupational disease. While this distinction may not have a large impact on the administration and outcome of every claim, it can cause a significant…
Securing Claim Closure in Washington
So you want to close a claim or secure settlement of a claim but the worker isn’t old enough for a claim resolution settlement agreement (CRSA)…what do you do? SBH might have the answer for you! There’s a new department coversheet for stipulated claim closures available on the Department’s website…
Reassessing an injured worker’s status for permanent total disability following a reopening application in Washington workers’ compensation
An injured worker is permanently and totally disabled within the meaning of the Industrial Insurance Act when, as a result of the industrial injury, he/she is unable to perform any gainful employment on a reasonable consistent basis existing in the labor market within the worker’s qualifications. After an injured worker…
Proximate Cause – The Often Overlooked Requirement for Claim Reopening in Washington
In order to reopen a workers’ compensation claim in Washington, a worker must establish that an accepted condition has objectively worsened since the date the claim was last closed or ordered to remain closed (either by an affirming order or a reopening denial order). However, the worsening must also be…
