Category: Washington Workers’ Compensation
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 L&I Self-Insurance Reminders About Employer Claim Closures
Happy 2025 from SBH Legal! Let’s start the year off with a refresh on self-insured employer closures in Washington. Self-insured employers have the authority to close claims if: (1) there have been no Department Orders resolving a dispute, (2) the claimant has returned to work for the same employer or…
Washington’s Department of Labor & Industries Announces Mystery Listening Sessions
Listening sessions scheduled by the Department of Labor & Industries are nothing new. It is common practice for the Department to ask for feedback from those directly or indirectly impacted by its rulemaking process and procedures. A recent notable series of listening sessions occurred when the Department was developing, drafting,…
Navigating claim compensability for injuries outside the State of Washington
Under the Industrial Insurance Act, workers for Washington employers are entitled to benefits for injuries sustained in the course of employment. Under Washington’s extraterritorial statute, this remains true even if the injury occurs outside the territorial limits of the state. Washington courts have recently placed limitations on the extraterritorial statute….
Washington L&I Expands Coverage for Acupuncture Treatment
The Washington Department of Labor & Industries recently adopted a new policy approving acupuncture as a covered treatment for chronic migraine when accepted under a workers compensation claim. Previously, acupuncture was a covered benefit only for treatment of accepted lumbar conditions. The Department adopted its lumbar coverage policy for acupuncture…
What constitutes a valid light duty job offer in Washington?
If an injured worker is not able to perform their job of injury, but is able to perform some type of work, offering a light duty job is often a good option. For a light duty job offer to be “valid” pursuant to RCW 51.32.090(b): A job description or job…
In Washington, willful or not, misrepresentation puts you on the spot
Everyone can agree, when you take something that you are not entitled to, there are consequences that follow. In Washington worker’s compensation claims it is no different. The Washington Administrative Code speaks to when an injured worker willfully, intentionally, and/or deliberately takes or accepts benefits that they are not entitled…
Washington Proposed Rule-Making for Third Party Recording: Additional Red Tape in an Already Onerous System?
Since the implementation of new rules allowing claimants to record examinations requested by the Department or Self-Insurer in 2023 employers have encountered increased difficulty in obtaining an independent medical examination (IMEs). Many providers expressed concerns about the unpredictable nature of claimants’ use of the recordings, and are not assuaged by…
Washington Court of Appeals: New Insight on Notice and the Authority of DLI Policies
In the State of Washington, employers are required to give notice of a mandatory IME at least 14 to 60 days prior to the examination, and must provide the worker with the date, time, and location of the exam. But is the worker free to miss the exam without penalty…
Washington State Approves Spinal Cord Stimulation for Certain Pain Conditions
On June 14, 2024, there was a final adoption of new guidelines for spinal cord stimulation (SCS). Spinal cord stimulation is a treatment for chronic pain involving the insertion of electrodes into the epidural space near the spinal cord that are connected to an internal or external electrical pulse generator….
Washington Legislature Potentially Provides Extended Benefits to Claimants on Reopen Applications
The Washington Industrial Insurance Act allows claimants to reopen their claims following closure when the conditions proximately related to their industrial injury or occupational disease objectively worsen post-closure pursuant to RCW 51.28.040. To complete a reopening application, the claimant must submit an application completed both by the claimant and by…
Normally Reasonable: Transferring Attending Providers in Washington Workers’ Compensation Claim
Claimant’s attending physician plays an important role in assisting claimant’s return to their job of injury. Their attentiveness and skill as a provider often dictate how efficiently a claim is processed. Many claims have one attending provider for the duration, however, there are some instances where claimant seeks treatment from…
How to Collect an Overpayment in Washington
It is not uncommon for an overpayment of benefits to occur during the administration a workers’ compensation claim. An overpayment may arise due to clerical error, innocent misrepresentation or willful misrepresentation (RCW 51.32.240). Often overpayments arise when a worker is paid provisional time loss benefits and the claim is later…
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,…
