Category: Washington Workers’ Compensation
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…
Monkeypox is on the rise in the State of Washington. What does that mean for occupational disease claims?
Is this the beginning of another global health crisis? In the wake of the COVID-19 pandemic, the world is facing yet another global health crisis: monkeypox. On August 4, 2022, the White House declared monkeypox a public health emergency. Since that time, the United States has seen a new wave…
Claimant Died: Now What?
It is commonly said that there are only two constants in life: death and taxes. While Washington workers’ compensation benefits are generally tax free, death does not always wait for claims to close. Therefore, when a claimant dies their claim remains open and additional work must be done in order…
Washington’s Department of Labor & Industries Issues Q&A for New IME Rules and Guidelines
The Department of Labor & Industries’ new rules and guidelines for independent medical examinations (IME) went into effect on April 23, 2022. These rules and guidelines follow the legislature’s 2020 passage of RCW 51.36.070, which set out defined reasons why the Department or self-insured employer can schedule an IME. The…
Board of Industrial Insurance Appeals Makes In Re Kathleen Houlihan a Significant Decision
On April 29, 2022, the Washington Board of Industrial Insurance Appeals published its new “Significant Decisions” from 2021. The Board issues hundreds of Decisions & Orders each year but designates only a select few as “Significant Decisions.” The Board’s Significant Decisions are important because they provide the Industrial Appeals Judges…
Washington L&I Conducts Ambient Heat Exposure Rulemaking
The Department is conducting rulemaking to update the requirements for occupational heat exposure from high ambient temperatures in all industries, including outdoor and indoor exposures. According to the pre-proposal filed on August 17, 2021, this permanent rulemaking will consider requirements for trigger temperatures or another measure of environmental conditions stress…
New L&I Rules Regarding IMEs Take Effect April 23, 2022
Starting April 23, 2022 the Washington Department of Labor & Industries will be implementing new rules regarding IME notices and what constitutes a “case progress examination.” The rules also create a process for a worker to dispute whether they should be required to attend an IME. Under the new rules…
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…
Washington’s Board of Industrial Insurance Appeals Provides Some Guidance in Applying Maphet
Ever since the Washington Court of Appeals issued the Clark County v. Maphet decision in late 2019, employers have struggled with the ramifications and implications of the decision. 10 Wn.App.2d 420 (2019). Under Maphet, if an employer authorizes treatment for a condition, it is also accepting the condition, even in…
A New Year Means New Rules and Guidelines
As we hit the ground running in 2022, there are few rule changes to keep in mind when administering claims in Washington. I’ve included a summary of the several changes and updates to keep in mind. Heading into January 2022, the Department has extended its emergency rule related to employer…
Washington Court of Appeals Issues Decision Restricting Type of Evidence to Rebut Firefighters’ Presumption
In a recently published decision, Bradley v. City of Olympia, the Washington Court of Appeals clarified the type of evidence an employer or the Department should present to rebut the presumption a firefighter’s cancer is work-related. RCW 51.32.185 establishes a rebuttable presumption for firefighters that cancer is an occupational disease….
Long COVID and Its Workers’ Compensation Implications in Washington
While COVID-19 still dominates all aspects of the workforce and complicates decisions on when to request that workers come back to in-person working, a new form of the virus has emerged which threatens to upend closely laid plans. Post-acute sequalae of SARS CoV-2 (PASC, otherwise known as “long” or “long-haul”…
