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 his or her physician stating that the conditions have worsened. The claimant could receive benefits up to 60 days prior to the date upon which the completed application was received.
The Washington Legislature has now passed House Bill 1902 to expand this statue to allow claimants to receive benefits up to 120 prior to the receipt of the reopening application if the delay in submitting the completed application was caused by the attending physician’s failure to timely complete their portion of the form. However, in order to for claimant to receive the extended period of benefits they must submit proof of that the claimant portion of the reopening application was submitted within 60-days of medical treatment being received and they submitted their application via certified mail or by electronic verification to the Department or self-insurer.
What this means for employer’s is that if the claimant can submit proof that they completed and provided to the employer the claimant portion of the reopening application within the original 60-day widow they can be entitled to benefits up to 120-prior to the provider completing their portion of the reopening application. However, there is a limitation that benefits cannot begin more than 60-days prior to the medical visit which precipitated the reopening application.
For example, a claimant visits their attending provider on January 1, 2022, because their industrially related conditions are worsening. Following that visit, they complete the claimant portion of a reopening application and provide it via certified mail to the employer or Department and it is received January 4, 2022. Claimant’s attending provider then completes the provider portion, and it is received by the employer or Department on March 15, 2022, under the statute currently in effect, the reopening application was completed on March 15, 2022, as that is when both the claimant and physician portions were received by the employer or Department. The claim is reopened, and claimant would be eligible for benefits beginning January 14, 2022, or 60-days prior to the completed reopening application. Under the new version of the statute, as claimant could prove that the claimant portion of the application was submitted and received by the employer on January 4, 2022, the claimant could receive benefits as early as November 15, 2021.
Once this statue becomes effective it will be necessary for employers to check when and how the claimant portion of the reopening application is received as the statute will require that it is received via certified mail. Additionally, the employers will need to verify with the Department whether there is an electronic record of when the claimant portion of the reopening application was received. If it was not received in one of the prescribed methods then benefits begin 60-days prior to the receipt of the physician’s portion of the reopening application. If it was received via certified mail or electronic verification through the Department then benefits begin up to 120-days prior to receipt of the physician portion of the reopening application. If you have any questions contact me at or by telephone at (971) 867-2724.
Posted by Joe Urbanski.
