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..Workers Compensation.

LEGAL QUESTIONS? CONTACT US AT: 425-641-6000

Workers compensation is intended to insure workers for injuries arising out of employment, from catastrophic workplace injuries to occupational disease claims which arise naturally and proximately out of workplace exposures. Workers compensation is a "no fault" system: unless your injury is directly caused by the intentional acts of the employer (for example, assault, or placing the employee in an environment where injury is certain to occur), the employer is Immune from civil liability. Instead, the worker is entitled to the benefits which are available under the Industrial Insurance Act contained in Title 51 of the Revised Code of Washington and implementing administrative regulations. Those benefits include time loss payments, payment of all claim related medical expenses, as well as the potential for vocational retraining if you are unable to return to your previous work due to your injury or occupational disease, an award of permanent partial disability and, in cases of total and permanent disability, the award of a pension.

Some employers insure directly with the Department of Labor and Industries. In other cases, large institutional employers sometimes choose to "self insure". Self-insurers are still governed by the standards of RCW Title 51, but benefits are generally administererd through Third Party Administrators, subject to oversight and review by the Department of Labor and Industries' Self Insurance Section.

It can be challenging to make the system work for you when you are the victim of an industrial injury or occupataional disease. Time loss benefits are generally limited to about 60% of your earnings at time of injury (slightly more if you have dependents) subject to a maximum ceiling, making it difficult to survive financially on reduced income during prolonged disability. The Department will not pay for acupuncture, nor will it pay for procedures which it deems novel or experimental, and sometimes it is necessary to appeal to the Board of Industrial Insurance Appeals for a detemination whether a certain medical condition or medical procedure will be covered. The Department and the injured worker may disagree over the nature and extent of his injuries, whether or not he is capable of returning to work, whether or not he is in need of vocational retraining, the extent of permanent disability, and many other issues. In additions, L and I claims managers while often well meaning, are understaffed, overworked, and difficult to contact. Third Party Adminstrators often seem more interested in controlling costs and closing files than in serving the needs of the injured workers. And periodic "IME" with predictably conservative doctors at times appear downright hostile and disbelieving of the claimant. All of this can be overwhelming to someone who is unfamiliar with and ill-equipped to negotiate the twists and turns of the L and I bureaucracy.

Joe Koplin has many years' experience dealing with the Department of Labor and Industries and self insurers and has handled many claims through appeal to the Board of Industrial Insurance Appeals and to Superior Court. His goals include making sure that his clients understand the system, that time loss is received, that clients are adequately diagnosed and treated and allowed to see appropriate specialists when necessary, that they receive vocational retraining when they are unable to return to their job at time of injury, and that their permanent disabilities are fairly evaluated and rated.

If you would like to discuss your case iwth Joe, you can contact him at joekoplin@mandk.net or directly at (425) 641-6000.