|
|
|
|
|
....
How
long do I have to file a claim?
{TOP
OF PAGE}
In the case of an "industrial injury" the time limit is one (1) year from the date of the injury. In the case of an "occupational disease" claim, the time limits are far more liberal: two years from the date that a doctor informed you in writing that your medical condition constitutes an occupational disease claim within the meaning of the workers compensation laws. Since a doctor would rarely, if ever, give you written notice of an occupational disease claim in accordance with the statute, the time limits for occupational disease claims never commence running and therefore never expire (but if you have reason to believe that you have an occupational disease claim, you should proceed promptly and not assume that you have unlimited time to file).
What is an "occupational disease" claim?
{TOP
OF PAGE}Unlike an "injury", an "occupational disease" claim is a medical condition which arises "naturally" and "proximately" out of the "distinctive conditions" of your employment. An example would be an office worker who develops a Repetitive Strain Injury I"RSI") which can be traced to the distinctive condition of the job requirements (i.e., long hours of keystroking at a computer keyboard) as opposed to non-work activities. Examples of occupational disease claims include carpal tunnel syndrome, tendonitis, and epicondylitits, or any other condition which arises out of cumulative micro-traumas over time.
What benefits am I entitled to?
{TOP
OF PAGE}
The benefits include time loss compensation benefits (generally around 60% of your pre-injury wages (more if you have dependents) up to certain maximum amounts), costs of reasonable and necessary medical care, and in appropriate cases a permanent partial disability (PPD) or total disability (pension) award. In certain cases, you may be eligible for vocational retraining if you can't return to your job at time of injury due to disability.
My employer has scheduled a medical exam. Do I have to go? {TOP OF PAGE} Almost always, the answer is "yes." The Department or your employer is generally entitled to have you examined by doctors which they choose as often as they deem reasonable to ascertain your current medical condition. How often the Department or an Employer can require you to attend medical examinations depends on the facts of your case, but when it becomes apparent that the Department or the Employer is "piling on" and multiple opinions simply to "pad" the file, you may be justified in refusing to attend an examination. Such a strategy is risky, since the Department or Employer may take your refusal to attend as "willful noncooperation" and may use your alleged noncooperation as a reason to close your claim! Any decision not to attend a requested medical exam should be made only after carefully weighing all of the relevant factors and the potential risks of non-compliance.
What if I can't physically go back to my old
job?
{TOP
OF PAGE}
If the residual disability and limitations of your injury preclude you from returning to your former job, you may qualify for vocational retraining. The Department of Labor and Industries is not obliged to restore your previous earnings capacity, but if you can't perform to your job at time of injury, then the Department of your Employer will retain a Vocational Consultant to evaluate your return to work options, including a lighter duty job with the same employer, a lighter duty job with another employer, and potentially vocational retraining. If you qualify for vocational retraining you will continue receiving time loss payments during the vocational retraining period. Vocational retraining plans are limited in the total dollar amount and duration of a vocational retraining plan, but they can nevertheless be very beneficial for an injured worker who is in need of retraining to re-enter the workforce.
My employer didn't pay workers comp premiums into
the system;.. now what? {TOP OF PAGE} You are covered, even if your employer hasn't paid in premiums to the Department of Labor and Industries. The Department will cover your claim, and seek reimbursement from the employer of the retroactive premium plus penalties, or it may seek reimbursement of all of the benefits paid. If you run into a problem with this, you should seek the advice of an attorney.
What is a Permanent Partial Disability award?
{TOP
OF PAGE}
Once you have reached MMI ("Maximum Medical Improvement") the Department or your Employer will either ask either your primary attending doctor or an outside doctor from a medical pane to "rate" you for a permanent partial disability award (PPD award). Impairment ratings are determined by reference to categories of impairments contained within the Labor and Industries laws (RCW Title 51) and the Washington Administrative Code, and by application of the American Medical Association Guide to Permanent Impairments. The disability rating converts into a monetary award based on the schedule of benefits in effect on the date of your original injury. You may feel that your disability is greater than the rating you have received, and it may be possible to establish a greater level of disability and, hence, a greater PPD award.
What is a Total Disability Pension?
{TOP
OF PAGE}
If as a result of your industrial injury you are unable to maintain any competitive employment, taking into consideration your age, education, prior work experience and transferable skills, and all prior health conditions, then you may qualify for a total disability pension. A total disability pension compensates you for lost future earning capacity, is roughly equal to the time loss payments you had been receiving, and continues for the rest of your life, unless you later return to work.
What
is the Second Injury Fund?
{TOP OF
PAGE} The Second Injury Fund is a separate fund maintained by the Department to pay total disability pensions arising from "combined effects" industrial injury claims. It applies where your industrial injury alone is not totally disabling, but you are deemed to be totally disabled based on the effects of the industrial injury in combination with all of your pre-existing and disabling medical conditions (e.g., high blood pressure, degenerative disk disease, depression, anxiety, neurological disorders, etc. ... you name it) and taking into consideration your age, education, work experience and residual function. If a self insured employer thinks that you may qualify for second injury fund relief, the employer will sometimes work with you to establish your entitlement to second injury fund relief because it benefits the employer financially when the second injury fund picks up the cost of the pension.
How
long do I have to reopen a closed claim?
{TOP OF
PAGE} Generally, you have seven (7) years from the date your claim closed to reopen your claim for worsening of your condition (known as an "Aggravation Application"). In order to reopen your claim, you will have to show by objective medical evidence (subjective complaints of pain and discomfort are not sufficient) that your medical condition causally related to the industrial injury claim or occupational disease condition has worsened, Objective medical evidence may include, for example, positive findings on X ray, MRI, CAT scan, or other objective diagnostic testing. After 7 years, the Department can still reopen your claim in its discretion for additional medical treatment, but not for time loss or other disability benefits. If you are approaching the seven-year anniversary of closure of your claim and you are experiencing increasing medical problems related to your industrial injury, it is essential that you discuss filing an aggravation application with your doctor.
How
are you paid for your services?
{TOP OF
PAGE} Workers compensation attorneys generally are paid on a contingent fee basis, based on a percentage of benefits of recovered. Fees are limited by law to 30% of all time loss and of any increased permanent partial disability award obtained. In the case of a total disability pension, fees are limited to a maximum of 15% of the actuarial value of the pension award (as computed by the pension department at Labor and Industries).
NOTICE: THE INFORMATION CONTAINED IN THESE PAGES IS INTENDED AS GENERAL INFORMATION ONLY AND NOT AS LEGAL ADVICE. NO ATTORNEY-CLIENT RELATIONSHIP IS CREATED BY VIEWING THESE PAGES NOR BY E MAIL INQUIRIES TO MOSCHETTO AND KOPLIN. |
