WORKERS COMPENSATION
Workers Compensation
If you sustain a work-related injury or develop a work-related disease or condition you may be eligible for industrial insurance benefits; including, medical treatment, wage replacement benefits, vocational retraining, and awards for loss of function and disability. You can complete an application for industrial insurance benefits with any L&I approved physician. However, to ensure you receive the maximum benefits allowed by law, we encourage you to immediately seek competent legal counsel who can advocate for you during claim administration and adjudication. The legal professionals at Endres Law Firm
have helped hundreds of injured workers obtain medical treatment and financial security.
Benefits
Wage Loss Compensation Benefits
If you are unable to work as a result of your industrial injury, you may be entitled to wage loss compensation benefits. Wage loss compensation benefits are based on a percentage of your wage at the time of your injury. If you are single, you are entitled to 60% of your monthly wage of injury. If you are married at the time of injury, you are entitled to 65% of your monthly wage of injury. You are entitled to an additional 2% for each dependant at the time of injury up to a maximum of 75% of your monthly wage of injury. A dependant is generally defined as any living child at the time of injury who is under the age of 18 years (or up to 23 if enrolled in a full time college program).
Your wage of injury is based on a combination of your hourly wage, bonuses, tips, health care benefits, mileage, or other benefit in lieu of compensation. It is vital that you provide your legal representative with evidence of all wage information so that your legal representative can maximize your wage loss benefits. If the Department issues an Order setting your wages, you only have sixty (60) days to protest the Order or it is deemed final. You should always consult an attorney to confirm the Wage Order is accurate.
Wage loss benefits are only payable when certified by your attending physician. Your attending physician certifies time loss compensation by filing out an Activity Prescription Form (APF) and submitting it to the claim manager assigned to your claim. Your attending physician plays a crucial role in your industrial insurance claim. It is important that you have a good relationship with your attending physician, so make sure you follow all treatment recommendations and show up for all your appointments. You have the right to choose your own attending physician. Do not allow your employer to choose one for you. You can find a list of approved providers on the Department of Labor and Industries website.
Should your attending physician recommend work restrictions in lieu of taking you off work, you may still be eligible for wage replacement benefits. Your employer has the right to provide you with a valid light duty job which accommodates your work restrictions as established by your physician. If the employer is unable to provide you with a valid, light-duty job, you are entitled to ongoing time loss benefits. Should your employer provide you with a valid, light-duty job that is approved by your attending physician you must take the job. If you reject the valid, light-duty job, your time loss compensation benefits cease. You should seek the assistance of an attorney if you stop receiving time loss benefits.
If you are terminated for cause while performing light-duty work, you will not be entitled to time loss benefits. You should be a model employee when you are an injured worker performing a light-duty job. If you think your employer is contemplating terminating your employment while you are performing a light-duty job, you should immediately contact a workers’ compensation attorney and an employment law attorney.
Your employer must abide by the work restrictions prescribed by your attending physician. You should notify your attending physician and the claim manager if the employer is forcing you to perform work beyond the prescribed work restrictions. You should also tell your attending physician if your light-duty job is aggravating your industrially-related conditions.
If your employer is not paying your full wage of injury while you are performing a valid, light-duty job, you may be entitled to partial time loss compensation benefits—also called Loss of Earning Power benefits. Generally, if your employer is not paying you your full wage of injury, you are entitled to 80% of the difference between your wage of injury and the current wage. For example, if you were making $1000 per week at the time of injury and your employer is paying you $500 per week on light duty, you are entitled to Loss of Earning Power benefits of $400 in addition to your $500 wage. You must file a Loss of Earning Power request form with your claim manager to receive benefits. You can obtain this paperwork at your representative’s office or the DLI website.
Vocational Services
Once an injured worker has reached maximum medical improvement the Department of Labor and Industries will typically assign a vocational case manager to assess the worker’s ability to return to work. The vocational case manager will apply the list of return to work priorities as outlined in RCW 51.32.095 until such time as the injured worker is deemed employable.
If the injured worker is found unable to return to work with the employer of injury or in the general labor market they may be offered a vocational retraining program in order to obtain the skills necessary to return to full-time gainful work.
The current vocational training pilot program (extended through June 30, 2014) offers up two years of retraining services and up to $17,599.11 in training funds. Retraining program can be formal classroom training, on-the-job training or a combination of both.
The vocational case manager must first seek approval from the attending physician prior to commencing a retraining goal. In some instances the attending physician defers to a performance based physical capacities evaluation (PB-PCE) for clarification of a worker’s tolerances.
In the event that a vocational retraining plan is approved by all parties the Department then submits an “option letter,” which give the injured the opportunity to retrain independently. As your legal representative we will diligently work all parties to ensure you receive the vocational services that you are entitled to.
If you have further questions regarding vocational retraining services please contact this office for a free, no obligation consultation. We will happily review your claim on a case-by-case basis and offer any assistance you may request.
Pensions
In certain circumstances an injured worker may be entitled to an award for permanent total disability (pension). Permanent total disability entitles an injured worker to receive monthly payments for the remainder of his or her life and, possibly, thereafter for the remainder of the spouses life.
A worker is eligible for permanent total disability benefits when industrially related conditions reach maximum medical improvement with residual impairment and the worker is not capable of obtaining or maintaining any work at any gainful employment and such incapacity is expected to continue for the foreseeable future.
The industrially related condition need only be a cause, no matter how significant, of the injured worker’s inability to obtain and maintain employment for a worker to be entitled to pension benefits.
A determination of permanent total disability requires a comprehensive assessment of how the industrially related condition impacts the worker’s wage earning capacity when considered in conjunction with the worker as a whole person, with all pre-existing conditions and infirmities as well as the worker’s age, education, training, experience, physical and mental limitations, and any other factors that could reasonably impact the worker’s ability to obtain and maintain employment.
It is imperative that an injured worker have competent legal representation to ensure that all decision makers consider the impact of an industrial injury on the whole person in assessing entitlement to pension benefits.