Tag Archives: Industrial Insurance Act

Money isn’t everything – Don’t let your insurer short your medical bills

One of the most common reasons injured workers contact me is because their doctor is asking for specific treatment and the self-insured employer refuses to pay. Obviously if the treatment is for a non-industrially-related condition, this would make sense. Sadly, these self-insurers play games and offer faulty excuses to get out of paying for the treatment of related conditions as well; a rather deceitful attempt to wiggle out of the deal struck in 1911 between legislators, businesses and labor leaders, most of whom represented the mammoth lumber industry which employed three-quarters of Washington’s workers at the turn of the 20th century.

History class aside, the purpose of the Industrial Insurance Act was and is to provide “sure and certain relief for workers, injured in their work…” To that end, the legislature has created a penalties provision to hold self-insured employers accountable for making timely payments of monetary benefits including time-loss payments and permanent partial disability awards. Unfortunately, this legislative protection has only been offered for monetary benefits and not medical or vocational benefits.

Thankfully the Board of Industrial Insurance Appeals, or BIIA, has recently addressed this issue. In the 2012 BIIA decision, In Re: Coston, the term “benefit” was broadened to include both monetary and medical benefits as well.

This is a fantastic tool which all injured worker representatives should be using to stop self-insured employers from delaying or refusing to pay for necessary treatment for industrially-related injuries and conditions.

If you have a question about benefits, need to protest a decision or you’re unsure about the next steps in your claim, call us at (509) 228-7011 or use our contact form  to set up a free consultation.

System Shutdown

WRITTEN BY RICH BYERS | JULY 2015

Growing up the only child of parents who never graduated high school, both spending nearly three decades as custodians for state colleges, I may have read an article like this one and thought that people are just whiners. On the backs of my parents I had food and clothes, a warm place to live and even got to do some extra-curricular activities like Little League. It was certainly not free of financial struggles, but in one way it was idyllic; through the efforts of my parents “I had it better than they did.”

I put myself through private college and then law school, mostly holding fast to that blue-collar-conservative ideology of working for what you get and not expecting anything more (even studying corporate law) until one day I got a call from my dad. His career had just ended.

He had been an often-promoted and exemplary employee for the State of Washington for over 30 years, a Vietnam-era veteran, and a great role model for me – teaching me that you get what you work for, and that’s that. Then, after over thirty years of heavy labor work, he was injured and his doctor told him he couldn’t return.

He suffered through physical pain, depression, a loss of identity as a contributing member of society, and the realization that a decades-long chapter of his life was now over – one which he hadn’t planned on ending so abruptly. To make things worse, this man who had never had a major claim for worker’s compensation was being met at every turn with a vicious fight from the Department of Labor and Industries. Not the American dream we like to imagine.

I changed the course of my study and my life and became a worker’s compensation attorney. I see everyday the degradation of our system of benefits for injured workers, and articles like this one only ring home the truth – we are experiencing a massive reduction in benefits and a general shift in thinking for workplace injuries. Bottom-line thinking is leaving injured workers – the vast majority of whom only want to return to work as soon as possible – often fighting for years just to receive treatment while their doctors are left grasping at straws to figure out why the very treatment that could get them back to work is being withheld.

This problem is multi-faceted like any other, but the shift of medical decision making from doctors to insurers is inexcusably running afoul of the intent of our Industrial Insurance Act. An injured worker’s sole source of remedy is L&I, to take the power away from doctors and place it in the hands of retro groups and employers who only care about their insurance rates is bordering on the criminal.

My dad’s experience changed my life. How has your life been touched by our failing worker’s comp system?

Blast from the past

Are you experiencing aggravation from a pre-existing injury (aka “lighting up)?

Unless you’re under 25 years old (and maybe still then) you probably have some old injury or complaint from your past. If you’re lucky, the sore neck from that fender bender, or injured knee from a brutal high school soccer game years ago, or other accident – will not come back to bother you.

Unfortunately, people with pre-existing injuries have to work just like the rest of us, and all too often, a workplace injury or repeated exposure can aggravate those injuries. Insurance companies (like the Department of L&I) often try to point the finger at old injuries to avoid coverage.

Here’s what you need to remember if that happens to you in an L&I claim: If an injury or repetitive use of a joint aggravates, lights up, or makes active a latent or quiescent infirmity or weakened physical condition, then the resulting disability is to be attributed to the injury, and not to the preexisting physical condition. More simply stated, if your workplace injury, occupational exposure, or repetitive joint use at work makes an old condition worse, the Industrial Insurance Act likely affords you L&I coverage.

If you’re having trouble getting treatment or L&I claim allowance because you have had some previous injury, call Carlisle & Byers for a free consultation.