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Navigating legal situations is complex. A common way to describe the feeling is like “walking through a maze.” If you’ve read many of our posts or articles, we have used that phrase more than once. Recently, we realized that metaphors don’t paint the complete picture of injured workers. Sure, you’re in a maze, but it’s one you never wanted to be in. You have to ask permission before taking every step; the person permitting you doesn’t care if you find your way through. The best outcome for them would be if you just give up and quit.
So you’re lost, hurt, and worried about your health and income, and the person who should be helping you through this time (your claim manager) is only interested in closing your claim and saving money. That alone is a lot to deal with; myths, misconceptions, and half-truths about the process only worsen things. So, let’s tackle a few of the more common things that make us go “hmm…”
Myth #1: You MUST report your injury immediately
Reporting your injury right away is the best thing to do – hands down. You get hurt at work, you tell your supervisor, you file a claim, you get treatment, you get better, you go back to work. This is how the system is supposed to operate, and you shouldn’t delay reporting because it only delays your treatment.
However, you technically have one year from the date you were injured (claims for injuries occurring at a specific time, like falling from a ladder, are called industrial injury claims) to file a claim with the Department of L&I. For example, say you fell off a ladder but it was only a small fall, you think you’re ok and gonna shake it off, and maybe you decide to wait for a few days to see how you feel. There’s nothing wrong with that, and you haven’t let the window close on filing a claim for benefits. But, the longer you put off treatment, the harder it is to recover, and after one year, it really is too late.
For occupational diseases, you have two years from the first time a doctor told you that your work caused your condition. And speaking of occupational diseases…
Myth #2: You can only receive workers’ comp if your injury happened suddenly
What if you’re an ironworker, and after 15 years of intense heavy lifting and abuse on your body, the rotator cuff in your left shoulder falls out? Okay, it probably didn’t just fall out, but your doctor tells you the pain is due to the repetitive strain you’ve put on your shoulders at your job, even though there wasn’t a specific, identifiable event that caused your condition. It happened over time. This is covered and called an “occupational disease claim.”
You have two years from the date your doctor tells you your work caused your condition. Generally, the best thing to do is tell that doctor immediately that you want to file a claim with L&I. For example, you find yourself in a position where your doctor told you your job caused your condition, but you didn’t file a claim (maybe it wasn’t all that bad then). But now, it’s causing you a great deal of discomfort, and you want treatment. It will all come down to the first visit, where your doctor told you that your condition – even if it wasn’t as serious as it is now – was caused by your work. If it’s been more than two years, your window of opportunity has likely closed.
Myth #3: You must see a company-appointed doctor for your injuries
If you work for a major corporation, perhaps like the one that starts with A and rhymes with Shmamazon, and you’re injured at work, you might be told that you must be treated by a company nurse or other medical provider on site. This is simply inaccurate, at least concerning an L&I claim. RCW 5.36.010 guarantees that we have a right to see whatever physician or licensed advanced registered nurse practitioner we choose. However, there is one asterisk – they must be a member of L&I’s medical provider network. This does not mean the doctor must work for L&I or your employer. This means that the doctor’s office is registered with the Department of L&I and understands that they will be compensated under the state’s established guidelines and will “accept” L&I insurance.
This issue is more significant than it may seem, and unfortunately, the scenario described above happens regularly. The worker gets injured, and the company doc says, “Meh, you’re fine; go back to work.” You believe them because they’re a medical provider, and we expect doctors and nurses to do what’s best for us, so you don’t file a claim. You live with the pain for a while and finally decide to mention it to your doctor, but it’s been a year since you were hurt. Now it’s too late to file a claim; whatever treatment you get will be from your insurance with copays and without time loss or any of the protections offered by the Industrial Insurance Act.
However, there are “Independent Medical Examinations” that you may be compelled to attend in certain situations. If you’ve recently been notified that one of these exams is being scheduled for you, remember that you now have the right to record the audio and video of the appointment! In fact, check out our blogs on IMEs and recording the exam.
Myth #4: Workers’ compensation only covers medical bills
Who gets rich on L&I? NOBODY. Period. Full stop. If you’ve been injured at work in Washington and think that means your employer or the state will do what’s right and make you whole again, you’re unfortunately wrong. L&I does not compensate injured workers for pain and suffering, such as damages you may receive in a motor vehicle accident settlement. However, L&I coverage is much more than just paying for medical bills. You may be entitled to time loss compensation (wage replacement benefits), permanent partial disability awards (financial amounts that compensate for a person’s reduced ability to earn an income in the future), vocational retraining, or even pension (wage replacement benefits for life). Plenty of strings and caveats are attached, and your time loss rate will likely be less than you were making while you were working, but the system is there to help you (if you can get through that maze).
Myth #5: My employer can fire me for filing a claim
Does this happen? Yes. Is it legal? HELL NO.
The reality is that businesses, just like people, don’t always follow the law. Claim suppression (trying to convince injured workers not to file claims), claim retaliation or discrimination (mistreating employees who file injury claims), and retaliatory firing (termination for filing a claim) are against the law. Employers can be fined rather heavily for engaging in these behaviors. That doesn’t mean that it won’t happen. Washington State allows employers to terminate employees for any reason as long as it doesn’t violate discrimination laws. So, if you’re physically unable to complete the job tasks, your employer may be able to end your employment provided they comply with FMLA and leave requirements that may apply. More often than firing, we see injured workers being harassed in the workplace after filing a claim, being shamed or ridiculed by management, or being made to complete meaningless or degrading tasks at work. If this happens to you, please call a workers’ comp lawyer.
Why is workers’ compensation law so confusing?
Washington workers’ compensation law is unique and ever-evolving. Three sides are in play: the injured worker, the employer, and the State, each of which has competing interests. Case Law and statutes try to guide how the system is administered, but after over 100 years in practice, The Industrial Insurance Act remains far from perfect. It is difficult and complicated, but there is a way through the maze with a bit of guidance from an experienced workers’ compensation attorney and a little demystifying of the common myths and misconceptions.
Free legal consultation with a workers’ comp lawyer
Workers’ compensation attorneys play a pivotal role in demystifying the complexities of the L&I system. Rich and Chris will easily guide you through the process by offering clarity and dispelling misconceptions.
To learn more about Washington workers’ compensation laws and how it relates to your claim, schedule a free consultation with Rich or Chris. You may also call Carlisle + Byers at (509) 228-7011.
