Workers' Compensation

Workers’ compensation covers the costs of medically proper and necessary treatment related to the industrial injury or exposure. Costs typically covered may include but are not limited to, expenses for providers, hospitals, surgeries, medication, dental care, home nursing care, equipment and prosthesis.

If injured workers are unable to return to gainful employment, vocational services such as counseling, job modifications and retraining may be available to help return them to the work force.

If an injured worker is vocationally and medically unable to obtain and maintain reasonably continuous gainful employment due to the residuals of the industrial injury or exposure, a monthly pension may be paid for the rest of his/her life. Some factors used to consider whether an injured worker is totally and permanently disabled may include age, job experience, transferable skills, education and any pre-existing conditions.

Under the Industrial Insurance Act, employers receive nearly complete immunity for liability under personal injury actions arising out of workplace injuries. However, if a “third party” (one who is not in the same employment as the injured worker) is at fault, then the injured worker may elect to personally pursue a third-party action. Common examples of third-party claims may include, but are not limited to, situations involving:

• Car accidents while on the job
• Accidents while working on the premises other than your employer
• Work injuries sustained from a negligent contractor or subcontractor

Industrial injury claims must be filed within one year after the day of the injury. Ultimately, the responsibility for filing the claim rests with the injured worker. See RCW 51.28.050.

An industrial injury is defined as “a sudden and tangible happening, of a traumatic nature, producing an immediate or prompt result, and occurring from without, and such physical conditions as result therefrom.” RCW 51.08.100. An injury occurs from an incident at a fixed point of time.

No. Washington State’s workers’ compensation provides sure and certain relief for injured workers and their dependents regardless of questions of fault. See RCW 51.04.010.

If injured workers have sustained a loss of earning power (LEP) exceeding five percent of wages at the time of injury, then LEP benefits may be paid. Generally, LEP compensation is based on 80 percent of the actual difference between the worker’s present wages and earning power at the time of injury. The LEP benefits may continue to the point of legal fixity.

Claims Managers may request IMEs to assist in resolving medical, aggravation and vocational issues, as well as obtaining impairment ratings. Often times, independent medical examiners will offer opinions inconsistent with those from your treating physician(s). In such an event, your workers’ compensation benefits may be in jeopardy. If you have questions or concerns, you should consult with an experienced Washington workers’ compensation attorney.

In order to establish an aggravation to reopen a claim, the injured worker must establish the worsening is: (1) substantiated by objective medical findings, (2) causally related to the industrial injury or occupational disease, and (3) objectively worse between the last claim closure or reopening denial and the date of the application to reopen.