Denial of Benefits May not be the Only Problem Plaguing WA Workers Comp

Olympia, WAIn Washington State, it appears there’s a bit more to worry about for Washingtonians beyond the potential for a situation that may result in a Washington State workers comp lawsuit, or a WA denied workers comp claim. The greater issue appears to be a continued rise in premiums that makes Washington state amongst the most expensive regions in the US for claims.

To that end the National Academy of Social Insurance (NASI), in October of last year, released a report that found the State of Washington to be third-highest out of 50 states with regard to the amount of workers compensation payouts by employers per $100 of payroll across a four-year window encompassing 2010 through 2014.

On the surface, it would appear as if a WA denied workers comp claim and the potential for a WA denied claim lawsuit would be the most appropriate response for workers injured on the job and denied benefits. However, the opposite appears to be true in many cases. To wit – claimants can, and do receive benefits in a majority of cases, but with benefits that may exceed what is their due in terms of amount and length.

What’s more, claimants who are more than ready to return to their jobs are prevented from doing so due to a system drowning in red tape and outdated protocols. And all this is a drain on an employer’s coffers. Would it be a possibility that an employer holds down wages to healthy, deserving employees in order to offset high workers compensation premiums?

According to lens (12/07/16), a publication under the auspices of the Business Institute of Washington, a participant in the Washington State Senate Commerce and Labor Committee meetings from last year talked of employees who were off the job by way of a workers compensation claim, but ready and willing to return to work and prevented from doing so. “I talked to [three] [sic] employees during interim,” said Washington State Senator Curtis King (Republican, District 14), in comments published in lens. “All three of them wanted to go back to work, all of them have gone through all the processes. They were waiting, and L&I (Washington Department of Labor and Industries) [sic] wouldn’t let them go back to work. They had been waiting months…they’ve seen the doctors…they’re chomping at the bit to go back to work, but that is not what the process is,” continued King, identified as a member of the committee.

An attorney in private practice in Washington who once managed the Self-Insured sector of L&I, cited a Washington Court of Appeals case from September of last year where a claimant received higher benefits than that which otherwise would be his due, because of bureaucratic process and protocol.

The case is Harder Mechanical Inc., v. Patrick Tierney (Case No. 74845-9-1, in the Court of Appeals of the State of Washington). Attorney Natalee Fillinger noted that claimant Patrick Tierney is a pipefitter by trade with a history of sporadic, part-time work. Tierney, according to Court documents, had been injured on a new job and granted workers compensation benefits.

Tierney’s benefits, according to Fillinger, were based on the presumption of a regular full-time schedule, as well as the claimant’s stated intent – as opposed to his actual work history – to be working full-time. Thus, a higher stipend of benefits was paid based on assumption and intent, rather than work history.

“…When you are making double on time loss,” Fillinger said, in comments published in lens, compared to “actually working, sometimes there can be a delay in recovery…[sic] there is nonsense in the way that the wage is done in the state of Washington and it will take legislative intervention.”

Which begs the question: while a claimant may launch a WA denied claim lawsuit when benefits are refused, might a Washington State Workers Comp lawsuit be similarly appropriate when benefits paid are too high, or granted but for too long when a claimant is ready, willing and able to return to the job?