Frequently Asked Questions (FAQ)

Q: My left hand was crushed when a pallet fell on it at work. Treatment is concluded, and the Department recently issued an order closing my claim and paying me a percentage of impairment for the two fingers that had to be amputated. The rating appears to be small. How are they supposed to rate disability?

A: When an injury is limited to the fingers, the hand, or the arm, the American Medical Association has a guide that is published to assist in evaluating the permanent partial disability. The rating is made in terms of “amputation value”. This means the value in relationship to the overall loss of function of the part of the body affected. Learn more about workers’ compensation claims.

Q: I sustained a severe burn on my hand at work. I was able to return to work, but I am not able to do all the things I could previously do. I am done with my treatment. What happens next?

A: Once treatment has achieved a point where nothing more can be done to cure the problem, the Department of Labor and Industries is supposed to attempt to assess the permanent partial disability that may exist, if any. An injury to your hand may involve loss of use of the hand itself due to decreased range of motion of fingers, depending on the amount of scar tissue that you have. Additionally, there are disability benefits available for impairment of the skin itself. These are described under “categories”. Learn more about workers’ compensation claims.

Q: I sustained severe burns to my face and neck when a chemical splashed on me at work. I am now done with treatment. The Department closed my claim because they say I am not entitled to permanent partial disability because they are not responsible for cosmetic damage. Is this true?

A: Under Washington’s Industrial Insurance Act, permanent partial disability is deemed to be a loss of bodily function. Purely cosmetic changes are not compensable. However, if you have sustained significant damage to your skin and require occasional, if not intermittent, uses of creams and ointments to help keep the scar tissue softened, or if you have to avoid exposure to sunlight or wind because it will cause drying, cracking or bleeding of the skin, there is likely a loss of bodily function that should be compensated. You can start by having your treating cosmetologist review the Washington Administrative Code as it applies to permanent skin impairment, or you can consult with an attorney who handles industrial insurance claims. Learn more about workers’ compensation claims.

Q: I recently went to a panel of doctors, at the request of the Department of Labor and Industries, for an examination. My claims manager tells me that the panel has rated my disability as a “Category 2″. What does this mean?

A: When an injured worker reaches a point where there is no further curative treatment that will benefit them, the Department of Labor and Industries is supposed to try to assess their permanent disability. If they are able to work, a permanent partial disability assessment is made. For injuries to the neck, back, low back, pelvis, lungs, heart, skin and others, the method of evaluating permanent disability is to select a “category” of impairment that most appropriately describes the person’s physical loss. Learn more about workers’ compensation claims.

Q: Are there circumstances under which a person can be reimbursed for taking care of a member of their family who was injured on the job?

A: The law provides for payment of personal care services provided by others to an injured worker. These personal care services have to be prescribed by a physician. The Department is reluctant to pay family members, believing that in many circumstances they are not as capable of providing the necessary services as professionals such as visiting nurses. However, the Department has recently established a set of guidelines for assisting family members, at least in head injury cases, in providing the necessary care. The Department is even willing to provide supervision of the family members by a trained professional to assure quality care is being provided to the disabled worker. This is a wonderful change in the Department policy which should reduce the cost to the Department and provide a loving caretaker for the seriously disabled worker. Learn more about workers’ compensation claims.

Q: I have worked in numerous mechanic shops over the years. Recently, my hearing has gotten worse. I had my hearing tested and found that I do have hearing loss. However, because all of my jobs have involved loud noises, my doctor has no idea which one caused the hearing loss. What do I do now?

A: Hearing loss claims, if not due to a singular event, such as an explosion, often occur due to repetitive trauma to the ears caused by loud noises occurring day after day. Because of this, it is often difficult to decide or determine when and where the hearing loss first began. Because of this difficulty, the Washington Supreme Court has determined that the employer to be held responsible for the hearing loss claim is the current employer when the condition first becomes disabling or requires medical treatment. This determination applies to all occupational disease claims, including repetitive stress trauma injuries such as carpal tunnel syndrome. Learn more about workers’ compensation claims.

Video Transcript

When a claim is closed, even if you’re able to go back to work, or particularly if you’re able to go back to work, but have some limitation, there are benefits called permanent partial disability benefits that are available. If the injury is to your neck, your back, to your lungs, some other conditions, there’s a rating system that are – it’s called a category system of impairment. For the low back, there are eight categories. For the neck, there are six. Each category has specifically designated findings associated with it.

If your doctor, or one of the department’s doctors looks at – does an examination, they will then look at these categories and compare your findings with the categories and try to estimate what category you fit into.

When it comes to parts of the body, such as arms, shoulders, ankles, knees, hips, then the Department of Labor and Industries uses the American Medical Association’s guide for evaluating permanent disability, and will rate according to the criteria in the guide, typically as a percentage of the loss of use of that extremity. So, for instance, if you had a knee surgery, you might be entitled to 20% or 30% permanent partial disability, or the leg, and they would then pay you 20% to 30% of the value assigned for an entire leg. These values are scheduled upwards by statute and by administrative code to establish a value that changes every year, that increases depending on how recent your injury has been.

Q: On my last visit with my doctor, I was told that my claims manager in Olympia had called and visited with my doctor about the treatment that I am going through right now. Does the Department of Labor and Industries have the right to speak directly with my own doctor?

A: Because they are deemed to be the “trustee” of the accident fund, the Department of Labor and Industries, by statute, has the right to discuss your treatment, medical history, prognosis, etc., with your physician. By statute, when a person files a worker’s compensation claim, they waive their patient/physician privilege. Up until recently, there was no such waiver in a personal injury setting. There are currently efforts underway by the insurance lobbying interests to change this. Learn more about workers’ compensation claims.

Q: I sustained an injury at work when someone drove a forklift into my foot. I now require the use of a special boot to continue driving a truck for my job. The Department of Labor and Industries closed my claim six months ago. My boot has worn out and needs to be replaced. What can I do?

Typically a special boot, if considered a prosthesis, can be paid for by the Department of Labor and Industries without having to apply to reopen the claim, if it is known that it is required due to the industrial injury. You should contact the Department of Labor and Industries. In addition, your question raises another issue, and that is whether or not the forklift driver was working for someone besides your employer. You may have the right to pursue a personal injury claim under what is called a “Third Party Action”. You typically have three years to bring a lawsuit for this type of claim. A third party claim allows you to recover damages for pain and suffering, emotional distress, loss of enjoyment of life, etc. Learn more about workers’ compensation claims.

Q: I recently fell from a ladder, landing on my right shoulder. When the doctor took x-rays, they discovered that I had severe arthritis in the shoulder joint. My doctor says the arthritis probably existed before my accident. Can the Department of Labor and Industries deny benefits to me because of this pre-existing arthritis in the shoulder?

A: Washington courts have, in prior cases, said that if an injury “lights up” or makes active a latent or weakened physical condition, all of the resulting disability is attributable to the injury. What this means is that unless the Department can establish that prior to this industrial injury you were actually having symptoms and disability as a result of the arthritis, then the industrial injury, which has made it symptomatic, is entirely responsible for all treatment and disability that continues thereafter. Learn more about workers’ compensation claims.

Q: I suffered an injury to my knee while working in Tri-Cities. I have continued to treat with my local doctor and have not been able to return to work. My husband’s employer wants to transfer him to California. What will happen to my claim?

A: The Department of Labor and Industries is more than equipped to handle situations like yours. Often, following an injury here in the State of Washington, an injured worker moves elsewhere. You will not be denied benefits simply because you no longer live here. In fact, recently the Department of Labor and Industries established a unit for handling claims specifically for people who live outside the state. I would suggest you ask your doctor to make arrangements for you to be referred to a physician of his choice in your new location. Should the Department of Labor and Industries deny access to further benefits or terminate your benefits, you will probably need to contact an attorney here in the State of Washington. This is because Worker’s Compensation benefits are different in each state.