Frequently Asked Questions (FAQ)
Washington’s workplace injury and accident laws aren’t always straightforward. They can be complex and written in a language that average people barely understand. That’s why many people in Central Washington aren’t sure about their legal options or how they can best advocate for themselves and their rights.
At Calbom & Schwab Law Group, PLLC, we make sure that every client gets answers to any questions they have. Our experienced attorneys are well-versed in laws related to workers’ compensation, personal injury, and Social Security Disability (SSD).
Below are some of the most common questions we’ve received from clients. If you have any questions that aren’t answered here, don’t be afraid to contact our law offices for more information. No matter who you are or where you come from, you can count on us to listen and provide answers.
Video Transcript:
That’s a very good question. I oftentimes run into individuals who have an on the job injury, and they are directed by their employer to go see a specific doctor. They are told they must go see this doctor. Under the Industrial Insurance Act, that’s wrong.
Once an individual suffers and on the job injury, they can choose whichever doctor they want to see. If you’re an injured worker, you do not have to go see a doctor that your employer wants you to go see. One of the problems is that sometimes doctors, or clinics even, are contracted with employers. And you have to ask yourself as an injured worker, do you want to go see a doctor like that? Do you really think that the doctor, or that clinic, is going to be completely unbiased since they have an economic or financial contract with their employer of injury?
The Department often schedules repeat examinations in what seems like an attempt to avoid making a final decision on a case. There is law that suggests that the Department must have good cause to force a worker to go to repeated examinations. However, at this time, good cause has been interpreted to mean almost any silly reason given by the Department. There is some point where the courts will allow one to say no to more exams, but it would have to be such an abuse of discretion that it would offend almost everyone before a refusal to attend would be supported in court. You can still refuse to go for good cause such as distance to the exam, illness, transportation, or personal knowledge of or past experience with the examiner which causes you to find him or her offensive. Learn more about workers’ compensation claims.
Video Transcript
At what point in time should you hire an attorney? It’s not always necessary to hire an attorney immediately. Go through treatment, see if you get better, negotiate with the insurance adjuster, and then give an attorney a call to discuss. In other cases it’s imperative to get a lawyer right away; for example a car accident case.
Most importantly ask – do we need to hire an attorney? If you are unsure of whether or not to hire somebody, call us today and we’ll give you the simple answer.
Q: I crushed two fingers at work when a paint can fell on them. I filed a claim under the employer I worked for, but received notice that the claim was rejected because I was described as an “independent contractor”. Why did the Department do this?
A: If someone who is injured is acting as an “independent contractor”, they have to maintain coverage for themselves and file the claim under their own business. However, there can be situations where a person, although licensed to do business as a contractor, may hire out to work as an employee. The crucial test is whether or not you brought to the employment anything more than your own personal talents or labor. Learn more about workers’ compensation claims.
Video Transcript
Hi, I’m Gracie Ortiz, and I am a paralegal at Calbom and Schwab.
Today I’m here to discuss social security offset. In the state of Washington, if an injured worker is receiving Social Security disability benefits and time
loss or pension benefits under a worker’s compensation claim, typically their benefits will be reduced. When the benefits are reduced, it’s called a social security offset. This amount is calculated by the Department of Labor and Industries using a formula that will determine the maximum amount any injured worker can receive with both benefits combined. The formula is called an ace. The ace is established by taking 80% of one year of the injured worker’s last five years’ highest earnings, or an average of any five years during their lifetime.
The time loss rate is then established by reducing the monthly social security entitlement from the ace. Because it does take some time after the injured worker has started receiving Social Security disability benefits and the social security department is in contact with the department to get the order issued, there is often a period where the injured worker is receiving 100% of both benefits. That entitlement is definitely going to be reduced and there will be an overpayment of benefits.
The department must also not commence the reduction of benefits until 30 days after they have been notified by Social Security that the injured worker is drawing social security benefits.
The overpayment is typically reduced from future time loss and permanent partial disability benefits at a rate of 25% per month. If social security is paying a back period of benefits, where time loss benefits have already been paid, it is typical that Social Security will reduce the social security benefits and LNI will take over the offset from the benefits there forward. Here at Calbom and Schwab, we encourage injured workers who have been off work for a year or believe they will be off work for a year to apply for social security benefits. Your time loss rate may be reduced, but when we take both benefits combined, it is never going to be less than your time loss rate, and may actually be more money in your pocket when you get both benefits combined. Social security also may provide additional benefits such as medical and prescription benefits, which will assist an injured worker in getting unrelated conditions or medical expenses covered. If you receive an order calculating the social security offset and you are concerned with the figures, we would welcome and encourage you to contact our office. And we would be happy to review the figures with you and see if there is some type of assistance we may provide you.
Q: Almost a year ago, I twisted my knee when my foot slipped on a stair at work. I have continued to work since then, but my knee has gotten worse. I did not file an accident report with my employer at the time of my accident because my injury did not seem too bad at the time. What can I do to see about getting treatment for my knee now?
A: A traumatic event occurring in the course of employment, is generally the definition of an industrial injury in the State of Washington. As long as you can show that the injury occurred while at the work site, it should be allowed and recognized by the Department of Labor and Industries. However, there is a time limit for filing claims for industrial injuries. A report of accident must be filed with the Department of Labor and Industries within one year of the date of the accident. It is not necessary that you specifically report it to your employer at the time the event occurred. The one year limit for filing these claims with the Department is strictly upheld by the courts. I would advise you to go see a doctor immediately, have the doctor help you fill out an accident report form and mail it to the Department of Labor and Industries. The longer you wait, the more you risk not getting it filed within one year of the date of accident. If you go beyond one year without filing the accident report, even if you had ten people willing to sign an affidavit that this knee problem started from an injury occurring in the course of your employment, you would be prohibited, by law, from filing such a claim. Learn more about workers’ compensation claims.