Medical treatment when DLI claim is closed

Recently, our office pursued lengthy appeal reached all the way to the state’s court. He appealed out with an interpretation of RCW 51.36.010.

We believed that a reasonable interpretation of the statute would allow discretionary medical coverage for “life-threatening conditions” are not only persons will be placed on the pension rolls, but also to allow coverage for those who might have had claims closed with permanent partial disability only.

Several years ago, in a similar case, we were able to get the Board of industrial insurance appeals and a Superior Court agreed that it was reasonable to interpret the statute so as to include both pension cases and non-pension cases.

More recent case, following a favor bold decision of the Board of industrial insurance, was his record by the self insured employer. Self-insured employer, and the Department of Labor and industries, were able to convince Superior Court that our interpretation was not reasonable.

We then filed an appeal to the Washington state Court of Appeals, division three and we were unsuccessful there.

When we attempted to petition the Supreme Court for review, after an extension of time for consideration by the court, their ultimate determination was to let the Court of Appeals decision stand.

This is unfortunate. It means that if you have a condition caused by injury or by an occupational disease, even though it may be a potential life-threatening condition, if it does not render him totally and permanently disabled, and your claim is closed with permanent partial disability, your only recourse is to applying to reopen the claim and go through a lengthy adjudication process to access further treatment.

We believe that this is an area that the legislature should address. Although there are not many cases where an injury or occupational disease is life-threatening and only partially disabled, the delay caused by having to go through the adjudication process seeking reopening of claim is the injured worker that serious risk.

Some of the conditions which might be “life-threatening” and only partially disabling would include injuries affecting the heart, or lungs. Conditions such as occupational asthma”, COPD, atrial fibrillation, heart valve damage, congestive heart disease are only a short list of the types of conditions that fall into this category.

We felt strongly enough about this issue that we pursue the matter hire and fire appeal. We eventually ran out of levels of appeal.

Those who work here at Calbom & Schwab takes the rights of injured workers very seriously. We have zealously pursue the issue of importance to the one client.

We hope to be able to continue to do so for years in the future.