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WORKERS' COMPENSATIONS: Which Benefits When

Posted by Foster Law on December 6, 2013

If you've been injured on the job or have developed an “occupational disease” (for instance, carpal tunnel syndrome or other repetitive stress injury caused or aggravated by distinctive conditions of your employment), you might be wondering which benefits you are entitled to once your claim is allowed. The following is a brief summary of the most common benefits which may be provided once you have an open (or reopened) claim:

1. Treatment: When a covered worker is injured at work or develops an occupational disease because of their job in the State of Washington, he or she is entitled to receive proper and necessary medical and surgical services at the hands of a physician or licensed advanced registered nurse practitioner of his or her own choosing (so long as the medical provider is an authorized member of L&I's new Medical Provider Network). Proper and necessary treatment refers to treatment that is diagnostic, curative, or rehabilitative in nature. For more information about treatment, visit http://www.lni.wa.gov/ClaimsIns/Claims/File/GetTreated/default.asp

2. Time-Loss Compensation (Temporary Total Disability): Temporary total disability is defined as an impairment of the mind or body that renders a worker unable to perform or obtain a gainful occupation with a reasonable degree of success and continuity. It is the loss of all reasonable wage-earning capacity. A worker is totally disabled if unable to obtain regular gainful employment within the range of the worker's capabilities, training, education, and experience. A worker is not totally disabled solely because of the inability to return to the worker's former occupation. However total disability does not mean that the worker must have become physically or mentally helpless.

If you have been injured and fit within the definition of total disability, you may be entitled to time-loss compensation benefits. These benefits are paid in bi-weekly installments while the injured worker meets the definition and his or her disability is certified by the attending physician in the claim. The easiest way for the attending physician to certify a worker's entitlement to time-loss compensation is by completing an activity prescription form, which should be submitted to the Department every thirty to sixty days. To obtain an activity prescription form, visit http://www.lni.wa.gov/FormPub/Detail.asp?DocID=2286

3. Permanent Partial Disability (PPD): Permanent partial disability is a loss of bodily function to a part or parts of the body proximately caused by the industrial injury or occupational disease. Disability is measured by the actual amputation of a specific body part or parts or, if the body part involved could be amputated but no amputation has actually occurred, the disability is measured in terms of the percentage of loss of function of that particular body part or parts. If the body part involved is a part that cannot be amputated such as the spine or mental health, then loss of function is measured according to a category rating system (i.e., the categories of impairment). Assessment of loss of bodily function is made by comparing the condition of the injured worker with criteria described in the categories and selecting the most appropriate category. Monetary payment is made based upon the “Permanent Partial Disability Award Schedule” in place at the time the injury occurred or the disease manifested itself. To find the applicable award schedule, visit http://www.lni.wa.gov/ClaimsIns/Claims/Benefits/Disability/PpdAwardScheds.asp

4. Permanent Total Disability (PTD or pension): The definition of permanent total disability is identical to the definition for temporary total disability except that total disability becomes permanent when it is reasonably expected to continue for the foreseeable future. Once total disability has become permanent, it is appropriate for a claim to be closed and for the injured worker to be placed on the Department pension rolls. Pension payments are made monthly and continue for the remainder of the injured worker's life (and for the spouse's life by election) so long as the worker is not gainfully employed or employable. Returning to gainful employment disqualifies an individual from the right to receive ongoing pension payments. If you are interested in learning more about pension benefits, visit http://www.lni.wa.gov/ClaimsIns/Claims/Benefits/Pension/default.asp

At Foster Law, P.C. we are expert, we are fierce, and we are compassionate. Our team offers decades of experience to helping literally thousands of injured workers obtain the benefits that are so crucial to maintaining their welfare and that of their families. If you are an injured worker or medical provider and have questions or concerns about the benefits outlined above or any other aspect of workers' compensation law in this state, we invite you to contact us. Initial consultations are complimentary. Don't leave your workers' compensation claim to chance; consult with experts.

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