Below you will find the critical questions that must be answered to effectively value your L&I claim. While no two claims are alike, there are a number of factors that increase your L&I claim value. Even a seemingly straightforward claim may have one or more of these factors, and the existence of any of them could exponentially increase the value of your L&I claim. These are the biggest factors for maximizing the value of your workers’ compensation claim. Take your time in reviewing and understanding them because you can bet that your Claim Manager or self-insured employer is not going to inform you of these.
Your L&I claim case is worth more if you also have an employment law claim.
Do you have an employment claim against your employer for retaliation, wrongful termination, disability discrimination, or unpaid wages? If the answer is yes, the value of your claim may increase exponentially. Many injured workers with open L&I claims find that their employer has taken, or plans to take an adverse action against them because they file an L&I claim, or they are out of work. An attorney that is experienced in both L&I law and employment law can prosecute your L&I claim while simultaneously filing a federal or state law claim for the violation of your employment rights by your employer. If you have a valid employment claim, your overall recovery is likely to be exponentially higher than if you only have a workers’ compensation claim. If you think you might have an employment claim, give us a call and we’ll walk you through your options. To our knowledge, we are the only law firm in Washington State with the experience and know-how to leverage employment claims alongside L&I claims to the benefit of our clients’ rights, and their fight for a maximum total award.
Your claims are worth more if you have a third party claim.
Can someone other than your employer be responsible for your injury? It is important to look closely at the cause of the injury, and in turn determine who might be responsible. The attorneys at Emery Reddy talk to potential clients all the time who are completely unaware that they have a third party injury. If you have a third party claim, we can sue the person responsible for causing it. We typically file this lawsuit in state or federal court, and then simultaneously litigate your workers’ compensation claim with L&I alongside your L&I claim. Your claim is worth exponentially more if you have a third party case. Examples of third party claims for include:
- You were involved in a construction injury – Construction injuries are common sources of third party injuries.
- Your workplace injury is the result of a car accident – Nearly every car accident results in a third party claim if it happened while you were working.
- You were injured as a result of a safety product failure, such a defective safety device.
- Another contractor working with or for your employer was at least partially responsible for your injury.
- You were hurt on someone else’s property while working.
- You were injured by a machine malfunction or other product issue.
After years of litigating third party cases, we’ve recovered millions for our clients in situations where they were hurt while delivering packages, tripped over ill-placed parcels in a doorway, were involved in an auto collision, or were hurt by a faulty safety strap, platform, or rigging.
When considering hiring an attorney to handle your third party claim, make sure that the attorney is also experienced in litigating L&I claims. Most “injury firms” do not handle L&I claims. To maximize your total award for all of your claims, we highly recommend hiring the same firm for all of your claims. A team of attorneys experienced in litigating injury law claims and L&I claims will understand how to leverage each claim in state (or federal) court and before the Board of Industrial Insurance Appeals in order to maximize the value of all of your claims. Hiring two different firms often creates lien issues, communication gaps, evidentiary issues, and strategy problems. You could wind up with a good L&I result that sinks your third party claim. Or you could wind up with a good third party result, but totally miss your ability to settle the underlying L&I claims, which could cost you your entire award. Our L&I and third party litigation team would be pleased to analyze your claims and tell you if you have a third party case that can be litigated in tandem with your L&I claim. Give us a call and we’ll tell you if we can help.
Time loss compensation
Are you unable to work? L&I (or your self-insured employer) is required to pay you for the time you miss work due to your industrial injury. The pay rate is 60-75% of your regular wages (up to a cap). The exact percentage depends on how many dependents you have. If you are already receiving time loss compensation, it is important to double-check the calculation because L&I often makes mistakes on wage orders, miscalculates rates, or just fails to take into account other income sources when it sets the rate. It is worth noting that time loss compensation is not taxable. The IRS considers it a disability benefit, and not taxable income.
Permanent Partial Disability
Do you have a serious injury? The more serious your injury, the greater the recovery to which you are entitled. Permanent partial disability (PPD) Injury awards are governed by schedule and can be found on L&I’s website here: http://lni.wa.gov/ClaimsIns/Files/SelfIns/ClaimMgt/2018PpdSched.pdf. The amount of money you receive for your injury is based on the type of injury and the level of severity of that injury, measured by a “category rating.”
What L&I doesn’t tell you is that the Claim Manager assigned to your case has a lot of discretion to set the applicable category rating. And the difference in the amount you will receive for your injury increases exponentially as the category rating increases. Take a look at the chart in this link: http://lni.wa.gov/ClaimsIns/Files/SelfIns/ClaimMgt/2018PpdSched.pdf. A “Category 2” Cervical and Cervicodorsal rating is paid at $20,548.51, but a “Category 3” rating is paid at $41,097.20. Your claim is doubled if the Claim Manager agrees to a Category 3 rating. Often, the difference between the Claim Manager issuing a lower rating, and a much higher rating (one that pays you the amount you truly deserve for your injury) is a good attorney and a supportive doctor. Make sure you have both before you agree to a PPD award. You often only get one shot at getting it right, and accepting a lower amount could bar you from any future recovery.
If you are over 50 and are severely injured, you may be entitled to a lifetime L&I pension. A pension is 60-75% (up to a cap) of your wage rate just prior to your injury. This amount is paid twice monthly for life. Any worker over 50 should consider reviewing their options for a pension with an attorney.
It is strongly advised that you talk to an L&I attorney before you start working with a Vocational Rehabilitation Counselor (VRC) or anytime you begin to understand that L&I may not agree with your level of disability or the reasons why you cannot return to the workforce. VRC’s and Claim Managers are skilled at finding ways to argue that you are healed or that you can return to the workforce in some other job – even if it’s a job you’ve never performed. A common tactic of VRC’s is to declare the injured worker able to return to work as a “cashier” even if the worker’s disability and lack of experience prevents him or her from doing the job. Often times there is very little chance in the worker able to secure the job in the first place.
Pensions are hotly contested. If you are eligible for one, your claim is expensive for the state (or your self-insured employer) to fund. In other words, your claim has value, and as such you should expect to fight hard for it.