Like all states, Washington carries certain legal mandates for employer-provided workers compensation benefits. Washington is currently one of only four states in which workers compensation insurance is provided by the state rather than private insurance companies, although not all employers are required to provide this coverage. If you have any employees or are injured at work, you need to be sure you are on the right side of the law. Here are the 10 things you need to know about workers compensation laws in Washington.
- Mandatory coverage laws: In general, employers with one or more employees are required to provide workers compensation insurance. However, there are some exceptions. For example, newspaper carriers, children under 18 working on a family farm, and hairdressers or barbers who rent booth space are exempt. Families employing a single domestic worker do not have to provide coverage, and neither do certain very small companies. Speak with your attorney if you are unsure whether coverage is mandated for your situation.
- How to get coverage: Employers who are required to provide workers compensation insurance have two options. Most employers purchase insurance from the state. However, some employers are eligible to self-insure. This means that the employer will bear all of the medical expenses if an employee is hurt on the job, but will not have to pay monthly premiums. This option is taken by some of Washington’s largest employers, collectively covering nearly a third of the workforce.
- Reporting requirements: If you are injured at work, you have one year to report an injury or two years from the date of diagnosis to report an occupational disease. Your medical providers are also mandated to report their findings and any relevant activity prescriptions if you cannot return to full duty. Both reports go to the state for state-insured employers or directly to self-insured employers. Talk to an attorney if you are unclear on where or how to submit your injury report. Remember that time is of the essence to ensure that your claim is paid.
- Paying for premiums: Washington state law allows employers to share the costs of workers compensation insurance with their employees. The exact division depends on whether the employer is self-insured or state-insured. The laws are somewhat complicated, so it is always best to speak with an attorney to ensure that your rights are protected.
- Medical care: Employees are entitled to see any doctor they choose and to change doctors at any time. You also have the right to seek a second opinion if desired. There is no time or financial cap on reasonable and necessary medical treatment, although providers must follow the fee schedules determined by the state. Self-insured employers must provide the same freedom of doctor choice as those insured by the state, and cannot cap payments provided they are medically necessary and reasonable. Talk to an attorney if you are having trouble getting your claim paid.
- Temporary total disability (TTD): If you are unable to return to work in a timely manner, temporary total disability (TTD) benefits apply. You will receive 60 to 75 percent of your regular wages, depending on your marital status and number of dependents. However, minimum and maximum dollar limits apply. No employee can receive less than 15 percent nor more than 120 percent of the state’s average monthly wage. In addition, the first three days that you are off work are not covered unless the total time off work is more than 14 days. There is no time cap on how long you can receive benefits, provided the absence from work is medically necessary.
- Permanent partial disability (PPD): PPD benefits apply when an employee loses the use of a body part due to a work injury or occupational disease. Payment amounts for total loss are set by the state, and partial loss is paid as a portion of the total loss amount.
- Permanent total disability (PTD): If you are permanently and totally disabled due to a work accident or occupational disease, you are entitled to lifetime payments calculated in the same manner as TTD benefits. However, these benefits are offset by any Social Security benefits that the injured worker receives. Employees aged 53 or over also have the option to negotiate a settlement rather than remaining in the workers compensation system for life.
- Discretionary vocational benefits: Vocational benefits are available if the state or the self-insured employer decides that it would be in both parties’ best interest to provide them. If you cannot return to the same job or a different job, a vocational counselor can work with you to develop a vocational plan based on your interests, skills, and medical limitations. Vocational benefits can also pay for school or other job training for up to two years.
- Death benefits: If an employee is killed at work, burial expenses are covered up to a certain dollar limit. A dependent spouse will receive 60 percent of the employee’s wages, and an additional 2 percent for each dependent child. Children receive benefits until they turn 18, or 23 if they are in school, and disabled children’s benefits may continue after that. If the spouse remarries, his or her benefits are discontinued 24 months after the remarriage.
Washington state law provides quite a few benefits for employees who are injured at work, but not all employers know or follow the laws. To make sure your rights are protected and you receive all the compensation to which you are entitled, contact an attorney as soon as possible after your injury or occupational disease diagnosis. You must follow all of the designated procedures and timelines in order to receive your compensation, and competent legal representation can help you make sure that nothing is missed.
Bryan Stubbs, Attorney At Law, assists clients throughout the Tacoma, WA area. To protect your rights, speak to us as soon as possible after an injury. For over 50 years, our office has been helping injured workers on workers compensation claims and third party claims. We will fight for your rights and secure the best outcome for your injury claim!
Contact Bryan Stubbs today at 253-383-5891 to schedule a free initial consultation. If you or a loved one have been seriously injured in an accident at work, call us today!