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Welcome to the blog of Scott, Kinney, Fjelstad & Mack, Attorneys at Law.
Attorney Jay Kinney will periodically post news, events, changes in the law, and educational information relevant to our areas of practice. If you are in need of further information about workers' compensation, Social Security Disability Insurance (SSDI) claim, or any form of accidental injury or employment law matter, please visit our web site at www.skf-law.com or contact us at 206-622-2200.
The Basics
Posted by: Jay Kinney
October 14, 2011
Topic: Time Loss Compensation
When you cannot work due to your injury or occupational disease, you should get time loss compensation, also called temporary total disability. Whether you qualify for time loss depends on the facts of your case, the evidence of your disability set out in your doctor's records. The department insists that your medical provider must certify your inability to work, and the opinion has to be based on objective findings. Objective findings are physical manifestations of your condition which the doctor can observe on physical examination. Two clear examples would be a broken bone, or a severe muscle spasm in your low back. Pain may be what keeps you from returning to work, but your doctor cannot measure your pain, so the department requires more than pain complaints to pay time loss. The doctor should fill out the department's standard Activity Prescription Form to trigger your time loss payments, but the form is not required if the doctor's chart notes set out the evidence that your condition is so severe you cannot return to substantial gainful employment.
Of course, things get complicated pretty quickly in Labor and Industries claims. The department and self insured employers are highly motivated to reduce claim costs, and the easiest ways to save money is to deny time loss and medical care. I will write about this in more detail. However, if your medical provider says you cannot work because of your injury and the department or self insured employer is not paying you, you should talk to an attorney.
Provisional time loss basics
Posted by: euser
December 16, 2010
Topic: Provisional time loss on Washington Workers Compensation Claims
Injured workers in Washington State are entitled to provisional time loss even before their claims are allowed. Under RCW 51.32.210 (state fund claims) and RCW 51.32.190(3) (self-insured claims), if time loss is certified by a doctor on the accident report or in the medical records, it must be paid within 14 days. Payments must continue at least semimonthly until the department issues a determinative order allowing or rejecting the claim. If the claim is ultimately rejected, RCW 51.32.240(3) allows the department to recoup the benefits from you.
The purpose of provisional time loss is to protect injured workers from possible financial hardship due to a delay in benefits, and to encourage the department and employer to quickly act on claims. Timely action is certainly necessary if you are unable to work, since the loss of a paycheck is certainly a financial emergency. According to the Board of Industrial Insurance Appeals, the "Legislature has apparently decided that this social and economic need of workers outweighs the prevention of the payment of any compensation until a determinative administrative decision has been made".
Provisional time loss does not depend on the eventual validity of the claim, and it only ends with the issuance of a binding order allowing or rejecting the claim. This order has meet the requirements of RCW 51.52.050.
