Washington workers’ compensation benefits take many forms. Some of these include: medical benefits, wage replacement and partial disability awards. But, how do you know which benefit applies to your specific workers’ compensation claim? The answer will essentially depend on the severity of your injury and whether this injury prevents you from returning to work. Let’s examine this further by taking a look at several possible workers’ compensation benefits.
Medical Benefits
Once your workers’ compensation claim has been approved, the Washington State Department of Labor & Industries (L&I), or your self-insured employer, will begin to cover medical bills directly related to your injury. This coverage may continue up until your doctor certifies that your injury has: (1) stabilized; and, (2) reached a point where further recovery is not anticipated. Coverage may also continue even if you go back to work, provided however, your workers’ compensation claim remains open.
Please note that workers’ compensation cannot pay for the following
- Conditions not related to a workplace injury or illness;
- Treatment, such as acupuncture, that is not covered by workers’ compensation; and,
- Treatment from providers that are not enrolled in L&I’s network.
Wage Replacement
It’s likely that you may miss work as a result of your work related injury. If so, and provided a doctor certifies that you are unable to work, you may be entitled to “time-loss compensation.” This is basically a payment for a portion of your lost wages. The payment is made by L&I or your self-insured employer.
An exception, however, applies to the three days immediately following the date of your injury. These days represent a waiting period. Neither L&I, nor, your self-insured employer will pay for lost wages on these days.
Keep in mind that time-loss compensation will not cover the total amount of your lost wages. This benefit only covers a portion of your lost wages. The benefit amount is 60 to 75 percent of the wages you were earning at the time of your injury.
Permanent Partial Disability
Some injured on the job may suffer a permanent disability as a result of the injury. If true to your workers’ compensation claim, you may qualify for a Permanent Partial Disability (PPD) award. A PPD technically means that you can still work, but your physical ability has been impaired. In order to qualify for this benefit, your PPD must be rated by a qualified doctor.
Permanent Total Disability
Pensions are available if you have suffered permanent total disability from a work related injury. More specifically, two types of pensions are available. The first applies to those cases in which a worker loses (or loses the use of): both legs, both arms, an arm and a leg, or his vision. In this situation, the worker is eligible for a monthly pension by law, even if he returns to work.
The second type of pension applies to those cases in which a person has suffered such an injury that the injury prevents him from ever becoming gainfully employed. Whether or not an injury prevents a person from ever becoming gainfully employed is a determination made by L&I.
Prescription Medications
L&I, or your self-insured employer, may pay for prescription medications used to treat a work related injury. However, as stated on L&I’s website, the prescription medications must be “necessary for treatment of accepted conditions resulting from industrial injuries and occupational diseases on open and allowed workers’ compensation claims.” Prescriptions for treatment of unrelated conditions, or conditions not accepted under a claim, must be paid for by the injured worker or billed to his private health insurance.
Travel Reimbursement
If you have been injured on the job and travel further than 15 miles to see a health care provider, you may be entitled to reimbursement for some of your travel expenses. Three requirements must be met, however, to receive this reimbursement. The requirements are:
- The health-care provider is further than 15 miles from your home.
- No other closer providers exist that can treat your condition.
- The travel reimbursement is pre-authorized by your claim manager.
Let the Phillips Law Firm Help
Understanding the specific benefits that may apply to your workers’ compensation claim can be quite confusing. Obtaining these benefits can also pose difficulties and involve legal and administrative nuances. Don’t get overwhelmed. Worse yet, don’t get denied benefits that you may be entitled to receive. Our firm has years of experience in assisting clients get the workers’ compensation benefits that they deserve and are entitled to. Simply contact us today and let us help.
