Vocational Rehabilitation Pilot Project

Information, Guidelines, Forms, Training, Draft Rules & Listserv

The new vocational rehabilitation pilot project began January 1, 2008.  There is a flood of information available to help you in complying with the requirements of the program.  Most information regarding all aspects of the project can be found at a special DLI webpage http://www.lni.wa.gov/ClaimsIns/Providers/Vocational/ImproveVoc/VIP.asp.  The scope of information covers everything from benefits provided, forms, process to have programs certified by the state as an approved vocational program, and other pertinent facts.

Until the draft rules have gone through the formal review process, the Department has adopted a specific set of guidelines for self-insured claims.  You can find them here at our website at http://www.wsiassn.org/documents/VocGuidelinesforSIEs_FINAL_4jan08_REVISED.pdf.  Please use these guidelines until the formal rules are adopted. [NOTE: THESE GUIDELINES HAVE BEEN REVISED TO ADDRESS ERRORS AND CONCERNS THAT WSIA EXPRESSED TO THE DEPARTMENT.  PLEASE USE THESE REVISED GUIDELINES.]

The new Self-Insured Vocational Reporting Form, a cover page that is to accompany all vocational communications with the Department, is posted at http://www.lni.wa.gov/forms/pdf/207190a0.pdf.  This new form takes the place of the E.A.R.  Additionally, there will be a new Self-Insured Vocational Services Closing Form.  That has not yet posted, but can be found at http://www.lni.wa.gov/FormPub/results.asp?Keyword=self-insurance when it is.

After some discussions with the Department on January 10, formal training on the new vocational requirements is already being developed for self-administered and TPA self-insured claims adjudicators.  A focus group will be reviewing and providing feedback to the Department on the preliminary training program, some time before the end of the month.  Actual training for self-insured claims adjudicators will be provided in mid-February.

The draft rules have been out for awhile.  WSIA solicited your feedback back in October and November 2007, and submitted comments to the Department at that time.  While formal rules are now out for public comment, with hearings scheduled for January 22 in Spokane, and January 24 in Olympia.  Here is a link to the draft rules http://www.lni.wa.gov/rules/AO07/16/0716Proposal.pdf.  If you have comments or concerns, the Department will accept written/emailed comments up until close of business on Thursday, January 31st.  Send your comments and concerns to Valerie Grimm at colb235@lni.wa.gov.

You can keep abreast of all issues related to the vocational pilot project by getting onto the special DLI Listserv with updated email information.  To make sure you get the most up to date information, sign up at http://www.lni.wa.gov/Main/Listservs/VocRehab.asp as soon as possible.

Lastly, there is a Vocational Fact Sheet put out from the Department earlier this week.  Here's the link to that document.  Fact Sheet

If you have any additional questions or concerns, please contact WSIA Executive Director Dave Kaplan at dave.kaplan@wsiassn.org as soon as possible.

Don't Shoot the Messenger!

Department Announces Initial Continuing Education Credits for Courses

The Department of Labor & Industries' Self-Insurance Section has finally reviewed the initial submittal of WSIA training programs for Continuing Education Credits.  The following is the Department's determination of credits for the training programs we offer:  Claims 1 - no credit; Claims 2 - no credit; Claims 3 - 3 credits (2 claims process, 1 medical); Claims 4 - 2 credits (2 claims process); WWCP Statutory Requirements - 4 credits (2 claims process, 1 legal, 1 elective); WWCP Medical Information - 12 credits (12 medical); WWCP Claims Management - 12 credits (11 claims process, 1 legal); Legal Issues Workshop - 9.5 credits (8.5 legal, 1 ethics); Region 6 10/18/07 mtg - 1.5 credits (1.5 medical); WSIA Winter East Conference Nov.07 - 5 credits (5 medical); Meeting of the Minds Oct.07 - 3.5 credits (2 legal, 1.5 claims process); Lorman's Workers'  Comp Update for WA Nov.07 - 2.5 credits (.5 legal, 1 claims process, 1 elective); and DLI's Advanced Topics in Washington Workers' Comp: Physical Capacity Calc and Return to Work Nov.07 - 7 credits (4 claims process, 3 medical).  ONLY THOSE COURSES TAKEN AFTER OCTOBER 1, 2007 ARE AWARDED CREDIT.

It is important to remember that you can take any training programs and submit them to the Department for consideration for the awarding of CEC's.  If you pursue that approach, please be sure to let us know which programs you have submitted for credit consideration.  We will be reviewing the Department's evaluation of our program, and will be posting the credit information here at the website (along with our own CEC's for maintaining your WWCP designation).  If you have any questions, please don't hesitate to contact WSIA Training Coordinator Bonnie Prater at bonnie.prater@wsiassn.org.

Department Announces Certified

Claims Administrator Testing Schedule for 2008

The Department of Labor & Industries has announced the dates for their Certified Claims Administrator testing.  The test dates are March 20, June 19, September 18, and December 18, 2008.  There is an application acceptance period for each exam.  For the March 20 test, your application must be submitted between December 17, 2007 and February 3, 2008.  For the June 19 test, your application must be submitted between March 23 and May 4.  For the September 18 test, your application must be submitted between June 23 and August 3.  And for the December 18 test, your application must be submitted between September 22 and November 2.  You can find the application at the Department's website at http://www.lni.wa.gov/forms/pdf/207177af.pdf.  Also, as you know, WSIA provides a one-day review course the day before each of the Department test dates.  Review courses, offered only to employees of WSIA member organizations, will be held on March 19, June 18, September 17, and December 17 at a location in Olympia.  Watch the WSIA website's Training Programs & Conferences page for more details.

Clarification Regarding Claims Administrator Certification,

Continuing Education Requirements, and Deadlines

There has been a number of questions regarding the Continuing Education option, as an alternative to re-testing, for maintaining the state's Claims Administrator Certification.  Hopefully this will clarify and answer most of those questions.

If your certification expires before October 1, 2008 you MUST take the Certified Claims Administrator test.  There are no exceptions to that.  No grandfathering.  You MUST take the test again.  Once you are certified, you will have five years to either collect a minimum of 75 Continuing Education Credits (20 in claims processing/procedures; 20 in legal issues; 20 in medical issues; 2 in ethics; and 13 in elective topics), or take the test again.

There is a tiered structure for those people whose certification expires between October 1, 2008 and September 30, 2012.

If your certification expires between October 1, 2008 and March 31, 2009, you must earn a minimum of 30 credits (8 in claims processing/procedures; 8 in legal issues; 8 in medical issues; 1 in ethics; and 5 in elective topics).

If your certification expires between April 1, 2009 and September 30, 2009, you must earn a minimum of 35 credits (10 in claims processing/procedures; 10 in legal issues; 10 in medical issues; 1 in ethics; and 4 in elective topics).

If your certification expires between October 1, 2009 and March 31, 2010, you must earn a minimum of 40 credits (11 in claims processing/procedures; 11 in legal issues; 11 in medical issues; 1 in ethics; and 6 in elective topics).

If your certification expires between April 1, 2010 and September 30, 2010, you must earn a minimum of 45 credits (12 in claims processing/procedures; 12 in legal issues; 12 in medical issues; 2 in ethics; and 7 in elective topics).

If your certification expires between October 1, 2010 and March 31, 2011, you must earn a minimum of 50 credits (14 in claims processing/procedures; 14 in legal issues; 13 in medical issues; 2 in ethics; and 7 in elective topics).

If your certification expires between April 1, 2011 and September 30, 2011, you must earn a minimum of 55 credits (15 in claims processing/procedures; 15 in legal issues; 15 in medical issues; 2 in ethics; and 8 in elective topics).

If your certification expires between October 1, 2011 and March 31, 2012, you must earn a minimum of 60 credits (16 in claims processing/procedures; 16 in legal issues; 16 in medical issues; 2 in ethics; and 10 in elective topics).

If your certification expires between April 1, 2012 and September 30, 2012, you must earn a minimum of 65 credits (18 in claims processing/procedures; 18 in legal issues; 18 in medical issues; 2 in ethics; and 9 in elective topics).

The Department will assign credits to courses that are submitted by education providers.  A Committee meets monthly to review the submittals, and then makes recommendations for the number of credits to be awarded.  WSIA has already submitted all of our training programs for review, as well as a number of Region meetings, conferences, and non-WSIA programs.  We have yet to hear anything back on the number of credits to be awarded, but will post those as soon as we receive them.

The Department will maintain a web-based database for for Certified Claims Administrators to track and report their credit hours.

For more information, consult the rule at http://www.lni.wa.gov/rules/AO06/19/0619Adoption.pdf.

Trouble Finding a Medical Examiner?

New Department Search Feature Makes it Quick & Painless

Need help finding a medical examiner for a particular specialty?  The Department has added a search function to their list of approved examiners.  https://fortress.wa.gov/lni/imets/.

Updated Self-Insurance Section

Phone Contact Listing ... Including Team Assignments

Need an updated list of Self-Insurance section phone numbers?  Here’s the link to the latest and greatest list, http://www.lni.wa.gov/ClaimsIns/Files/SelfIns/SelfInsPhoneList.pdf, updated January 1, 2008 .  Note that the list now includes which adjudicator and which consultant work on which claims Team.  Check back at this link periodically for updated information.

Requesting Self-Insured and

Requesting State Fund Claims Files

In response to changes in public disclosure law, the Department of Labor & Industries has changed the way they process and respond to requests for prior industrial insurance claims files.  You will need to submit TWO requests: one to Norm Voiles for information on self insured claims (faxed to 360-902-6900), and then requests for State Fund claims histories to Paula Clayton (faxed to 360-902-6970.)  If you have questions on the status of State Fund claims information requests, you can call 360-902-5656.  Most State Fund requests will be handled within 10 business days.

You Pay for It, Use It!

DOSH Safety Materials Available for Your Use

The Department of Labor & Industries’ Division of Occupational Safety & Health has at least 27 downloadable safety videos, 75 industry fact sheets, 18 employee safety rule training kits, 85 online safety presentations, 52 construction industry toolbox talks, and over 2000 different safety, health, and risk management video titles for checkout in their safety library.  YOU pay for these services, so please take advantage of them.  You can find these materials at the DOSH webpage at the Department’s website at http://www.lni.wa.gov/safety/.

Electronic Filing of Claims Appeals

At the Board of Industrial Insurance Appeals

Did you know you can file your claims appeals electronically, online?  You can!  Go to the Board of Industrial Insurance Appeals website at www.biia.wa.gov and click on the E-filing logo.  Your appeal is submitted instantly, saving time and postage.  You are able to print a copy for your records, and a receipt showing that your submittal was received.  Give it a try!

as of 1/11/2008

REVISED 1/28/2008