Washington Supreme Court Rules

Against Employers in Granger “Banked Hours” Case

On Thursday, March 1, 2007 the Washington State Supreme Court ruled in the case of DLI v. Granger that employers that stop paying the hourly benefits to Taft-Hartley trusts will be required to include the value of those medical benefits into wages for purposes of determining time loss payments.  Currently, employers stopped paying into the trusts if the injured worker had accumulated benefits (“banked hours”) already paid by the employer.  To read the entire 9-0 decision, go to http://www.courts.wa.gov/opinions/?fa=opinions.disp&filename=781397MAJ.

National Council of Self-Insurers

Annual Conference on May 20-23, 2007

The National Council of Self-Insurers’ Annual Conference will be held May 20-23, 2007 in Palm Springs, California at the La Quinta Resort.  Agenda topics include: ACOEM’s New Work Disability Prevention Guideline; Varying Management Practices of Self-Insured Programs; Modern Techniques to Obtain Workers’ Compensation Data; and the Challenge of Integrated Disability Management.  If you haven’t been, this is a worthwhile opportunity to meet key players in the self-insured community, on a national level, and compare notes.  The agenda and registration information is posted on the Annual Meeting page of the National Council’s web site, whose address is www.natcouncil.com.  More specifically, the registration forms, information about hotel room reservations and the special events of the meeting may be downloaded.  As a side note, WSIA Executive Director Dave Kaplan serves on the Board of Governors for NCSI and is in his second year in that capacity.

Self-Insurance Section Looking for

Historical Photos for New Office Space

Many of you are aware that the L&I Self Insurance program is scheduled to relocate sometime in April.  (All units will be moving to a new building in the Tumwater area - details, once finalized, will be published at the WSIA website.)  In designing their new space, they have reserved a wall to recognize self-insurers and their history in Washington State.  They hope to locate several black and white photographs from a cross section of self-insured employers and all the industries they represent.  [For example, pictures of logging from Weyerhaeuser, or plane manufacturing from Boeing, wine bottling from Ste. Michelle, etc.]  Any and all photos will be appreciated.  If you have any photos you'd like to share with the Department, please forward them to them by March 15, 2007.  They can accept either hardcopy photos or electronic files.  Please forward electronic photos to mcgm235@lni.wa.gov, and hardcopies to Margaret Conley, P.O. Box 44890, Olympia, WA  98504-4890.  If you would like your photo returned to you, they would be happy to make a copy and return the photo as quickly as possible.  Be sure to include the address to which they should return the original.

New Self-Insured Rules

and Rules Changes In Store for 2007

The Department has announced a number of new rules and potential rules changes for 2007.  First, rules governing a continuing education system, as an alternative to testing to maintain Claims Adjudicator Certification, are being developed.  The draft rules should be posted at the Department website soon, and a formal hearing held in June 2007 (if not earlier.)  Second, the Department will implement rules to establish an experience rating for self-insurers’ use of the industrial insurance second injury fund.  This came as a result of the Legislature passing SSB 5992 in 2005.  Third, as part of SHB 1310 from the 2005 Legislature, the Department will implement rules to enable self-insured employers to provide claim data electronically.  This is the basis for the Self-Insured Electronic Data Reporting System (SIEDRS) project that WSIA has been pursing for over a decade.  While none of the language for these rules has yet been posted, you can find links to the Department’s announcement for each of the proposed rules at their website at http://www.lni.wa.gov/LawRule/WhatsNew/Proposed/default.asp?RuleID=263.

Workers’ Compensation News

From Around the Country

While things fester in the Washington State Legislature, workers’ compensation reform and other workers’ comp issues progress elsewhere.  In Missouri, a state judge upheld a workers’ compensation reform law supported by employers and adopted by the Missouri legislature in 2005.  A major change of the law was the modification of the definition of a compensable accident to include events where work is the “prevailing” factor contributing to an injury, instead of the “substantial” factor.  Labor (of course) challenged the legislation.  In Delaware, Governor Ruth Ann Minner signed into law comprehensive workers’ compensation reform legislation that establishes a new medical payment system and practice guidelines – the equivalent of Washington’s Medical Aid Fees and Rules.  The law also mandates that a new workers’ comp rating plan be filed with the insurance commissioner designed to lower to employers’ rates.  The legislation is estimated to save approximately 20% on workers’ comp rates.  And in Iowa, the trial attorneys and labor have been pushing for legislation that would overturn nearly 95 years of workers’ compensation law and eliminate employer directed medical care.  While the bill got a hearing, the bill had not yet been voted out of committee.

Proposed Medical Aid Fee Schedule

Up for Hearing March 27, 2007

The Department’s Medical Aid Fee Schedule (proposed to take effect July 1, 2007) is posted at the Department’s website.  A hearing will be held at the Department’s Headquarters in Tumwater on March 27, 2007 for public comments.  Everyone is welcome to submit comments.  To review the fee schedule, go to http://www.lni.wa.gov/rules/AO06/36/0636Proposal.pdf.

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.

Updated Self-Insurance Section

Phone Contact Listing

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 3, 2007.  Check back at the link periodically for updated information.

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/.

Self-Insured Employer Notice of Denial (SIF-4)

Now Available Online

You can now access a fillable SIF-4 template online at the Department of Labor & Industries’ website at http://www.lni.wa.gov/Forms/pdf/207163af.pdf.  Please remember that while you can use the template, you cannot change or delete text, font size, layout or headings.  It must remain substantially similar, and must contain all legal language as provided by statute or rule.  You can find other forms at the Department’s website by going to the homepage, click on “Get a Form or Publication,” and search for forms using key words or the form number.

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!