If you settle your workplace back injury, will the Washington Department of Labor and Industries (L&I) pay you what they pay everyone else? That’s a reasonable question to ask. The state controls every aspect of the worker’s compensation system. It makes sense to have concerns about claim fairness and equity.
If you want to know for sure, you must compare your potential settlement to L&I’s average workers’ comp. back injury settlement. Unfortunately, that’s not that easy to do. While you’ll find a great deal of data on paid claims, the L&I website provides mostly settlement rates, disability percentages, and disability guidelines. When you need straight answers about claims procedures, disability requirements, and average settlements, a worker’s compensation lawyer is your best resource.
L&I Injury Data
L&I produces and maintains meticulous online resources. But because they release data in compliance with federal and state privacy laws, you might not have access to all the information you want. Their injury data page provides links to years of statistics and decades of reports.
When you search their files, you’ll find details about types of injuries and body parts, industries involved, injured workers’ occupations, and other information. You’ll also find comprehensive information about state-funded back injury claims paid during the last fiscal year.
Back injuries are the second most frequent workplace injury. With 13,453 accepted claims, only finger and fingernail injuries occur more frequently. Available claim data includes totals paid on closed claims and estimated costs for open claims.
The data from the most recent year is:
- Total accepted back injury claims: 11,358. These include traumatic back and spinal injuries, strains, surface wounds, open wounds, burns, multiple traumas, and other categories.
- Total paid on back injury claims: $115,689,721.
- Average incurred cost per back injury claim: $10,186.
What Settlements Does L&I Pay?
Not every injured worker qualifies for a back injury settlement. It’s often up to you to explore the possibilities. Whether you temporarily cannot work or you may never go back to work, you may pursue three different types of settlements.
Claim Resolution Structured Settlement Agreements
Washington Administrative Code gives L&I the authority to negotiate a structured settlement agreement with you. Their ideal structured settlement candidate is a 50-year-old worker with an accepted claim lasting 180 days or more.
They suggest that you might also be a candidate if you have:
- An open lost-time claim;
- A supplemental income (Social Security, retirement, etc.);
- A desire to return to work; and
- No interest in retraining.
A structured settlement is a negotiated arrangement that allows you to exchange your current benefits for future lump sum payments. You, your employer, or L&I have the right to initiate the process. If you have a legal representative, you should discuss the benefits and drawbacks before you complete the settlement process.
Once you negotiate the payment terms, you sign a contract that describes all the terms of your agreement. In some cases, when you accept a structured settlement, you give up your right to recover additional medical benefits for your injury.
Permanent Partial Disability Awards
When you’ve reached maximum medical improvement, you may qualify to receive a payment based on any permanent partial disabilities (PPD) you sustained. L&I pays PPD benefits based on your injury, its severity, and a physician-assigned PPD rating.
A physician who wasn’t involved in your treatment usually conducts an independent medical examination and issues a disability rating. Each rating corresponds with a total body impairment percentage. Cervical, lumbar, and dorsal back injuries have separate rating categories.
Under the PPD award system, the independent physician is solely responsible for rating your disability. As these ratings determine how much money you receive, Washington Administrative Code, WAC §296-20-2010, provides statutory rating guidance for medical care professionals. L&I chooses the doctor and that doctor’s disability rating controls your PPD payment amount. The potential conflict of interests does little to inspire confidence in the overall process.
L&I uses your disability rating and a Disability Category Awards schedule to calculate your PPD settlement.
They apply a formula that includes:
- Back injury category (cervical, lumbar, dorsal);
- Category impairment ratings from 2 to 8;
- Brain and back impairment percentages from 10 percent to 75 percent; and
- Whole-body impairment value, currently $214,222.98.
You receive your PPD settlement in monthly installments. You may also qualify to receive a PPD down payment.
Your Right to Protest or Appeal a PPD Decision
If you, your doctor, or your employer disagree with L&I’s PPD findings, you have the right to protest or appeal. You must file your protest or appeal within 60 days of the decision. You may write a protest letter and send it to your L&I claim manager, or you may file an online appeal with the Board of Industrial Insurance Appeals. Until the end of June 2021, the Board of Industrial Insurance Appeals will hold all hearings via Zoom.
An L&I pension provides a lifetime income when you can’t work due to a permanent total disability. You automatically qualify for a pension if you have one of the following disabilities: loss of use of both arms, both legs, or one arm and one leg, or total vision loss. When you qualify for a pension, you receive an amount that’s equal to your lost-time benefit. The amount you receive depends on your salary, marital status, your average wage when you sustained an on-the-job injury, and other factors.
You must certify your disability annually unless you have a specified disability, and you may receive periodic cost of living adjustments. Depending on the payment option you select, your family may receive survivor’s pension benefits after your death.
Contact a Worker’s Compensation Attorney
If you believe you qualify for a worker’s compensation settlement, consult with a workers’ compensation attorney before you begin negotiations. Attorneys negotiate with the Department of Labor & Industries on your behalf. If you have already received a low offer, a workers’ compensation attorney can help you through the appeal process. Most attorneys offer a free initial consultation where you have an opportunity to discuss your case and get the help you need.