COVID-19 – File a Claim for WORKERS’ COMPENSATION

Workers who contract COVID through exposure to the coronavirus on the job may be able to file a claim for workers’ compensation benefits.

Exposure to the Coronavirus on the job could have a significant impact on a worker and their family. In those rare circumstances where the facts line up to support allowance of a claim, the benefits available under a workers’ compensation claim could help to alleviate this impact.

Coronavirus, COVID-19 and Workers’ Compensation Claims

Workers with significant exposures on-the-job, or with specific conditions of their employment exposing them to the virus, could file a claim and potentially receive benefits. With exposure to the Coronavirus rather commonplace within our communities, the connection between work exposure and development of COVID-19 must be direct and clear in order for a claim to be allowed.

Washington State has issued guidance for the Department of Labor and Industries (DLI) that there should be a presumption that the onset of COVID-19 is related to work exposures for some frontline workers, including healthcare workers and medical professionals. If a period of quarantine is medically necessary, the workers’ compensation claim would pay time loss compensation for these workers, even if they are not ill, for up to 14 days.

Other frontline workers, especially those performing essential services in high-risk environments, could also be entitled to benefits under a workers’ compensation claim. For claimants working in jobs not explicitly covered under the presumption of work relatedness, each claim will be reviewed on an individual, case-by-case basis. Specific criteria must be met for a claim to be allowed. The first step is to file a claim.

“Unfortunately, although DLI’s guidance is great news for frontline healthcare workers, for most other people the guidance incorrectly states the legal standard for allowing an occupational disease claim. For instance, DLI suggests that there must be “an increased risk or greater likelihood of contracting the condition” in the person’s particular employment. The Washington State Supreme Court has rejected the “increased risk” test (elsewhere referred to as the “positional risk” doctrine) in several cases, most recently in Street v. Weyerhaeuser, 189 Wn. 2d 187, 200-01 (2018).” –Brian Wright

If you believe you have been exposed to the Coronavirus and developed COVID-19 due to an on-the-job exposure, you should contact an attorney. If you have questions about COVID-19 and workers’ compensation, our firm is available to assist you.

Benefits Under a Workers’ Compensation Claim

The benefits available would include time loss compensation for the days the worker is unable to work due to quarantine or illness. The claim would cover the cost of allowed medical treatment. In many cases, if there is no onset of symptoms or recovery from illness happens quickly, there may be relatively little compensation paid under a claim.

In some cases, people face hospitalization and extended periods of recovery. In King County, as of the date of this writing, the data shows that 6.4% of positive cases require hospitalization. The King County daily summary dashboard provides statistics about testing numbers and rates for positive results, hospitalizations and deaths.

Medical expenses can quickly add up, and time lost from work may be greater than one would expect.

Permanent Impairment After COVID-19

In most cases, there are no lasting effects that remain after recovery from COVID-19. However, it is now becoming clear that there can be permanent effects from COVID-19 in some cases, even for people who recover without the need for hospitalization.

If there is permanent residual impairment after COVID-19, an allowed workers’ compensation claim would provide a monetary impairment award once the claim closes. The most common reported permanent effects are connected to impaired lung function. There are also reports of stroke, kidney, liver and heart conditions that remain after recovery from COVID-19.

Impairment awards paid at claim closure are based on ratings of permanent impairment made by a physician. For injury to internal organs, the State uses a category system for rating impairment. Each category relates to a set of symptoms present, with higher categories compensating for higher levels of impairment due to greater loss of function.

In the rare case where death results, the worker’s family could receive a burial benefit and compensation for the loss of life due to the work exposure and illness.

Filing a Claim for COVID-19

For those that are diagnosed with COVID-19 that were significantly exposed to the Coronavirus on-the-job, a worker can file a claim with the Department of Labor and Industries. A claim can be filed:

  • Online via DLI’s FileFast tool.
  • By phone: 1-877-561-3453 (FILE).
  • At your doctor’s office (if you complete the Report of Accident at your doctor’s office, the doctor files the form for you).

You can watch a DLI video that generally describes the process for filing a claim if you need more information about the steps to be taken.

More Information and Resources

DLI has a page of information and links to resources dedicated to answering questions about COVID-19 and workers’ compensation. This includes questions raised by employers and businesses, injured workers whose non-COVID claims have been impacted by the social changes brought on by the virus, as well as workers who believe they have developed COVID-19 through work exposure.

The Washington Department of Health has a COVID-19 Information Line: 1-800-525-0127. Phone lines are staffed from 6 am – 10 pm. Interpreter services are available in multiple languages.

If you have questions about COVID-19 and workers’ compensation, or if your claim was denied, please feel free to contact our firm. We offer a free case analysis, and would be happy to discuss your specific circumstances with you.

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Launch of Interpreter System Delayed

The launch of the planned interpreter system for scheduling services is being delayed by the Department of Labor and Industries (DLI).

DLI is currently reassessing their implementation timeline for the new interpreter scheduling system, InterpreterWorks.  This reassessment includes the following:

  • Review of current work done to build this system.
  • Incorporating feedback of end-users received during test-sessions.
  • Clarifying registration process for both interpreters and providers.
  • Determine a go-live date.

The go-live date is expected to be announced sometime this spring, with at least 30 days advance notice. To ensure a smooth transition, DLI will allow current schedulers to continue operating for a limited amount of time. In the meantime, users are recommended to continue to use their current interpreter system process.

Get More Info, and Give DLI Your Opinion

DLI offers answers to the most frequently asked questions (FAQs) and invites you to learn more.  DLI also encourage both providers and interpreters to register for the new online appointment scheduling system through interpretingWorks

Please contact DLI directly at interpretation@Lni.wa.gov with any questions or concerns. Voicing your opinion now may help everyone involved in the provision of interpreter services to claimants.

De-activating Interpreter Agency Accounts

To comply with the new law, all interpreter agency accounts, and interpreters doing business with DLI under those agency group accounts, will be de-activated in early 2021. Interpreters who want to continue providing services to injured workers and victims of crime may enroll with interpretingWorks or maintain an independent interpreter provider account at DLI. Agencies have one year to bill DLI for services provided prior to this cut-off date. 

What Will Happen to Independent Interpreters?

There will be limited opportunities for independent interpreters to provide services for DLI appointments after the interpretingWorks roll-out. Their services are only approved for use in on-demand appointments that do not have a pre-scheduled time, such as emergency, urgent care, and walk-in appointments.

In very rare cases, DLI may approve a claimant’s request to work with a consistent, independent interpreter. These requests will be addressed on a case-by-case basis.

What About the Claimant’s Needs?

A lack of choice in which interpreter an injured worker chooses to work with while going through the process of medical and vocational services under a claim is significant. It is not like requesting a driver through a ride-share app, but that is how the system seems to treat it, at least at first glance.

There may be more bumps in the road on this journey towards implementation of the new interpreter system. Claimants should make their opinions and needs known to DLI along the way.

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Healthy Washington–Roadmap to Recovery

“Healthy Washington — Roadmap to Recovery” is the COVID-19 phased recovery plan announced by Governor Inslee on January 5, 2021. The Healthy Washington recovery plan will take effect on Monday, January 11, 2021. All regions start under Phase 1 guidelines.

This new recovery system aims to safely ease some restrictions while also maintaining crucial hospital capacity, protecting access to healthcare and promoting economic recovery across the State.

Eight Regions

There will be eight regions of four or more counties, divided according to available health care services based on metrics such as hospitalizations, case data and disease mobility.

Source: WA’s Governor’s Office on Medium

The Healthy Washington — Roadmap to Recovery regions are as follows:

  • Central: King, Pierce, Snohomish
  • East: Adams, Asotin, Ferry, Garfield, Lincoln, Pend Oreille, Spokane, Stevens, Whitman
  • North: Island, San Juan, Skagit, Whatcom
  • North Central: Chelan, Douglas, Grant, Okanogan
  • Northwest: Clallam, Jefferson, Kitsap, Mason
  • South Central: Benton, Columbia, Franklin, Kittitas, Walla Walla, Yakima
  • Southwest: Clark, Cowlitz, Klickitat, Skamania, Wahkiakum
  • West: Grays Harbor, Lewis, Pacific, Thurston
Restrictions Under Healthy Washington – Roadmap to Recovery

Key restrictions in Phase 1 are:

  • Indoor social gatherings are prohibited, outdoor social gatherings are limited to ten people and no more than two distinct households.
  • Indoor worship services, retail stores, professional services and personal services (hair salons, nail salons, etc…) are limited to 25 percent capacity. Where possible, remote work/attendance and curbside pickup are encouraged.
  • Indoor dining at any eating or drinking establishment is prohibited. Outdoor dining is limited to six people per table and no more than two households at each table. Establishments must close by 11 p.m.
  • Weddings and funeral ceremonies are limited to no more than 30 people. Indoor receptions, wakes or similar related gatherings in conjunction with such services are prohibited.
  • Indoor entertainment establishments may offer private reservations for individual households and no more than 6 people. General admission is prohibited.
  • Outdoor entertainment establishments may offer timed ticketed events to groups of ten (limit two households) at a time.

Depending on the activity, additional restrictions and/or requirements for reopening (required masking, spacing, etc…) may also be in effect. To read the full phase activity chart, and for additional information on Phase 1 permitted activities, see here.

How Regions Will Progress Through the Phases

Progress through the Healthy Washington phases is dictated by four metrics measured by region:

  • Decreasing trend in two week rate of COVID-19 cases per 100,000 population (decrease has to be greater than 10 percent)
  • Decreasing trend in two-week rate in new COVID-19 hospital admission rates per 100,000 population (decrease must be greater than 10 percent)
  • Total (COVID and non-COVID) ICU occupancy has to be less than 90 percent capacity
  • COVID-19 test positivity rate must be less than 10 percent.

Progress will be determined automatically, no application by the regions will be required. The Washington State Department of Health will evaluate metrics each Friday, with any movement – forward or backward – taking effect the following Monday.

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HVAC Systems Can Help Reduce COVID-19

Optimized HVAC systems can help reduce exposure to COVID-19. The Department of Labor & Industries (L&I) just published “COVID-19 Guidance on Ventilation in the Workplace” – a one-page tip sheet on ventilation improvements that can be made to help provide a workplace free of safety and health hazards.

Coronavirus is a serious workplace health hazard. Adequate ventilation throughout the work environment can help to maintain a safe and healthy workplace.

Items that can be addressed to update HVAC systems include:

  • Building owners and managers can work with an HVAC professional to optimize building ventilation.
  • Document inspections performed, the findings of those inspections and the changes made.
  • Replace air filters regularly, and look into ways to improve air filtration, including use of HEPA filters.
  • Ensure exhaust fans in restrooms are set up properly, are fully functional, and are set to remain in constant operation.
  • Change settings that shut systems down or reduce their use during off hours, so that air is continually circulated within the building.
  • Set up the HVAC systems to bring in as much outside air as possible, avoiding recirculation of indoor air.

The tip sheet provides detailed instructions for these and other steps that can be taken to optimize HVAC systems in workplaces.

Free safety and health assistance for employers is
available from L&I’s Consultation Program:
DOSHConsultation@Lni.wa.gov or
www.Lni.wa.gov/DOSHConsultation.

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Appeals Hearings All Remote Through June 2021


All Board of Industrial Insurance Appeals hearings will be by remote access through June of 2021. The Board has extended the period of time that Board offices will remain closed to the public due to the Coronavirus.

Board judges will typically handle proceedings by telephone conference calls. In certain circumstances, the judge may opt for video conferencing using a third-party service, CourtCall. This is usually for the purpose of appeals hearings, where evidence and testimony is presented, rather than more informal procedural events.

Conferences and Hearings to Be Adjusted

Board judges will reach out to those parties with events impacted by this extension. The judge will ask if they can convert the proceedings from live to remote-access events. In the event that a party is aggrieved that the appeal proceedings will be remote, a request can be made for the case to be continued to a later date. This would most likely be in the case of a hearing. This decision is at the judge’s discretion. Any rescheduled event date is subject to the availability of the judges and parties and will likely cause a delay in proceedings.

More Information and Assistance

More information about this process can be found on the Board’s website.

We often suggest that claimants have legal representation when their case is on appeal. This may be especially true when appeal hearings will be conducted via remote access. Feel free to contact our firm for assistance with your case. We offer a free analysis of your case and will give you our opinion on whether you need legal assistance, or not, and how we recommend you proceed.

COVID-19 Restrictions Tightened in WA

COVID-19 restrictions tightened for the entire state for 4- week period.

On Saturday, Governor Inslee announced a tightening of the restrictions on activities in place to prevent the spread of the coronavirus. The new restrictions take effect on midnight tonight, November 16, 2020, with the exception of those placed on restaurants and bars, which take effect on Wednesday. The restrictions are currently set to expire on December 14th.

CW Remains Fully Operational

Causey Wright has remained open and fully operational in a manner that almost matches the current increased restrictions exactly. We have maintained a low number of essential employees and clients/visitors inside the office, with most employees working from home, since the beginning of the pandemic. We have precautions and procedures in place to ensure the safety of anyone in the office. We will make minor adjustments to our plan to adapt as the COVID-19 restrictions tightened require.

Litigation Events

All scheduled court proceedings before the Board of Industrial Insurance Appeals and the Superior Courts are held via a remote-access. In many cases, our clients have opted to provide their testimony, whether before the judge or through a deposition, from our office. We have computers, web cameras and a strong wifi signal, and your attorney will be in the office, as well, to help with the process and provide full legal services before, during and after the litigation event.

We will coordinate with each client to meet their needs. For some, the ability to participate in their litigation from home is welcome. Others prefer to be in the office. Either way, we can make it work.

The COVID-19 restrictions tightened, but your case has not stopped. If you have concerns about an upcoming proceeding, or if you need assistance with a workers’ compensation claim, please contact us.

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Cloise & Mike Construction Fined $92,000+

Cloise & Mike Construction, Inc., a firm with nearly 20 years of safety violations, has been fined more than $92,000 after a recent inspection.

The construction company has an extensive history of safety problems in Kitsap, Pierce and Grays Harbor counties. The serious safety violations found during this recent inspection included failing to enforce the use of fall protection while roofing a home under construction in Hoquiam.

The Department of Labor & Industries (L&I) opened its latest inspection of Cloise & Mike Construction, Inc. (formerly Choice & Mike Construction) after receiving an anonymous report in May that included photographs showing four employees engaged in roofing work on a steep pitch roof with no fall protection installed. 

Inspectors found that, in addition to employees working at height without proper fall protection, employees were not wearing masks or social distancing, which is a violation of COVID-19 workplace safety rules.

History of Violations

Since 2001, Cloise & Mike Construction has been cited for more than two dozen serious and repeat safety violations after being inspected 26 times. Seven of those inspections occurred in the last three years, resulting in more than $200,000 in fines.

“This isn’t a case of the company not knowing what the rules are,” said Anne Soiza, L&I assistant director for the Division of Occupational Safety and Health (DOSH).

“Cloise & Mike has ignored their fall hazards, putting their workers at serious risk, for nearly two decades. We hope these substantial fines will motivate them to recognize their obligations and prevent any future tragic outcome for their workers,” said Soiza.

The violations occurred on the construction of new homes in various cities including Bremerton, Bainbridge Island, Gig Harbor, Tacoma, Lakewood and Hoquiam.

In addition to the violations mentioned above, the May inspection resulted in another eight violations:

  • no fall protection at four feet and greater while working on a steep pitch;
  • no fall protection work plan;
  • not complying with COVID-19 protections in construction;
  • training programs not effective in practice;
  • no hard hat worn while working under roofers;
  • hands not kept free while ascending a ladder;
  • ladder not extending three feet above the landing; and
  • no walk-around safety inspection
Penalties and Appeal Rights

Cloise & Mike Construction, Inc. is appealing this inspection and two others. Employers have 15 business days from the time they receive the citation from L&I to appeal.

Penalty money paid as a result of a citation is placed in the workers’ compensation supplemental pension fund, helping injured workers and families of those who have died on the job.

Safety Training and Consultations

Fall protection training and other L&I safety guides can be found on the L&I website, here. Businesses can also request a safety consultation from DOSH.

L&I’s Consultation Program offers confidential, no-fee, professional advice and assistance to Washington businesses. These services can help them find and fix hazards in the workplace and strengthen their safety program.

Business owners can call a consultant  or request an onsite consultation to schedule any of the following services:

Safety and Health Consultation

Safety or Industrial Hygiene consultants provide assistance with building your safety program, training, identifying and controlling hazards, and following applicable safety rules. No fines or penalties will result from issues uncovered during a consultation. However, consultants will ask you to correct any serious issues and offer assistance.

Risk Management Consultation

Risk management consultants can review your workplace injury history and provide a step-by-step plan to help you prevent injuries and control industrial insurance costs.

Ergonomic Consultation

Ergonomic specialists can help you find solutions to prevent sprain and strain injuries. These injuries are associated with high worker’s compensation costs.

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Washington Healthplan Finder Open for Shopping

Washington Healthplan Finder is an online marketplace for individuals and families in Washington to compare and enroll in health insurance coverage and gain access to tax credits, reduced cost sharing and public programs such as Medicaid. Washington Healthplan Finder offers a wide range of resources to help people navigate their coverage options – including in-person enrollment centers, virtual video or phone assistance, and the WAPlanfinder Mobile App.

Open Enrollment Nov. 1 – Jan. 15

Starting Nov. 1, Washingtonians seeking health coverage can shop more options this year – with financial assistance – by visiting Washington Healthplan Finder to sign up for health and dental coverage. The qualified health and dental plans open enrollment period for enrollment is from Nov. 1, 2020 to Jan. 15, 2021.

For those seeking coverage starting January 1, customers need to enroll in a plan by December 15. Those who enroll after that deadline and before January 15 will have a coverage start date of February 1.

Reminder: Enrollment is offered year-round to individuals and families in need through Washington Apple Health (Medicaid).

About Washington Apple Health

In Washington, Medicaid is called Washington Apple Health. Free or low-cost coverage is available year-round for those who qualify. Since the Affordable Care Act launched in October 2013, more people have access to preventive care, such as cancer screenings, treatment for diabetes and high blood pressure, and many other health care services they need to stay healthy. Apple Health clients enroll and renew online using Washington Healthplan Finder. Apple Health is administered by the Washington State Health Care Authority: www.hca.wa.gov.

New Plans Offered in the Online Marketplace

New in the marketplace for 2021 will be Cascade Care offerings that enable consumers to shop, choose, and save from more options in all counties. Cascade Care plans offer high value, standard benefits.

Cascade Care is expanding access, choice, and value for Washingtonians at a time when they need it most. These plans offer deductibles that are on average $1,000 less than other plans, and cover more services prior to meeting a deductible, including primary care visits, mental health services, and generic drugs. Most customers will see that average premium costs and deductibles of Exchange plans are lower than previous years, including eight counties where a Cascade Care plans – either Cascade or Cascade Select – is the lowest-cost silver plan.

“As more Washingtonians are impacted by the Coronavirus pandemic, having health coverage is crucial during these difficult times” said Exchange Chief Executive Officer, Pam MacEwan. “We encourage all Washingtonians who are seeking health coverage to shop Washington Healthplanfinder during open enrollment and find plans for how they’re living.”

“With new plans available, we encourage customers to shop around for the best health plan that fits their needs,” adds MacEwan. “For example, many renewing customers can switch to the lowest cost plan in their same metal tier and save money, and many customers can save more than $50 a month by shopping.”

More Information and Assistance Available

Washington Healthplan Finder offers a wide range of resources to help people navigate their coverage options – including in-person enrollment centers, virtual video or phone assistance, and the WAPlanfinder Mobile App. Anyone requiring help signing up for coverage through Washington Healthplan Finder may contact the Customer Support Center at 1-855-923-4633; TTY: 855-627-9604. They may also contact an Exchange certified Navigator, Broker, or Enrollment center who can answer insurance questions and help with enrollment. Free help from local experts is accessible via the WAPlanfinder Mobile App or by visiting www.wahealthplanfinder.org/.

During the 2021 open enrollment period, the Customer Support Center will be open 7:30 a.m. – 8:00 p.m. Monday – Friday. Additionally, extended hours are scheduled each month through the enrollment period.

Prepare for the Application Process

Before starting the application process, customers will need to gather the following:

• Legal names of all household members
• Birthdates for household members
• Home and mailing address
• Social Security Number or immigration documents (Families which include  unlawfully present immigrants may also apply)
• Income information (recent pay stubs, tax return, or W-2)
• Tax filing status
• Current health plan information
• Tribal membership (if enrolled in a federally recognized tribe)

Reminder: workers’ compensation benefits are not taxable income and should not be included in the household income figures when applying for benefits.

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Remote Workplace Injuries – Are You Covered?

Are remote workplace injuries a covered event? Maybe, yes.

Now that we’re in a pandemic, it is possible for workers to be injured while not in the office or on the job site. Because many employees are working from home, it is possible that an injury at home might be a covered event.

Course of Employment

The Board of Industrial Insurance Appeals is an administrative law court that oversees, among other things, appeals in workers’ compensation cases. The Board publishes significant decisions made on a variety of topics, including course of employment questions. The sheer number of significant decisions on this topic demonstrates that the answer to most questions of “Am I Covered?” is “maybe.”

Generally, a worker who is injured while in the course of employment is able to file a workers’ compensation claim. In most cases, an injury occurs on the employer’s premises, but not always. For instance, an employee driving a car while furthering the employer’s business – say, a plumber driving a truck to a site where work will be performed, bringing tools and equipment required for the job – is likely a covered employee.

In the case of employees working from home due to protective steps taken in response to the pandemic, coverage may extend to the employee’s home. As an example, if you are working from home and, as part of your usual work duties, you have to lift a box of necessary tools up to your work surface and, while doing so, you injure your shoulder, you may have a covered injury event. Remote workplace injuries may be covered events, if the criteria for claim allowance are met.

Filing a Claim for an Injury

For those that have suffered an injury, whether on the employer’s premises or at home, a claim may be filed with the Department of Labor and Industries. A claim can be filed:

  • Online via DLI’s FileFast tool.
  • By phone: 1-877-561-3453 (FILE).
  • At your doctor’s office (if you complete the Report of Accident at your doctor’s office, the doctor files the form for you).

You can watch a DLI video that generally describes the process for filing a claim if you need more information about the steps to be taken.

More Information or Assistance

If you have questions about workers’ compensation, or if you already filed a claim and your claim was denied, please feel free to contact our firm. We offer a free case analysis, and would be happy to discuss your specific circumstances with you.

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Wildfire Smoke Worker-Safety Rules

Washington State is among the first to begin developing wildfire smoke worker-safety rules.

Wildfire Smoke Exposure is a Problem for Workers

The number of acres burned by wildfires in our state each year is increasing. Smoke from the Western wildfires last month left Washington with some of the worst air quality in the world at times, according to the Environmental Protection Agency.

For outdoor workers in construction, agriculture, and other jobs, being exposed to the bad air and the health risks that came with it was especially concerning as they reported to work each day.

What’s Being Done

To help these and other workers, the Department of Labor & Industries (L&I) is developing new workplace safety and health rules regarding wildfire smoke. This week, L&I filed the official notification, known as a CR-101, the first step in the rulemaking process.

“It’s clear that wildfire smoke isn’t a short-term issue. It impacts all of us, but is especially concerning for workers who have to be outside and breathe it in all day long,” said Craig Blackwood, deputy assistant director, Division of Occupational Safety and Health.

“By developing clear rules that spell out the safety and health requirements related to protective equipment and training, we can help businesses protect workers from these serious hazards,” said Blackwood.

Smoke from wildfires contains chemicals, gases and fine particles that can harm health. The health hazards continue even after fires are extinguished and cleanup work begins.

Some of the issues expected to be addressed in the new wildfire smoke worker-safety rules include:

  • identification of harmful exposures;
  • training and instruction; and
  • control of harmful exposures.

Washington is just the second state to formally undertake rulemaking regarding workers and wildfire smoke. California was the first, adopting wildfire smoke worker-safety rules in 2019.

You can Provide Input to the Process

L&I plans to hold meetings in the next few months to begin gathering information from stakeholders to help create an initial draft wildfire smoke rule. Like all rulemaking processes, once there is an official draft rule, there will also be opportunities for public input.

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Published by Causey Wright

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