All posts by Kit Case

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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Washington COVID-19 Immigrant Relief Fund

The Washington COVID-19 Immigrant Relief Fund was set up to support undocumented immigrants. All of us are being impacted by COVID-19, but many people in Washington aren’t eligible for federal stimulus funds or unemployment insurance because of immigration status. Now, they can apply for a one-time direct payment of $1,000, up to $3,000 per household.

In Washington State, immigrants have always been neighbors and essential workers. They help keep the economy strong, contribute to our communities, and care for our families.

During the COVID-19 pandemic, immigrant families have been at the highest risk for getting the virus, losing work, or needing to support family members in new ways. The federal government intentionally left millions of people out of much-needed financial support, based on immigration status.

All of us who call Washington home deserve support to make it through this time. That’s why immigrant-led organizations partnered with the Governor’s office to establish the Washington COVID-19 Immigrant Relief Fund. This year, they will distribute $40 million in CARES Act funds allocated to Washington to support immigrants in Washington who are ineligible for other federal funds or unemployment insurance due to their immigration status.

Who Can Apply, and How

People in need of this assistance can apply to receive a $1,000 one-time direct payment (up to $3,000 per household). Your information will never be voluntarily shared with the government or ICE, and the public charge rule should not apply for this fund. You can get help with your application in multiple languages.

Apply for the Washington COVID-19 Immigrant Relief Fund

To apply for the relief fund, you must:

  • Be a Washington resident
  • Be at least 18 years old
  • Have been been significantly affected by the pandemic (such as losing work, being infected by the virus, or caring for a family member who was infected)
  • Not be eligible to receive federal stimulus funds or unemployment insurance because of immigration status

The last day to apply is December 6th.

Applications will be accepted on a first come, first served basis since the total fund is limited. Applications will be prioritized by those in greatest need.

Please share this information broadly. Together, we can be neighbors taking care of neighbors.

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Court Order Sought in Monte Cristo Ballroom Case

A default judgment order has been requested from the Snohomish County Superior Court in the Monte Cristo Ballroom case. The state Attorney General’s Office (AGO) and Department of Labor & Industries (L&I) want a court to order Monte Cristo Ballroom LLC and its owner, Anthony Reeves, to repay wages owed former employees.

We wrote about this case in a prior post, MONTE CRISTO BALLROOM HIT WITH WAGE THEFT CHARGES.

The state agencies will file a motion for a default judgment on October 8, 2020 in Snohomish County Superior Court. If granted, the court’s order would become a legally enforceable tool for L&I to go after wages owed to 156 employees. The order, for example, could be the foundation for legal actions such as property liens and levies against bank accounts held by the company or owner.

“Workers deserve to be paid fairly for their work, period,” said state Attorney General Bob Ferguson. “Employers do not have the right to deduct whatever they want from their employees’ paychecks without their consent.

“When Washington workers’ rights are violated, L&I and my office will partner to enforce the law and hold them accountable,” he said. “Our action brings us one step closer to accountability and justice for the impacted workers.”

The initial complaint, filed in December 2019, stemmed from Reeves’ taking a $2.99 “meal” charge from 156 employees during each shift worked between December 2016 and April 2019. The Monte Cristo owner took the money from workers’ paychecks without their permission in return for allowing them to eat leftovers from catered events — whether the workers wanted to eat the food or not.

In all, the deductions covered 4,100 shifts and totaled $12,386.86.

“This order gives us another way to get employees the wages they earned,” said L&I Director Joel Sacks. “While the amount of money taken from individual workers each shift may seem relatively small, in the end it added up to thousands of dollars that should have gone to employees and their families and not into the owner’s pockets.”

Employees filed complaints

The Monte Cristo Ballroom LLC, 1507 Wall St. in Everett, stopped operating in October 2019. Since the sudden closure, more workers have filed wage complaints with L&I.

L&I attempted to settle with Monte Cristo for the wages owed the workers. An agreement drafted in September 2019 set out a payment schedule through October 2020, and ordered the restaurant to stop taking money without the employee’s consent. Reeves never signed that document.

As part of the court filing, the agencies are asking for attorney’s fees and processing fees. If approved, that would add about $2,700 to the wages and interest owed.

L&I oversees the state’s wage-and-hour laws. The agency investigates all wage-payment complaints. More information on wages or filing a complaint is available on L&I’s wage-and-hour webpage. Employers and workers may also call 360-902-5316 or 1-866-219-7321.

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Truckers Need Face Masks, Too

Truckers need face masks. They travel alone a lot, isolated in truck cabs, often with little direct contact with other people. While this may lower their risk of catching or spreading COVID-19, they must still protect themselves and others when making even brief stops along their route.

There is no assurance that a person who talks, coughs or sneezes – or even breathes heavily – as they walk by is not infected. Many people don’t realize they are infected, because they may be infectious BEFORE they feel any symptoms.

Drivers may feel a false sense of security at familiar customer sites, truck stops or other public places. This is especially true if they don’t expect lengthy social interactions. Wearing a face mask helps keep drivers and others safe, along with social distancing and other prevention measures.

High-Risk Truckers Need Face Masks Even More

Long-haul truckers may make repeat trips to hotspot areas of the country. Traveling from one hotspot region to another, and another, puts them at increased risk for exposure to the coronavirus.

Some drivers serve clients who are operating high-risk worksites, such as meatpacking plants. Often, drivers need to wait while a trailer is loaded. At a minimum, there is interaction required to handle the paperwork when picking up or dropping off a load.

All drivers need to interact people along their journey. Truck stops often have drive-through fast-food options that allow truckers to avoid indoor dining. Some we have spoken with report that these fast-food lanes are now more crowded than usual, as the general public utilizes them to also avoid inside dining. Truckers need to keep up the pace to finish their runs on time, so may opt to go into a store or fast-food restaurant to get food rather than use the drive-throughs, increasing their risk of exposure.

Using a mask, practicing social distancing and following hand washing protocols are the best tools available to keep drivers, and their families, safe. Truckers need face masks, too.

More Information For Truckers About Face Masks

As part of the Keep Trucking Safe program, a Tip Sheet is available with information about the use of face masks for truckers. You can download the Tip Sheet here.

The Tip Sheet covers selecting the right mask, how properly use and care for the mask, and has a link for more information if use of a respirator is needed.

The Keep Trucking Safe program is run by the Trucking Injury Reduction Emphasis (TIRES), a project of the Safety & Health Assessment & Research for Prevention (SHARP) program of the Washington State Department of Labor and Industries.

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National Average Weekly Wage Increase

The new national average weekly wage increase, or NAWW, means an increase in maximum and minimum compensation rates for Longshore claims, as described below, effective October 1st.

Industry Notice 182 – National Average Weekly Wage (NAWW), Maximum and Minimum Compensation Rates, and Annual Adjustments Under Section 10(f), Effective October 1, 2020

Based on data compiled and published by the Bureau of Labor Statistics (BLS), the United States Department of Labor has made a final determination of the national average weekly wage, for the period commencing October 1, 2020.  Determinations have also been made for the maximum and minimum compensation rates and the percentage increase from the current national average weekly wage.

The following determinations are for the period October 1, 2020 through September 30, 2021:

  • National Average Weekly Wag                $816.35
  • Maximum Compensation                            $1,632.70
  • Minimum Compensation                             $408.18
  • Percentage Increase                                      4.65%

Industry Notice 182, which is available here on the OWCP, Division of Federal Employees’, Longshore and Harbor Workers’ Compensation website, outlines the annual 10(f)  adjustments in detail.

Longshore Industry Notices are documents issued typically to Longshore’s business partners and/or clients and provide guidance, instruction, and/or information relevant to the application of the Longshore and Harbor Workers’ Compensation Act (LHWCA).

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Proposal for Steady Workers’ Comp Rates for 2021

The Washington State Department of Labor & Industries (DLI) is making a proposal for steady workers’ comp rates for 2021. It is proposing no increase in the average cost for workers’ compensation insurance next year. If the proposal is adopted, this will be the first time in 20 years that workers’ compensation rates have dropped or stayed steady for four years in a row.

“Our 2021 rate proposal recognizes the toll the pandemic is taking on employers and workers in our state,” DLI Director Joel Sacks said. “Although our projected workers’ compensation costs are going up, we’re keeping premiums the same by taking advantage of the reserves we’ve built over the years by improving services and reducing disability.”

Employers and workers pay into the workers’ compensation system to help cover the cost of providing wage and disability benefits for injured workers, as well as medical treatment of injuries and illnesses.

On September 22, DLI began the process of taking public comment on the rate proposal. Hearings will be held in October via Zoom, as well, details below.

Keeping rates steady and predictable

If the proposal for steady workers’ comp rates is adopted, this will be the fourth year in a row with no increase in the average rate.

While financial projections point to the need for a significant increase to cover all of the costs for injuries and illnesses that occur in 2021, the agency is proposing using funds from the workers’ compensations contingency reserve to keep the rate from climbing.

DLI has focused on preparing for a downturn in the economy by building workers’ compensation reserve funds and keeping rates steady and predictable, in part through improvements and reforms. These include implementing vocational recovery services to support return to work for injured workers and employers, and using best practices in occupational health and vocational services.

One effort that’s helped thousands of injured workers and employers is the Stay at Work program. Through the program, employers receive financial support from DLI so they can offer light-duty jobs to injured workers, which allows them to remain in the workforce while they recover.

“We all know how tough it is right now. It’s exactly why we have a reserve— so we are ready for an economic downturn,” said Sacks. “We hope that keeping the average rate the same next year will help our communities get through this and come out the other side strong.”

Washington charges for workers compensation coverage based on hours worked. When looking at rates as a percentage of payroll, rates in Washington have gone down each of the last 10 years.

Along with no proposed increase, DLI has been taking steps to help businesses struggling to pay workers’ compensation premiums. In April, the agency announced it was offering a grace period for premium payments, along with payment plans for employers facing financial difficulties during the pandemic. That program was extended in July and has helped thousands of businesses.

Employers and workers would pay the same on average under 2021 proposal

With the proposed overall rate change of zero percent, the average premium per employee is not expected to change overall. However, there will be changes by class and employer.

Workers will pay on average about a quarter of the premium, a similar percentage to that paid in 2020.

Public hearings planned

To support social distancing, public hearings on the rate proposal will be held virtually this year. Two hearings are scheduled to take input about the rate proposal before a final decision is made. Final rates will be adopted by November 30 and go into effect January 1, 2021.

Public hearings are scheduled for 10 a.m. on October 27 and 29. These hearings are being held via ZOOM and by phone to comply with Gov. Jay Inslee’s COVID-19 restrictions limiting the number of people attending in-person public gatherings.

2021 rate hearings
  • October 27, 2020 at 10 a.m.
    Joining by computer:
    Join Zoom Meeting at  https://zoom.us/j/99395316830
    Meeting ID: 993 9531 6830
    Passcode: Oct2720!
    Joining by phone:  253-215-8782 US (Tacoma)
    Meeting ID: 993 9531 6830
    Passcode: 35862365
  • October 29, 2020 at 10 a.m.
    Joining by computer:
    Join Zoom Meeting at  https://zoom.us/j/97637403577
    Meeting ID: 976 3740 3577
    Passcode: 4n*z2LvM
    Joining by phone:  253-215-8782 US (Tacoma)
    Meeting ID: 976 3740 3577
    Passcode: 44645997

People are encouraged to submit comments in writing to:

    Jo Anne Attwood
    Administrative Regulations Analyst
    Department of Labor & Industries
    PO Box 41448
    Olympia, WA  98504-4148
    Or email JoAnne.Attwood@Lni.wa.gov.

All comments must be received by 5 p.m. on October 30.

More information about the proposal is available at www.Lni.wa.gov/2021Rates.

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BIIA Proceedings by Video/Phone Through January 2021

Proceedings by Video/Phone will be how Board of Industrial Insurance Appeals cases will be heard, through at least January 2021. Since we last wrote about this – APPEAL PROCEEDINGS WILL BE BY REMOTE ACCESS THROUGH JULY – additional options have been put in place, including Zoom proceedings.

Opening of BIIA Offices and Live Proceedings on Hold

When and how the BIIA will open their offices depends on the COVID-19 situation and guidance from Governor Inslee’s office.  On July 24, 2020, the Governor extended the Safe Start proclamation, and BIIA offices remain closed to the public at this time.

The BIIA will continue with only telephone/video proceedings through the end of January 2021.  Contact your assigned judge about using CourtCall or Zoom for video proceedings, or if you have questions about how to proceed.

More Information and Assistance

More information about the process for proceedings by video/phone can be found on the Board’s website. There is updated information for the use of Zoom for proceedings on a variety of devices, with step-by-step instructions and helpful screenshots:

If you have an appeal pending, you may also contact the judge assigned to your case, or their assistant, if you more information.

We often suggest that claimants have legal representation when their case is on appeal. This may be especially true when appeal proceedings will be 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.

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Hazard Alert on Hospital Worker Safety

A COVID-19 Hazard Alert on hospital worker safety has been issued by the Washington State Departments of Labor & Industries (DLI) and Health (DOH).

Concern over COVID-19 cases in hospital workers has prompted DLI and DOH to clarify and update hospital guidance to prevent the spread of the virus to staff and patients.

The Hazard Alert on hospital worker safety was issued on September 17, 2020. It highlights key worker safety and health requirements and guidance on employee training, proper use of respirators and Personal Protective Equipment (PPE), social distancing, disinfecting procedures, and the importance of a comprehensive infection control program. The alert aligns hospital requirements with the most current information about transmitting the virus.

“Health care workers are on the front lines of the pandemic caring for others. This Hazard Alert spells out what hospitals must do to take care of all of their workers to prevent them from getting infected on the job,” said Anne Soiza, DLI assistant director for the Division of Occupational Safety and Health (DOSH).

“Employee safety and patient safety are equally important,” Soiza added.

Details of the Hazard Alert on Hospital Worker Safety

The alert covers several key areas including training on COVID-19 procedures and infection control. Among the requirements, hospitals must:

  • Replace disposable respirators and procedural masks daily at the beginning of each shift and immediately upon employee request when soiled or damaged during the shift. Multiple shift use of disposable respirators/masks is not allowed.
  • Train and ensure sick employees do not report to work and immediately leave work when they become symptomatic.
  • Ensure facilities are adequately staffed with qualified infection prevention staff and resources.
  • Provide adequate space and procedures for employees to physically distance at a minimum of six feet in break rooms, nurse stations, cafeteria and other spaces where they congregate.
  • Maintain hospital-wide policies and procedures consistent with state and national guidelines as they evolve for COVID-19.

DLI is working closely with the DOH on this issue. DOH supports local health agencies as they respond to COVID-19 cases and outbreaks, including those at hospitals, and conducts oversight of hospitals under state licensing laws.

DOH is coordinating with local health agencies and the Washington State Hospital Association on opportunities to provide hospitals with the education and support necessary to keep health care employees and patients safe from COVID-19 and other infections.

Guidance for Specific Industries

Along with the guidance for health care and long-term care workers, guidance for other industries is available on the DLI DOSH coronavirus webpage.

The state coronavirus webpage has links to important information and guidance related to the pandemic from numerous state agencies.

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