Uncategorized

Washington Healthplanfinder Will Start Open Enrollment Nov. 1

Note: Keep in mind when applying for health insurance that workers’ compensation payments are NOT taxable income and should NOT be included in your household income figure. – kc

Shortened, six-week open enrollment period begins at 8 a.m. November 1st and extends through December 15th

The Washington Health Benefit Exchange today confirmed the resources and assistance options available statewide to residents using Washington Healthplanfinder to sign up for health and dental coverage during the open enrollment period that begins at 8 a.m., Nov. 1st.

Different from previous open enrollment periods, residents have until Dec. 15 – six weeks total – to sign up for health and dental insurance through Washington Healthplanfinder that covers themselves and their family during the upcoming year.

“The window for residents to shop and sign up for health and dental insurance is shorter this year. The start of open enrollment should signal all customers to begin evaluating their options as quickly as possible in order to choose their 2019 coverage before the open enrollment period ends on Dec. 15.” – Pam MacEwan, CEO of the Washington Health Benefit Exchange

Customers accessing Washington Healthplanfinder during open enrollment will be greeted with a more streamlined method for taking action related to their health insurance, including finding financial help. Determining eligibility for free or low-cost coverage offered exclusively through Washington Healthplanfinder is a primary response customers may now select from a redesigned homepage that asks visitors “What would you like to do today?”

Washington Healthplanfinder also remains the only place Washingtonians can compare health plans offered in their county before connecting with coverage that best meets their needs. Smart Planfinder, the consumer decision-support tool introduced in 2017, offers the most advanced method for choosing health insurance. By inputting provider preferences, prescription drug requirements and cost considerations, Smart Planfinder can identify “Smart Choice” plans that more effectively meet projected medical needs.

In-person support may be accessed through Washington Healthplanfinder’sextensive network of trained navigators and brokers. Available at designated enrollment centers and other locations based throughout the state, navigators and brokers offer expert in-person assistance to any individual who needs help enrolling in 2019 health and dental plans.

Linking up with a nearby navigator or broker is easiest through the WAPlanfinder mobile app. By identifying a customer’s current location, WAPlanfinder provides contact information for and directions to the closest in-person help in their neighborhood. The app also directly connects customers with answers to frequently asked questions and allows for coverage-related documents to be uploaded quickly and securely.

As is the case every open enrollment period, customers may access over-the-phone assistance by calling Washington Healthplanfinder’s toll-free Customer Support Center (1-855-923-4633). Throughout the open enrollment period, the Customer Support Center will be available during weekdays from 7:30 a.m. to 8 p.m. and on Saturdays from 10 a.m. to 2:30 p.m. Additional hours of availability will be extended at peak sign-up times during open enrollment.  

Special sign-up events are also expected to be held leading up to the Dec. 15 deadline for 2019 coverage. Locations and other information for those events can be found by visiting the #GetCoveredWA hub located at www.wahbexchange.org.  

Reminders: Enrollment is offered year-round to individuals and families through Washington Apple Health (Medicaid). Customers enrolled in Apple Health will receive a notice of 60 days before the month they enrolled in or renewed their coverage last year.

About Washington Healthplanfinder

Washington Healthplanfinder 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. The next open enrollment period for Washington Healthplanfinder begins on Nov. 1.

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, like 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 Healthplanfinder. Apple Health is administered by the Washington State Health Care Authority: www.hca.wa.gov.

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Workers' Compensation Coverage

WA State DLI Proposes Significant Drop in Workers’ Comp Rates for 2019

The price of workers’ compensation insurance in Washington will likely drop significantly in 2019. The state Department of Labor & Industries (L&I) proposed a 5 percent decrease in the average premium employers pay for the coverage.

If approved, the rate decrease would be the largest drop since 2007. The lower rate would mean employers would pay an average of about $58 less a year per employee for workers’ compensation coverage. Employees would pay about $6 less a year for their share of the cost.

The proposed decrease would mean Washington workers and employers, as a group, pay $136 million less in premiums.  

The public will have an opportunity to provide input about the rate proposal before a final decision is made in December.  

L&I Director Joel Sacks says decreases in work-related injuries, along with L&I initiatives to improve outcomes for injured workers and reduce costs, have made the system healthier and are contributing to the proposed decrease. 

“We’ve seen a big drop in injuries at work in our state since 2012. And that’s great news because preventing injuries and making workplaces safe is our number one goal,” said Sacks. “Along with that, we’re doing a better job helping injured workers heal and return to work. That’s good for workers and employers, and helps us lower the cost of workers’ compensation coverage.”  

One example of an effort that’s helping workers and employers is L&I’s Stay at Work Program. It pays for some of the costs for employers to keep injured workers in light-duty jobs until they fully recover. Since 2012, the program has provided $72 million to employers, which has helped provide 27,000 workers with light-duty jobs while they heal.

L&I has also established opioid prescription guidelines which have resulted in a 90 percent reduction in the number of workers receiving opioids at 6-12 weeks after injury. And the agency has been providing vocational support and assistance earlier in injury claims, which has helped reduce long-term disability. In the last five years, these and other improvements have resulted in a more than $2 billion reduction in projected long-term costs for the workers’ compensation system.  

Helping workers recover and keeping the workers’ compensation system healthy

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. The premiums also provide a safety net by ensuring reserves are available to cover the unexpected, like a natural disaster or downturn in the economy.

Each fall, L&I determines the proposed rate for the following year by looking closely at several factors, including expected workers’ compensation payouts, the size of the contingency reserve, wage inflation and other financial indicators.

A 2.5 percent decrease last year, along with some small increases in workers’ compensation premiums since 2014, have kept rates steady and predictable, making it easier for employers to budget for workers’ compensation costs while also building and maintaining an adequate reserve fund for the workers’ compensation system.

Public hearings planned for October

The agency will hold three public hearings where people can learn about and comment on the proposed 2019 rates. The hearings are scheduled for: 

  • Tumwater, Oct. 30, 9 a.m., Dept. of Labor & Industries Headquarters
  • Tukwila, Oct. 30, 1 p.m., Dept. of Labor & Industries Tukwila Office
  • Spokane Valley, Oct. 31, 9 a.m., Spokane CenterPlace 

People can also comment in writing to Jo Anne Attwood, administrative regulations analyst, P. O. Box 41448, Olympia, WA 98504-4148; or email joanne.attwood@Lni.wa.gov. All comments must be received by 5 p.m. Nov. 2, 2018.

More information about the proposal is available at www.Lni.wa.gov/Rates. Final rates will be adopted by early December and go into effect Jan. 1, 2019.

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Election 2018

WA State Voter Registration Deadline: October 29

The deadline for online and mail-in voter registration has passed, but voters can still register in-person to be able to vote in the election on November 6th. 

  • FIND your county elections department’s location, office hours and contact information.
  • Go in-person – – ASAP! – –  and REGISTER to vote.
  • Then, VOTE!!!

Your fellow citizens will thank you.

 

Photo by Chris Piascik on Foter.com / CC BY-NC-ND

Attorney Profile

Causey Wright Team Profile: Brian Wright

Brian Wright  |  MANAGING ATTORNEY, OWNER

Brian grew up in the greater Seattle area and worked various jobs in the construction industry until he returned to school, earning degrees in Japanese Studies and Political Science from the University of Washington. He obtained his law degree, cum laude, from Seattle University School of Law, and served on the editorial board of the Seattle University Law Review. Brian is licensed to practice before the Washington State Supreme Court, United States District Court for the Western District of Washington, and the United States Court of Appeals for the Ninth Circuit.

Brian represents injured and disabled workers with workers’ compensation claims before the Washington State Department of Labor & Industries and those covered by the federal Longshore and Harbor Workers Compensation Act which includes waterfront workers, overseas defense contractors (Defense Base Act), and domestic non-appropriated fund employees at U.S. military installations (Nonappropriated Fund Instrumentalities Act).

Brian also collaborates with other law firms filing lawsuits in Washington State on behalf of victims of asbestos-related diseases, and he litigates the occasional Jones Act/maritime case.

In addition to his busy litigation practice, Brian is active with several organizations which help preserve the rights of injured workers. He is an Eagle member of the Washington State Association for Justice (WSAJ), and for 2017-2018 he served as the Chair of its Workers’ Compensation Section. Brian is also a member of the Workers’ Injury Law & Advocacy Group(WILG), a national non-profit organization dedicated to representing the interests of injured workers and their families. He has written and filed “friend of the court” briefs in Washington State on behalf of WILG in significant workers’ compensation cases.

Brian has been named to the Super Lawyers list of Rising Stars, 2016 – 2018 as a “Top Rated Workers’ Compensation Attorney in Seattle“.  Brian has a rating of “10.0 Superb” by Avvo. He was also named a Rising Star by WILG in 2014.

 

 

Defense Base Act

Defense Base Act Coverage for U.S. Government Contractors Working in Puerto Rico

October 15, 2018

NOTICE TO EMPLOYERS, INSURANCE CARRIERS, SELF-INSURED EMPLOYERS UNDER THE LONGSHORE AND HARBOR WORKERS’ COMPENSATION ACT, AND OTHER INTERESTED PERSONS

SUBJECT: Defense Base Act Coverage for U.S. Government Contractors Working in Puerto Rico

In the aftermath of the devastation caused by Hurricanes Irma and Maria in Puerto Rico in September of 2017, various agencies of the United States have utilized the services of private contractors to provide humanitarian and other assistance as part of the global relief effort there. The Defense Base Act (DBA) requires private contractors performing work under a U.S. government contract to purchase DBA insurance to cover their employees working in Puerto Rico.

The DBA, an extension of the Longshore and Harbor Workers’ Compensation Act, applies to injuries incurred by workers in Puerto Rico working under a contract with the U.S. government, see Section 1, 42 U.S.C. § 1651(a)(1-6).

Federal agency contracting personnel should include contract provisions requiring private contractors to secure DBA insurance from a carrier authorized by the U.S. Department of Labor.  Because the DBA applies to all employees of government contractors, DBA insurance must be in place before workers are deployed to Puerto Rico or work is performed in Puerto Rico.  The DBA applies to U.S. workers, local workers, and foreign national workers.

When DBA insurance is properly secured, the DBA provides the exclusive remedy for these workers who sustain an injury, an illness, or are killed. The DBA is administered by the United States Department of Labor, Office of Workers’ Compensation Programs (OWCP), Division of Longshore and Harbor Workers’ Compensation (DLHWC).  OWCP/DLHWC authorizes insurance carriers to write DBA policies and employers to self-insure for DBA. See a list of those insurance carriers which are currently authorized to write DBA coverage.

If an employee covered by the DBA sustains a work-related injury, it must be reported to OWCP/DLHWC.  The DBA carrier should also be contacted immediately.  An employee may submit a claim for injuries arising from employment under a U.S. government contract in Puerto Rico to OWCP/DLHWC.  The case will then be assigned based on where the claimant resides.

For more information Visit the USDOL Defenst Base Act  and Division of Longshore and Harbor Workers’ Compensation Defense Base Act pages.

Photo by The National Guard on Foter.com / CC BY

Workers' Compensation, workplace injury

Recovering From Injury – “Is Heroism the Standard?” Redux

Judge David B. Torrey

Today’s post comes from guest author Thomas Domer, from The Domer Law Firm. Boy, does this ring true. – KC

My friend and colleague, Professor and Judge David Torrey, with whom I serve on the Board of the College of Workers’ Compensation Lawyers, recently posted this blog in response to an insurance industry speaker’s exhortation that injured workers should “ get off their asses” and get better. Here’s his moving response:

Many in the workers’ compensation community complain that seriously injured workers can develop a disability lifestyle, become dependent on drugs, and unreasonably extend their disabilities. Instead of falling into such a lifestyle, these critics argue, disabled workers should show “resilience.” This rhetoric, which I have written about before on this blog, has its genesis in progressive medical/rehabilitation thinking, Muscular Christianity (I think), and, realistically, employer/insurer cost considerations.

The complaint is legitimate, and one with which I have some sympathy. I also believe that some legitimately injured workers do indeed unreasonably extend their disabilities — if only waiting for a generous lump sum settlement. Many readers will know of the sharp critique of this type advanced by Dr. Nortin Hadler in his many books.

On the other hand, the “duty-of-resilience” critique can go too far, and is often articulated in overly simplistic terms. At my agency’s conference in Hershey, Pennsylvania (June 7-8), an articulate industry speaker, addressing an audience about medical marijuana, posited forcefully that the “choice between opioids and medical marijuana [for chronic pain patients] is a false choice….” What workers need to do, instead, is show some resilience and “get off their asses!” After all, a friend of his, who is partially paraplegic, has shown resilience and will often go hiking with him. If she can do it, so can others!

I believe the speaker knew his audience and thus took some pleasure in feeding these lions of the community some red meat, and indeed they rewarded this coarse declaration with a leonine roar of applause.

Yet, his panel partner, Dr. Michael Wolk, thereupon gently reminded the industry speaker — and the audience — that not all people respond to pain and other impairments the same way; indeed, he posited that science has shown that one’s genetic make-up can affect the ability to be resilient.

Dr. Wolk (my God, an astonishing speaker) might also have remarked, as have other physicians at our Pennsylvania conferences, that heroism is not appropriately considered the recovery standard in the first place. Commentators like the industry speaker, talking about resilience, often invoke exceptional individuals, like Christopher Reeve, but most of us realize that not everyone is Superman.

This point was vividly made two years ago in the memoir, A Body Undone: Living on After Great Pain (NYU Press 2016). The author, Christina Crosby, a professor at Wesleyan University, was rendered quadriplegic in a cycling accident, and has been left with chronic pain as well. She recounts in her memoir what life is like with such a catastrophic injury, shows that she indeed has great resilience — but leaves the heroism narrative behind. She makes clear that her circumstances, like education; a life of reflection and discipline; and the unflagging love and support of her family, make her ability to bounce back possible. Most of us know that not every injury victim will have these advantages. (My complete review of Professor Crosby’s book is posted at the research website www.davetorrey.info.)

Is all this not common sense? We have known for a century, after all, that young men respond differently to their traumatic wartime exposures. Some show a grim resilience; some are troubled for life, but are able to continue on; some are broken. In the modern day, most of us would not address such veterans with the admonition that they get off their asses. Injured workers deserve the same respect.

 

Coverage Decision

WA State DLI Ends Coverage of Therapeutic Genicular Nerve Blocks for Knee Pain

The Washington State Department of Labor & Industries made a coverage decision on therapeutic genicular nerve blocks recently.  Genicular nerve block for treating chronic knee pain is not a covered benefit, effective October 1, 2018. 

The knee joint is innervated by the articular branches of several nerves including the femoral, common peroneal, saphenous, tibial and obturator nerves. These articular branches around the knee joint are known as genicular nerves.

Per the Department of Labor and Industries, genicular nerve block for treating chronic knee pain is controversial. The effectiveness of the procedure on relieving chronic knee pain is not established. The safety of repetitive anesthetic/steroid injections to the genicular nerves is unproven. 

The white paper produced to outline the basis for this decision includes reference to the practice guideline published by The American Society of Anesthesiologists, “Practice Guidelines for Chronic Pain Management” in 2010 []. It pulls the quote from the document “peripheral somatic nerve blocks should not be used for long-term treatment of chronic pain”.  The paper’s conclusion statement is: “The evidence regarding genicular nerve block is scant. Though some evidence showed that GNB might provide short-term pain relief, the effectiveness of this procedure on chronic knee pain has not been established. The safety and effectiveness of repetitive anesthetic/steroid injections are unproven.”

Genicular nerve block (GNB) may be performed for diagnosis or perioperative care. GNB for treating chronic knee pain is not covered.

Coverage Decision

WA State DLI New Coverage Decision – Surgery for Lumbar Radiculopathy/Sciatica

The Washington State Department of Labor & Industries has adopted a new Health Technology Clinical Committee coverage determination about surgery for lumbar radiculopathy/sciatica, effective November 1, 2018.

Surgeries for lumbar radiculopathy/sciatica are covered, with conditions.

Conditions of Coverage:

Open discectomy or microdiscectomy with or without endoscopy (lumbar laminectomy, laminotomy, discectomy, foraminotomy) are covered with the following conditions:

  • For adult patients with lumbar radiculopathy with subjective and objective neurologic findings that are corroborated with an advanced imaging test (i.e., Computed Tomography (CT) scan, Magnetic Resonance Imaging (MRI) or myelogram), AND

  • There is a failure to improve with a minimum of six weeks of non-surgical care, unless progressive motor weakness is present

Non-covered indicators:

Minimally invasive procedures that do not include laminectomy, laminotomy, or foraminotomy including but not limited to energy ablation techniques, Automated Percutaneous Lumbar Discectomy (APLD), percutaneous laser, nucleoplasty, etc. are not covered.

Background Information:

The State Health Technology Clinical Committee (HTCC) reviewed surgery for lumbar radiculopathy/sciatica in May 2018 and finalized the determination on July 13, 2018. Complete information on this HTCC determination is available here.

In adopting this HTCC coverage determination, the Department has concluded that the determination does not conflict with any state statute. Any coverage for investigational treatment would be considered per WAC 296-20-02850.  Any coverage for health technologies that have a FDA Humanitarian Device Exemption status would be considered per RCW 70.14.120 (1) (b).

Implementation of the Coverage Decision:

All requests for surgery for lumbar radiculopathy/sciatica require prior authorization. The service may be covered only for care of a condition accepted on or related to the claim.

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Construction Updates

Working from Barges – Seattle’s Colman Dock Project Underway

 

Colman Dock in Seattle is the largest Washington State Ferries terminal and supports transportation across Puget Sound between downtown Seattle and communities in Kitsap County and the Olympic Peninsula. Key components of Colman Dock are aging and vulnerable to seismic events. The layout of today’s facility also creates safety concerns and operational inefficiencies due to conflicts between vehicles, bicycles and pedestrian traffic.

The Washington State Department of Transportation (WSDOT) has undertaken an enormous project to repair the multimodal terminal at Colman Dock without interruption to ferry service.

Key project elements include:

  • Replacing the existing timber trestle portion of the dock with a new concrete and steel trestle
  • Replacing the main terminal building
  • Replacing the passenger-only ferry facility on the south edge of Colman Dock with funding from King County
  • Constructing a new elevated walkway between the terminal building and the passenger-only ferry facility

Construction will continue until 2023 and the terminal will remain open throughout construction. 

Working from barges will help increase space on Colman Dock during construction.  WSDOT notes “Our contractor is using multiple barges at a time to stage construction equipment and huge cranes used to rebuild Colman Dock. Working from the water allows us to reduce our shore side construction zone footprint in every stage of the project. Smaller construction zones mean more room on the dock for vehicle holding.”

For a full description and details, see the WSDOT page dedicated to the project.  More pictures are available on the WSDOT Flickr page, as well.

 

Worker Safety

OSHA Warns Hurricane Florence Clean Up Workers to Practice Caution

Today’s post was shared by Jon L Gelman and comes from www.ehstoday.com

As Hurricane Florence damage is assessed and affected areas began to clean up, workers and residents are being faced with numerous hazards caused by the storm.

OSHA is warming emergency crews to take precautions and to address hazards from flooding, power loss, structural damage, fallen trees and storm debris.

“Workers involved in storm recovery can face a range of safety and health hazards,” said OSHA Regional Administrator Kurt Petermeyer in a statement. “Risks can be minimized with knowledge, safe work practices, and personal protective equipment.”

Only individuals with proper training, equipment, and experience should conduct recovery and cleanup activities. The agency recommends measures after a weather disaster should include the following:

  • Evaluating the work area for hazards;
  • Assessing the stability of structures and walking surfaces;
  • Fall protection for elevated surfaces;
  • Assuming all power lines are live;
  • Using chainsaws, portable generators, ladders, and other equipment properly; and,
  • Using personal protective equipment, such as gloves, hard hats, hearing and foot protection, and eye protectors.

OSHA maintains a comprehensive website with safety tips to help employers and workers. Individuals involved in response and recovery efforts may call OSHA’s toll-free hotline at 800-321-OSHA (6742).

[Click here to see the original post]

 

Photo by Virginia Sea Grant on Foter.com / CC BY-ND

Published by Causey Wright