As of January 1, 2012, a significant change in Washington’s workers’ compensation laws created Claims Resolution Structured Settlement Agreements, or CRSSAs.  The CRSSA provides an opportunity to resolve the claims of injured workers age 55 and over through structured settlements, an option intended to reduce overall claim costs for the Department of Labor and Industries, potentially leading to lower workers’ compensation premiums for both businesses and workers, while providing an alternative for injured workers who feel “stuck” in the Department’s system and wish to pursue retirement or alternative work goals outside their claims. – See more detail in our prior post on this subject here. 

        The Office of the Attorney General provides legal oversight to the Department and assists in the crafting of structured settlement agreements, including the agreement contracts.  The Board of Industrial Insurance Appeals, a separate State agency tasked with resolving disputed issues in workers’ compensation claims, among other things, has been given the responsibility to review CRSSAs and, thumbs-up or thumbs-down, approve or deny them.

        The CRSSA program is immense, involves three separate State agencies, and the laws that created the program were crafted as a concept with each agency left to determine their specific role and policies with the hopeful expectation that those roles and policies would efficiently mesh and result in a flushing out of the most expensive claims in the workers’ compensation system – total disability pension cases.   A claim that results in a disability pension is expensive for the Department of Labor and Industries not only because it has to fund a lifetime pension, often with survivor benefits for the injured worker’s spouse, but also because of the Herculean effort put into avoiding placement on the pension rolls in all but the most clear-cut cases.  

Since the inception of the CRSSA program, 60 cases have been through an approved structured settlement review by the Board of Industrial Insurance Appeals.  Of those, 31 have been rejected and 29 have been approved. 

        Vocational services provided to injured workers facing placement on the pension rolls if retraining services are not successful can be costly.  No stone is left unturned in the search for a retraining plan that will result in a finding of employability instead of total disability.  In one recent case, a vocational counselor put in a not-insignificant amount of time to try to document our client’s ability to return to work as a Disc Jockey – not because of the sweet tones in his voice, his love of radio, his prior work experience or an aptitude for performing the job, but because he had been the voice on the radio during a short time while in the military during the Vietnam War (and, because he had no education or work experience in light-duty work over the past 40+ years of his work life).  More common is a determination that an injured worker can return to work as a Parking Lot Attendant.  Our current discussions within the law firm lead us to believe that there have been more injured workers found employable as Parking Lot Attendants by the Department of Labor and Industries than there are positions at every parking lot across the state.  Although I do not have data to support that assertion, it is, by far, the most common outcome of vocational evaluations in our case load.  No stone unturned.

There is no blueprint for a standard approach – each claim is unique and each settlement agreement proposal is reviewed individually based on the facts in the claim and the circumstances of the injured worker. 

        Since the inception of the CRSSA program, 60 cases have been through an approved structured settlement review by the Board of Industrial Insurance Appeals.  Of those, 31 have been rejected and 29 have been approved.  I believe there are now 22 cases remaining in the pipeline that have not yet received a review determination.  A bottleneck effect has occurred with our cases since last fall, when the Office of the Attorney General put the brakes on the process while evaluating several agreements denied authorization to proceed by the Board of Industrial Insurance Appeals.  As each agreement is submitted for review, those approved and denied are thoroughly analyzed to determine which elements led to approval and which led to denials in an attempt to clarify the requirements of the Board.  Adjustments to pending contracts are made with each new item learned, refining the process each time.  Until recently, this analysis was done behind closed doors, with little to no discussion of the process with us.  The effect for the injured workers we represent who have been awaiting a settlement in their claim has been MONTHS of delay, initially with no details as to why.  After incessant phone calls and complaints, the lines of communication opened a bit and all parties are now working more collaboratively to craft contracts that will pass muster and, hopefully, be approved by the Board.

        The Attorneys General assigned to work on CRSSAs are making their best guesses to determine what the assigned Judges at the Board of Industrial Insurance Appeals want to see in a structured settlement.  There is no blueprint for a standard approach – each claim is unique and each settlement agreement proposal is reviewed individually based on the facts in the claim and the circumstances of the injured worker.  Because of the very short timeframe given to the Board by the statutes that created CRSSAs, which dictates an approval or denial within 14 days of filing, there is no time for any meaningful discussion between the parties and the Judge.  Thumbs-up or Thumbs-Down, that’s it.  If denied, the application can be altered and resubmitted to try to gain approval – not usually by changing the terms of the agreement but typically by updating the documentation of how that agreement will be implemented and how it will be in the “best interest of the worker” – the Board’s required role is to provide this oversight, this judgment of the overall agreement and whether or not it is in the worker’s best interest, usually without ever setting sight on the worker.

        The wrinkles have not yet been ironed out, yet already legislation has been introduced this year to amend last year’s statutes to open up the program to any worker over the age of 40.  House Bill 1097 and Senate Bill 5127, which initially would have removed the age restriction for CRSSAs entirely, have now been amended to lower the age limit from 55 to 40.  These bills have not yet passed but are a sign of how itchy the powers that be are to change the century-old system of workers’ compensation coverage in this State.  That said, I have a few clients that are not yet aged into the current CRSSA system that are watching this legislation carefully, hoping that they can take advantage of the option to cut their ties with the State in exchange for a cash payout.

A structured settlement is not right for everyone in every case.  If you are interested in exploring this option under your own claim, please feel free to contact Causey Law Firm for assistance.