Injured Worker
Rights and Responsibilities

Taken from the “Worker’s Guide to Industrial Insurance Benefits”
The Department of Labor and Industries

Responsibilities

To return to gainful employment as quickly as possible

To cooperate with all reasonable requests in determining disability and developing and implementing vocational services
     -    Note: If the worker fails to cooperate without good cause, the department or                         self-insurer,  with notice to the worker, may suspend any further action on the                       worker’s claim as long as the practice continues and may reduce, suspend or deny                 compensation for such period.

To report the injury or exposure to the employer as soon as possible

To file a claim when a work-related injury or illness occurs

To tell the attending physician the injury or illness is work related and to keep the physician informed of his or her medical status

To keep in touch with the employer regarding the progress of his or her recovery and return to work plans

To report significant changes to the department or self-insurer, such as medical condition, change or address, return to work status, hire/dismissal of attorney, etc.

To contact the department if he or she does not agree with some aspect of the vocational planning process

Rights

To file a claim for a work-related injury or illness without penalty or discrimination by the employer

To obtain prompt medical treatment for the work-related injury or illness and to refuse treatment once the condition is determined

To choose a qualified doctor for treatment, consult with another doctor or change doctors with prior approval from the department or self-insurer

To receive time-loss compensation when the injury prevents return to work and the medical condition is unstable; or while actively participating in approved vocational services. (The first time-loss payment should be mailed within 14 days after the department receives the doctor’s certification of disability.)

To apply for a change in compensation

To have his or her records kept confidential

To be actively involved in his or her treatment and /or return to work program

To return to work while completing recovery with the attending doctor’s approval as long as the work does not interfere with recovery

To have all modified job changes reviewed and approved by the attending doctor

To send a written request to the department of self-insurer to review his or her claim file and records

To be informed of the progress of vocational activities

To dispute a vocational ability to work determination or an approved formal vocational plan within 15 calendar days from the date the notification of the decision was received

To protest or appeal in writing a department or self-insurer decision that is unrelated to vocational services within 60 days of receiving notice of the decision

To request a reopening of the claim, if the condition worsens or requires medical attention, within 7 years of the date the first claim closure became final, or, in the case of an eye injury, 10 years

To file a lawsuit against a third party who caused the work related injury or illness and/or ask the department to file a lawsuit on the worker’s behalf

To have the department, upon written request, set reasonable attorney fees for legal services before the department
     -    Note: The Board of Industrial Appeals or the court system will, upon written                       request, set reasonable attorney fees for services before the board or the court.

To have legal representation and terminate legal representation

To apply for social security disability benefits, if appropriate

To receive compensation for permanent partial disability or total disability due to industrial accident/injury

To receive compensation for permanent loss of function to one or more parts of the body (permanent partial disability) or for inability to ever return to gainful employment (permanent total disability), as a result of the work-related injury or illness


Role of the Vocational Rehabilitation Counselor

Taken from the “Workers’ Guide to Industrial Insurance Benefits”
Department of Labor and Industries.

Your claim manager may ask a vocational counselor to work with you, your employer and your doctor to identify the problems that are preventing you from returning to your job.

L & I expects your active participation in all return to work activities. The sooner the problems preventing your return to work are identified and resolved, the better your chances of keeping your job or finding a new one.

The vocational counselor will outline the services, if any, that are necessary to resolve the problems. His or her suggestions may include the following:

  • Temporary modification of the regular job. The physical demands of your job could be changed temporarily to accommodate your physical restrictions. This may include part-time or light duty work.
  • Permanent modification of the regular job. Tasks could be permanently modified to tailor the physical demands of the job to your physical restrictions.
  • Return to work at a new job. A permanent job, in keeping with your physical restrictions, could be made available with the same employer.

If it appears that you are not likely to return to work with our employer, but have skills, which enable you to work elsewhere, you may be asked to undergo a formal employability assessment.

A vocational counselor will assess your employment options by matching your experience, education, knowledge, interests, age, skills, and physical and mental capabilities to the job market in your area.

The counselor will be responsible for gathering the information needed to complete the assessment and to make recommendations to your claim manager regarding your employability. The counselor will work closely with you, your employer and your doctor in this process.