What is a “medical only” workers’ compensation claim?
As the name suggests, when an L&I claim is medical only, then L&I or the self-insured employer pays only for medical expenses. Therefore, you do not receive other benefits such as time-loss compensation, loss of earning power, or permanent partial disability. You also cannot get permanent total disability or death benefits. When a workers’ compensation claim pays for these other benefits, it is called a “compensable claim.”
From my perspective, “medical only” claims are appropriate when doctors can treat the workplace injury or occupational disease quickly. In practice, this type of L&I claim works when there is no break in your employment or ability to earn wages. For example, a work injury claimant who is cut off at work may need urgent medical attention. The person is rushed to the hospital to clean and bandage or suture the wound. If all goes well, the injured worker may miss less than a day of work. The injury will heal and will not have a limiting impact on the worker’s ability to do their job. Under these circumstances, a “medical only” workers’ compensation claim is appropriate. The insurance covers medical expenses due to work accidents. From here, there is no need for other benefits under the claim.
Employing tactics under a workers’ compensation claim
People who are injured on the job should know that L&I provides incentives to employers with no claims (or “medical only” claims). Businesses that prevent workplace injuries from happening get a “no-claim discount” from L&I. Here, the condition is not to have a “compensable claim” for a period of 3 years. Employer discounts range from 10-40% of the base rate for your business. Consequently, some businesses and employers go to great lengths to ensure that no compensable claim is filed.
Some employers reduce compensable workers’ compensation claim volumes by increasing workplace safety. Others provide employees with accommodations and flexibility so as not to disrupt the worker’s employment. I applaud such employers because it is a win for both the worker and the employer.
Unfortunately, some employers try to limit compensable claims unfairly, to the detriment of the worker. In these cases, employers may argue that the injuries are less significant than they are. Another strategy is when the employer creates a job to keep the work injury claimant working, regardless of the claimant’s medical condition. For example, some people have been paid their regular salary to watch security videos while recovering from injuries. This is not necessarily a bad thing, unless the employer has ulterior motives. For example, when employees have a workers’ compensation claim, some employers struggle to find the basis for firing the claimant for work injury with just cause. When an employer fires a person with a workers’ compensation claim for cause, he or she is not eligible to receive benefits such as time-loss compensation benefits.
Summary and conclusion
To summarize, a medical-only workers’ compensation claim is appropriate after a simple on-the-job injury. Remember, such a workplace injury must not have a long-term impact on your physical abilities or your future employment. However, if you suffered a more serious illness or injury, the Industrial Insurance Act (RCW 51) provides other claim benefits. Additionally, these other benefits are important when your work injury has a real impact on your functioning and employability.
This article first appeared at https://tarareck.com/l-and-I-claim-medical-treatment/