Washington Workers' Compensation

Workers’ Comp Case Study

The Situation

Our member, a manufacturer in Washington with over 500 employees, received a workers' comp claim notice from a brake operator who had only been on the job for two months. The employee said he was experiencing pain in his left knee. The Washington State Department of Labor and Industries (L&I) allowed the claim and labeled it an industrial injury. Once our member heard of this, they immediately contacted their dedicated workers’ comp claims manager at Vigilant. This claim could have easily led to $100,000+ in workers' compensation claims costs.

The Solution

Our team at Vigilant began to investigate the workers' comp claim. It was discovered the worker had extensive prior work history (six years) as a brake operator with another employer. Vigilant protested the claim with L&I on behalf of the member, stating the condition was due to prolonged use of the worker's leg, and therefore was the result of occupational disease. L&I then reconsidered the injury as a result of Vigilant's protest, and new paperwork was processed, confirming the worker's belief that the condition was “an occupational problem due to operating a press brake for six years with all his weight on his left leg.”

L&I cancelled the allowance of the claim as an industrial injury and allowed the claim as an occupational disease claim, charging less than 10% of the liability to the current employer, with the remainder of the liability charged to the previous employer. Between surgery, time loss payments, and retraining we estimate our member saved more than $100,000. Meanwhile, the injured worker received the care he needed as a result of the claim. Our assistance during the entire claims process was covered by our member's participation in our Washington retro program. There were no additional charges for phone calls, the investigation time, meetings, or paperwork.