Significant Decisions

Subject Index

Click on a letter to navigate the BIIA's Significant Decision subject index.

Significant Decisions (complete document list all headnotes) in PDF format.

Proper Citation Form for Significant Decisions

The proper citation form for any decision contained in Significant Decisions is:

In re Mario Miranda, BIIA Dec., 40,116 (1972)

Decisions issued by the Board, which have not been identified as significant, should not be cited as if they were significant.  The proper citation form for a Board decision and order not identified is:

In re Injured Worker, Dckt. No. 00 000000 (February 1, 1900)

A · B · C · D · E · F · G · H · I · J · K · L · M · N · O · P · Q · R · S · T · U · V · W · X · Y · Z

ABATEMENT (RCW 51.32.040)
ABUSE OF DISCRETION
See AGRRAVATION, MEDICAL BILLS, SCOPE OF REVIEW, STANDARD OF REVIEW, THIRD PARTY ACTIONS and VOCATIONAL REHABILITATION)
ACCIDENT REPORT
(See APPLICATION FOR BENEFITS)
AGGRAVATION (RCW 51.32.160)
(See also APPLICATION TO REOPEN CLAIM, DIMINUTION OF DISABILITY, OCCUPATIONAL DISEASE, PERMANENT PARTIAL DISABILITY, PERMANENT TOTAL DISABILITY, RES JUDICATA, RETROACTIVITY OF STATUTORY AMENDMENTS, SUBSEQUENT CONDITION TRACEABLE TO ORIGINAL INJURY and TIMELINESS OF APPLICATION TO REOPEN CLAIM)
 
Applicability of 1988 amendments
"Deemed granted" application to reopen claim
Discretionary reopening by Director
Effect of abeyance order on "deemed granted" provisions (RCW 51.32.160)
Extension of time to act on application to reopen claim
First closure based on medical recommendation
First terminal date: effect of Board's determination of effective date of closure
First terminal date: effect of subsequent ministerial order
First terminal date findings
Last closing order not final
Objective evidence requirement
Over seven years after initial closure (RCW 51.32.160)
Permanent total disability
Proximate cause of worsened condition: new injury vs. aggravation
Proximate cause of worsened condition: new occupational disease vs. aggravation
Proximate cause of worsened condition: pre-existing condition
Psychiatric conditions
Res Judicata – See RES JUDICATA Aggravation
Scope of Review – See SCOPE OF REVIEW Aggravation
Survivor's benefits based on permanent total disability of deceased worker – See SURVIVOR'S BENEFITS Aggravation
Temporary worsening
"APPEALABLE ONLY" ORDER
(See NOTICE OF APPEAL and PROTEST AND REQUEST FOR RECONSIDERATION)
APPEALABLE ORDERS
Attorney fees for services rendered only before Department
Department agreed exam
Department order fixing interest pursuant to order of superior court
Informal letters
Interlocutory orders
Ministerial orders
Oral decisions
Orders held in abeyance (RCW 51.52.060)
Protest divests Board of authority to hear appeal – See also NOTICE OF APPEALProtest treated as notice of appeal
Provisional time loss compensation orders (RCW 51.32.210) – See also APPEALABLE ORDERS Interlocutory orders
Self-insured employer's order (RCW 51.32.055)
Temporary orders
APPLICATION FOR BENEFITS
Application to reopen treated as accident report
Reasonable notification
APPLICATION TO REOPEN CLAIM
Accident report treated as application to reopen
Office notes treated as application to reopen
APPORTIONMENT BETWEEN INSURERS
(See OCCUPATIONAL DISEASE)
ASSESSMENTS
(See also DEPARTMENT, PENALTIES and RETROSPECTIVE RATINGS)
Bankruptcy
Classification of business
Communication of order (RCW 51.48.120)
Decisions appealable – See APPEALABLE ORDERS Informal letters
Delegation of authority to issue Notices and Orders of Assessment
Effect of failure to allow inspection of records (RCW 51.48.040)
Equitable powers
Estimated premiums
Existence of partnership
Failure to maintain records
Limited liability company
Piece Work
Penalties
Prime contractor liability (RCW 51.12.070)
Reassumption of jurisdiction (RCW 51.48.131)
Subcontractors
Successor liability — Limitation of action (RCW 51.16.190)
ATTENDANT SERVICES
ATTENDING PHYSICIAN
Selection (RCW 51.36.010)
Transfer (WAC 296-20-065)
ATTORNEY FEES FIXED BY BOARD (RCW 51.52.120)
Attorney fees not allowed on interest award
Factors to be considered
Fees for services rendered only before Department - See APPEALABLE ORDERS Attorney fees for services rendered before the Department
AUDIOLOGISTS

(See CAUSAL RELATIONSHIP)0

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B
BENEFICIARIES
(See also COMPUTATION OF BENEFITS)
Abandonment of spouse (RCW 51.08.020)
Child (RCW 51.08.030)
Dependent (RCW 51.08.050)
Permanent partial disability benefits
Permanent total disability benefits
Spouse (RCW 51.32.040)
BENEFITS PENDING APPEAL
BOARD
(See also PETITIONS FOR REVIEW, SANCTIONS, SCOPE OF REVIEW and STANDARD OF REVIEW)
Additional evidence secured on Board's own motion (RCW 51.52.102; WAC 263-12-120)
Appearance of fairness doctrine
Binding examinations
Constitutional questions
County in which hearings held
Discovery
Equitable powers
Examination by industrial appeals judge
Hearing
Joinder – See decisions listed under JOINDER
Jurisdiction determination based on Department file – See SCOPE OF REVIEW
Jurisdiction in assessment appeal – See SCOPE OF REVIEW
Jurisdiction in WISHA appeal (RCW 49.17)
Moot Appeals
Motion to vacate order adopting proposed decision and order
Motion to vacate order denying petition for review
Motion to vacate order dismissing appeal
Motion to vacate order on agreement of party
New evidence
Nunc pro tunc order
Offer of judgment CR 68
Order on agreement of parties – See also SAFETY AND HEALTH Order on Agreement of Parties
Petition for review
Reassignment of Industrial Appeals Judge
Remand for additional evidence
Remands from Superior Court
Response to petition for review
Sanctions – See SANCTIONS
Scope of review - See SCOPE OF REVIEW Closing Order
Stay of proceedings
Subpoena
Substitution of parties
Summary judgment
Summary judgment - time limits
Telephone hearings
Transcript corrections
 
Two member Board
BURDEN OF PROOF
(See also MOTION TO DISMISS)
Abandonment
Employer appeal
Fraud – See FRAUD Burden of Proof
Hearing loss
Injury – See INJURY Burden of Proof
New in-home healthcare
WISHA appeals – See SAFETY AND HEALTH Burden of Proof
WISHA - failure to abate - See SAFETY & HEALTH Burden of Proof - failure to abate
Vocational Rehabilitation - See VOCATIONAL REHABILITATION Burden of Proof
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C
CAUSAL RELATIONSHIP
See also AGGRAVATION, PERMANENT TOTAL DISABILITY and SUBSEQUENT CONDITION TRACEABLE TO ORIGINAL INJURY)
Audiologist
Chiropractor
Physical therapist
Physician's assistant
Psychologist
CHIROPRACTORS
(See CAUSAL RELATIONSHIP)
COLLATERAL ESTOPPEL
(See also RES JUDICATA)
Department order in another claim
Prior Board decision in same claim
Superior court judgment in unrelated case
COLLATERAL SOURCE RULE
(See EVIDENCE)
COMBINED EFFECTS
(See PERMANENT TOTAL DISABILITY)
COMMUNICATION OF DEPARTMENT ORDER
Address shown by Department records
Failure to provide order to assignee of self-insured employer
Failure to provide order to attending physician
Failure to provide order to attorney or representative
Failure to provide order to custodial parent
Failure to provide order to retrospective rating group
Presumptions of mailing and receipt
Receipt of copy of Department order
Strict compliance with service provisions (RCW 51.52.050)
COMPUTATION OF BENEFITS
(See also LOSS OF EARNING POWER and TIME LOSS COMPENSATION)
Burial expenses
Change of circumstances (RCW 51.28.040)
Support provided to dependents (RCW 51.32.050(5))
CORPORATE OFFICERS, DIRECTORS AND SHAREHOLDERS
(See COVERAGE AND EXCLUSIONS)
COSMETIC DEFECT
(See PERMANENT PARTIAL DISABILITY and INJURY)
COURSE OF EMPLOYMENT (RCW 51.08.013; RCW 51.08.180(1))
Abandoment
Aggressor doctrine
"Arising out of employment" test distinguished
Commission of felony (RCW 51.32.020)
Deviation
Dual purpose doctrine
Education and training off jobsite
Going and coming rule
Goodwill
Horseplay
Intoxication
Job site
Lunch period (RCW 51.32.015; RCW 51.36.040)
"On call" employees
Parking area exclusion (RCW 51.08.013)
Personal comfort doctrine
Reaction to treatment for probable occupational disease
Recreational activities
Resident workers
Sidewalk
Training programs
COVERAGE AND EXCLUSIONS
(See also EMPLOYER-EMPLOYEE and INDEPENDENT CONTRACTORS)
Chore service workers
Corporate officers (RCW 51.12.020(9) (1979); RCW 51.12.020(8) (1987)(1992))
Course of trade, business or profession of employer (RCW 51.12.020(3))
Effect of allowed Federal Employees Compensation Act claim
Elective adoption
Extraterritorial
Federal Employees Compensation Act
Inmates
Interstate truckers - Owner-operators
Jockeys
Limited liability company
Longshore and Harbor Workers' Compensation Act
Partners (RCW 51.12.020(5))
Reciprocity agreements
Religious or charitable organizations
Self employment
Social events
Sole proprietors (RCW 51.12.020(5))
Waiver of benefits (RCW 51.04.060)
CRIME VICTIMS COMPENSATION
(See Timeliness of claim)
Burden of proof-injury resulting death
Limitation of benefits for felony conviction of the victim (RCW 7.68.070(19))
Temporary total disability benefits
CUSTODY OF CHILDREN
Invalid child in custody of state institution (RCW 51.32.010 and RCW 51.32.020)
Determined by court order
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D
DENIAL OF APPEAL
(See DEPARTMENT, PETITION FOR REVIW)
DEPARTMENT
(See also ASSESSMENTS)
Administration costs, self-insurers
Administrative convenience
Agreed examination
Ambiguous orders
Authority of Department not to pursue collection of final assessment
Authority to adjudicate claim after closure
Authority to adjudicate claim after closure – medical bills
Authority to bind parties to final disposition - See APPEALABLE ORDERS Department Agreed Exam
Authority to honor support enforcement lien
Authority to issue further adherence order
Authority to issue nunc pro tunc order
Authority to issue order while superior court appeal pending
Authority to issue subsequent order once the period for appeal has passed
Authority to issue subsequent order while appeal pending
Authority to modify order
Authority to correct underpayments of benefits - See also SELF-INSURANCE Authority to recoup overpayment of benefits
Authority to regulate out-of-state providers – See PROVIDERS
Delegation of authority to issue Notices and Orders of Assessment – See ASSESSMENTS
Delegation of authority to receive protests and requests for reconsideration – See PROTESTS
Determination of new injury vs. aggravation (WAC 296-14-420) – See also JOINDER Department as necessary party
Employer inclusion in claims administration
Ministerial order
Providers – See PROVIDERS
Reassumption of jurisdiction (RCW 51.48.131) – See ASSESSMENTS
Reassumption of jurisdiction (RCW 51.52.060)
Reassumption of jurisdiction – WISHA - See SAFETY AND HEALTH Reassumption of jurisdiction by Department
Rules
Void order
DEPOSITIONS
DIMINUTION OF DISABILITY (RCW 51.32.160)
DISCOVERY
Applicability of civil rules -- medical experts
Motion to compel
Physician-patient privilege
Protective order
Sanctions – See SANCTIONS Discovery
Testifying v. consulting experts
DISCRETIONARY DECISIONS
(See AGGRAVATION, MEDICAL BILLS, PENALITIES, SCOPE OF REVIEW, STANDARD OF REVIEW, THIRD PARTY ACTIONS and VOCATIONAL REHABILITIATION)
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E
EMPLOYER-EMPLOYEE (RCW 51.08.070; RCW 51.08.180)
(See also COVERAGE AND EXCLUSIONS and INDEPENDENT CONTRACTORS)
Choreworkers
Home remodeling contractors
Home services provider
Insurance agents – See INDEPENDENT CONTRACTORS
Jurors
Loggers - See INDEPENDENT CONTRACTORS
Outside salespeople – See INDEPENDENT CONTRACTORS
Partners (RCW 51.12.020(5))
Real estate agents – See INDEPENDENT CONTRACTORS
Route managers
Volunteers
EMPLOYER'S FAILURE TO PROVIDE MEDICAL CARE
EQUITABLE POWERS
(See BOARD)
ETHICS
Attorney as witness
EVASION OF BURDENS (RCW 51.04.060)
(See COVERAGE AND EXCLUSIONS and PENALTIES)
EVIDENCE
(See also EXPERT TESTIMONY)
Admissibility of expert opinion - See EXPERT TESTIMONY
Attorney as witness
Collateral source rule
Documents
Effect of failure to allow inspection of records (RCW 51.48.040)
Exhibits containing hearsay
Judicial notice
Judicial notice of AMA guides
Learned treatise
Physician-patient privilege
Psychologist-patient privilege
Rebuttal testimony
Statements by interpreter
EXCLUSIONS FROM COVERAGE
(See COVERAGE AND EXCLUSIONS)
EXEMPTION OF AWARDS (RCW 51.32.040)
(See PENALTIES)
EXPERT TESTIMONY
(See also CAUSAL RELATIONSHIP, EVIDENCE)
Admissibility of opinions
Conclusions
Physician's assistant
Scope of expertise
Vocational expert testifying by hypothetical
EXTRATERRITORIAL COVERAGE
(See COVERAGE AND EXCLUSIONS)
EYEGLASSES
(See PROPERTY DAMAGE AS RESULT OF INDUSTRIAL ACCIDENT)
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F
FIXITY OF CONDITION
(See ABATEMENT and PERMANENT TOTAL DISABILITY)
FRAUD
Burden of proof
Discovery (RCW 51.32.240(4))
Effect of worker's failure to present evidence when due
Material mispresentation
Time period of fraudulent activity
G
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H
HEARING LOSS
(See OCCUPATIONAL DISEASE)
HEART ATTACK
(See also EMPLOYER'S FAILURE TO PROVIDE MEDICAL CARE, INJURY and SUBSEQUENT CONDITIONS TRACEABLE TO ORIGINAL INJURY)
Emotional stress
Presumption in RCW 51.32.185
Unusual exertion
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I
INDEPENDENT CONTRACTORS
(See also COVERAGE AND EXCLUSIONS and EMPLOYER-EMPLOYEE)
Entertainers
Home health care attendant
Insurance agents
Loggers
Outside salespeople
Real estate agents
Sole proprietors
INJURY (RCW 51.08.100)
(See also HEART ATTACK, EMPLOYER'S FAILURE TO PROVIDE MEDICAL CARE, OCCUPATIONAL DISEASE, SCOPE OF REVIEW and SUBSEQUENT CONDITION TRACEABLE TO ORIGINAL INJURY)
Burden of Proof
Idiopathic fall
Injury v. occupational disease
Normal bodily movement
"Physical conditions"
Physical/mental conditions
Proximate cause: new injury v. aggravation – See AGGRAVATION
Psychiatric conditions (mental/mental) – see also "Sudden and tangible happening"
"Sudden and tangible happening"
Toxic Encephalopathy
"Traumatic nature"
Unusual exertion not required
INTEREST (RCW 51.52.135)
Attorney fees not allowed on interest award
Fixing interest following superior court appeal
Loss of earning power benefits
Time-loss compensation
Waiver impermissible
INTERPRETERS
Qualification (RCW2.43.040)
Requirement to provide at deposition
Requirement to provide at examination
INTERVENTION
Medical providers
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J
JOINDER
Department as necessary party
Multiple claims and employers
Provider as necessary party
Single claim, multiple possible employers/insurers
JURISDICTION
(See BOARD, DEPARTMENT, NOTICE OF APPEAL, PROTEST AND REQUEST FOR RECONSIDERATION, SCOPE OF REVIEW, STANDARD OF REVIEW, TIMELINESS OF CLAIM and TIMELINESS OF APPLICATION TO REOPEN CLAIM)
K
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L
LIGHT DUTY
(See TIME LOSS COMPENSATION)
 
LONGSHOREMEN'S AND HARBOR WORKER'S COMPENSATION ACT
(See COVERAGE AND EXCLUSIONS)
LOSS OF EARNING POWER (RCW 51.32.090(3))
(See also TIME LOSS COMPENSATION)
Comparison wages after reopening
Department obligated to make eligibility determination
Effect of completing vocational rehabilitation
Effect of not seeking full-time employment
Effect of not working
Effect of wage increase in pre- and post-injury employments
Entitlement after reopening
Entitlement beyond date condition becomes fixed
Proof required
Rebuttable presumption of entitlement
Res judicata – See RES JUDICATA Time loss compensation
Simultaneous loss of earning power and time-loss compensation
Unemployment compensation
Wages (RCW 51.08.178) – See TIME LOSS COMPENSATION
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M
MARITIME CLAIMS
(See COVERAGE AND EXCLUSIONS)
MEDICAL BILLS
Discretion of Department – See STANDARD OF REVIEW Medical Bills
Recovery of overpayment – See DEPARTMENT Authority to recoup overpayment of benefits
MISCELLANEOUS SERVICES AND APPLIANCES - WAC 296-23-165
Adjustable bed
Power chair lift
MINISTERIAL ORDERS
(See AGGRAVATION and APPEALABLE ORDERS)
MOTION TO DISMISS
(See also BURDEN OF PROOF)
Failure of make a prima facie case
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N
NOTICE OF APPEAL (RCW 51.52.050, RCW 51.52.060)
(See also COMMUNICATION OF DEPARTMENT ORDER, PROTEST AND REQUEST FOR RECONSIDERATION and STATUTES)
Aggrieved party
Assignee as person affected or aggrieved
Contents required
Protest and notice of appeal
Timeliness
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O
OCCUPATIONAL DISEASE (RCW 51.08.140)
(See also AGGRAVATION, COURSE OF EMPLOYMENT, SCOPE OF REVIEW, INJURY and TIMELINESS OF CLAIM)
Aggravation of preexisting condition
Aggravation of preexisting occupational disease vs. new occupational disease – See AGGRAVATION Proximate cause of worsened condition: new occupational disease vs. aggravation
Apportionment
Concurrent employers
Date of manifestation – see Schedule of benefits appealable
Hearing loss
Last injurious exposure – see Successive insurers - See also COVERAGE & EXCLUSION
Longshore and Harbor Workers' Compensation Act
Occupational disease v. injury
Onset of condition
Proximate cause: occupational disease v. aggravation – See AGGRAVATION
Psychiatric conditions (mental/mental)
Reaction to treatment for probable occupational disease – See COURSE OF EMPLOYMENT
Schedule of benefits applicable
Schedule of benefits -- beneficiary of deceased worker
Successive insurers
Time-loss compensation benefits
Tinnitus
Toxic Encephalopathy
OFFSETTING PRIVATE INSURANCE BENEFITS AGAINST TIME LOSS COMPENSATION
(See PENALTIES)
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P
PENALTIES (RCW 51.48.017)
(See also ASSESSMENTS, SCOPE OF REVIEW and STANDARD OF REVIEW)
Employer's liability for acts of service company
Failure to keep records of employee hours
Failure to secure payment of compensation (RCW 51.48.010)
Failure to submit medical reports (WAC 296-15-070(3))
Offsetting employment contract benefits against monetary award for permanent partial disability
Offsetting private insurance benefits against time loss compensation
Review of penalties (RCW 51.48.080)
Sidebar agreements
Standard of review (RCW 51.48.010) – See STANDARD OF REVIEW
Unreasonable delay
Unreasonable delay - medical treatment
WISHA – See SAFETY AND HEALTH Penalties
PENSION RESERVE
Calculation
Deduction of prior permanent partial disability award (RCW 51.32.080))(Previously RCW 51.32.080(2))
Reduction
Standard of Review
PERMANENT PARTIAL DISABILITY (RCW 51.32.080)
(See also PENSION RESERVE)
Ambiguous orders
Amputation value
Award after pension determination
Beneficiaries
Category rating
Cervical conditions
Chiropractors
Converting premature permanent partial disability award to time loss compensation
Cosmetic defect
Fixity of all conditions required
Hearing loss – See OCCUPATIONAL DISEASE
Interest (RCW 51.32.080 (6))
Interest rate (RCW 51.32.080(4))
Migraine headaches
Multiple levels of the spine
Pension does not preclude payment of award under another claim – See also Award after pension determination
Pension due to combined effects may preclude payment of award under another claim
Permanent partial disability award paid in lieu of pension benefits
Permanent partial disability award should not be converted to time loss compensation where permanent total disability follows
Prior permanent total disability determination – See Award after pension
Rating
Rating by Board
Schedule of benefits – See also OCCUPATIONAL DISEASE Schedule of benefits applicable
Segregation
Survivors’ Benefits
Temporomandibular joint
Tinnitus
Twenty-five percent reduction (RCW 51.32.080(2))
PERMANENT TOTAL DISABILITY (RCW 51.08.160)
(See also AGGRAVATION, DIMINUTION OF DISABILITY, PENSION RESERVE, STATUTORY PENSION and SUICIDE)
Age as factor
Availability of work in geographical area
Beneficiaries
Combined effects of preexisting and subsequent disabilities
Continuing medical benefits
Deduction of prior permanent partial disability award (RCW 51.32.080(2))
Effective date of pension
Employment on closing date
Fixity of condition at time of death from unrelated cause (RCW 51.32.050(6))
Gainful Employment
Obtaining work vs. performing work
Odd lot
Option 2 benefits under RCW 51.32.099
Part-time employment
Permanent partial disability award under another claim
Permanent total disability under another claim
Reduction of benefits by prior permanent partial disability award
Retroactive effective date of pension
Subsequent industrial injury
Survivors’ benefits
Termination of benefits (RCW 51.32.160) – See DIMINUTION OF DISABILITY (RCW 51.32.160)
Vocational testimony
PETITIONS FOR REVIEW (RCW 51.52.104; RCW 51.52.106)
Issue first raised in petition for review
Order denying appeal
Scope of review
PRIMA FACIE CASE
(See BURDEN OF PROOF and MOTION TO DISMISS)
PROCEDURE BEFORE BOARD
(See BENEFITS PENDING APPEAL, BOARD, BURDEN OF PROOF, DEPOSITIONS, DISCOVERY, INTERVENTION, JOINDER, MOTION TO DISMISS, PETITIONS FOR REVIEW, SANCTIONS, SCOPE OF REVIEW, STANDING and STAYS ON APPEAL) 
PROPERTY DAMAGE AS A RESULT OF "INDUSTRIAL ACCIDENT" (RCW 51.36.020)
Breast implant
Eyeglasses
PROTEST AND REQUEST FOR RECONSIDERATION (RCW 51.52.050)
(See also NOTICE OF APPEAL)
Application to reopen treated as protest
Contents
Deemed-granted application to reopen claim
Department order, once protested, is not final order – See also Protest divests board of jurisdiction
Filing by mail permissible
Filing by mail, proof of
Filing with self-insured employer (WAC 296-20-09701)
Limitations on time to act
Notice of Appeal – See NOTICE OF APPEAL
Must be in writing
Protest of "Appealable Only" order
Protest divests Board of jurisdiction over appeal
Self-insured employer's order
PROVIDERS
Approved examiners lists
Audits
Department's authority to regulate out-of-state providers
Limitations of actions
Peer review
Provider appeals
Treatment
PROXIMATE CAUSE
(See also AGGRAVATION, PERMANENT TOTAL DISABILITY and SUBSEQUENT CONDITION TRACEABLE TO ORIGINAL INJURY)
Significant cause
PSYCHOLOGISTS
(See CAUSAL RELATIONSHIP)
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Q
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R
REASSUMPTION OF JURISDICTION (RCW 51.52.060)
(See DEPARTMENT)
 
REFUSAL TO ATTEND MEDICAL EXAMINATION
(See SUSPENSION OF BENEFITS)
RES JUDICATA
(See also AGGRAVATION, APPEALABLE ORDERS and COLLATERAL ESTOPPEL)
Absence of finding concerning previously litigated issue
Acceptance of condition
Aggravation
Allowance of claim
Ambiguous orders
Clerical error
Conditions not explicitly segregated
Extension of time to act on application to reopen claim
Informal letter
Matters concluded by order rejecting a claim
Occupational Disease
Orders void ab initio
Segregation order
Self-insured employer's order
Subject matter of appeal
Surviving beneficiary's claim affected by prior adjudication on the merits in worker's claim
Time-loss compensation
Time within which Department may modify order – See DEPARTMENT Authority to modify order
Wages at time of injury
RETROACTIVITY OF STATUTORY AMENDMENTS
Aggravation (RCW 51.32.160)
Children's benefits (RCW 51.08.030)
Interest rate increases (RCW 51.32.080(4))
Occupational disease statute of limitations (RCW 51.28.055)
Schedule of benefits applicable in occupational disease claim (RCW 51.32.180)
Social security retirement offset (RCW 51.32.225)
Underinsured motorist insurance recovery (RCW 51.24.030)
Wages (RCW 51.08.178)
RETROSPECTIVE RATINGS
(See also ASSESSMENTS and DEPARTMENT)
Relief from retrospective rating assessment
Standard of review - See STANDARD OF REVIEW Retrospective rating adjustments
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S
SAFETY AND HEALTH
Amendment of citation
Appeals
Authority to issue nunc pro tunc order
Burden of proof
Burden of proof – failure to abate
Corporate officers
"Employee misconduct" defense
Employer (RCW 49.17.020(3))
Enforcement of safety standards in federal enclave
Feasibility defense
Federal guidelines
General contractor liability for safe environment
General contractor liability - multiple employer worksite
General duty standards - WAC 296-24-073
Grouped violations
Grouping of violations
Immediate restraint
Industry-specific standards
Leased employees
Multiple citations
Order on agreement of parties
Penalties
Process Safety Management
Reassumption of jurisdiction by Department
Repeat violations
Safe workplace rule
Scope of review – SCOPE OF REVIEW Safety and Health
"Serious" violation
"Willful" violation
SANCTIONS
Civil Rule 11
Discovery
Failure to attend CR 35 medical examination
Frivolous defense
SCOPE OF REVIEW
(See also BOARD, PETITIONS FOR REVIEW, STANDARD OF REVIEW and TIME LOSS COMPENSATION)
Aggravation
Allowance of claim
Assessments
Closing order
Closing order segregating condition
Compromise of lien against third party recovery (RCW 51.24.060(3))
Coverage and exclusions
"Deemed granted" application to reopen claim
Department order not communicated
Discrimination claims (RCW 51.48.025)
Employer's appeal of order that holds the claim open
Fixity of all conditions required
Fraud determinations
Issues limited by notice of appeal
Interlocutory time-loss orders
Multiple injuries
Occupational disease and industrial injury as alternative theories
Order terminating pension since worker gainfully employed
Penalty assessments
Penalty assessment, Director's refusal to assess
Rejected claim
Safety and Health
Second injury fund – See SECOND INJURY FUND Jurisdiction
Suspension of benefits
Time loss compensation
Ultimate issue
Vocational rehabilitation determinations
SECOND INJURY FUND (RCW 51.16.120)
Authority to reimburse self-insured employer for overpayment of time-loss compensation benefits
Bodily disorder
Continuing medical benefit
Date of charge against pension reserve
Jurisdiction
Knowledge of disabling condition
Permanent partial disability payment (RCW 51.16.120(1))
Pre-existing disability
Time loss compensation
SELF-INSURANCE
(See also PENALTIES and DEPARTMENT)
Authority to recoup overpayment of benefits
Closing order
Insolvency of self-insured employer
Subsidiaries (WAC 296-15-023)
SOCIAL SECURITY DISABILITY OFFSET (RCW 51.32.220)
Adequacy of notice
Average monthly wage
Computation
Computation after reentitlement to benefits
Computation based on benefit levels in effect on:
Cost of living increases (COLI's)
Effective date of offset
Limitation on recovery of overpayment (RCW 51.32.230)
Loss of earning power benefits
State offset computed in same manner as federal offset
Time loss compensation
SOCIAL SECURITY RETIREMENT OFFSET (RCW 51.32.225)
Applicability
Calculation
Effective date of offset
No federal pre-emption of social security retirement offset
STANDARD OF REVIEW
(See also SCOPE OF REVIEW)
Claims Administration
Medical bills
Penalty assessments
Pension reserve calculation
Provider revocation
Removal of physician from approved examiners list
Retrospective rating adjustments
Time loss compensation benefits as part of vocational rehabilitation plan
Vocational rehabilitation determinations
Vocational rehabilitation vs. time loss compensation
Waiver of time limit for reopening claims
STANDING
STARE DECISIS
STATUTES
(See also RETROACTIVITY OF STATUTORY AMENDMENTS)
Substantial compliance
STATUTES OF LIMITATION
(See NOTICE OF APPEAL, TIMELINESS OF APPLICATION TO REOPEN CLAIM, TIMELINESS OF CLAIM, PROTEST AND REQUEST FOR RECONDSIDERATION and RETROACTIVITY OF STATUTORY AMENDMENTS)
STATUTORY AMENDMENTS
Effective date - See RETROACTIVITY OF STATUTORY AMENDMENTSAggravation
STATUTORY PENSION (RCW 51.08.160)
STAYS ON APPEAL
(See also BENEFITS PENDING APPEAL)
Effect of appeal to Board on Department's order
Effect of appeal to superior court on Department's authority to take further action on claim
SUBSEQUENT CONDITION TRACEABLE TO ORIGINAL INJURY
(See also AGGRAVATION)
Aggravation by treatment
Injury sustained en route from vocational appointment
Migraine headaches
New incident aggravating prior injury
Worry over industrial injury causing further condition
SUCCESSIVE INSURERS
(See OCCUPATIONAL DISEASE)
SUICIDE (RCW 51.32.020)
Permanent total disability at time of death (RCW 51.32.050(6))
Volitional act
SUMMARY JUDGMENT
(See BOARD)
SURVIVORS' BENEFITS
(See BENEFICIARIES, PERMANENT TOTAL DISABILITY, RES JUDICATA, SUICIDE, THIRD PARTY ACTIONS and TIMELINESS OF CLAIM)
Aggravation
Timeliness of claim - See TIMELINESS OF CLAIM
SUSPENSION OF BENEFITS (RCW 51.32.110)
Failure to comply (WAC 296-14-410)
Good cause
No show fees
Refusal to attend medical examination
Retroactive Suspension
Vocational plan not pursued due to worker's relocation
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T
THIRD PARTY ACTIONS (RCW 51.24)
Accord and satisfaction
Allocation of fault
Assignment of action
Assignment of interest in distribution of recovery
Benefits
Compromise of lien
Definition of injury
Distribution of recovery
Insurance guarantee association recovery
Interest
Multiple beneficiaries
Recovery limited to injury caused by the third party
Reduction of lien due to employer fault (RCW 51.24.060(1)(f))
Settlement for nuisance value
Settlement of action
Surviving spouse's recovery for loss of consortium
Underinsured motorist insurance policy owned by employer
TIME LOSS COMPENSATION (RCW 51.32.090)
(See also LOSS OF EARNING POWER)
Attending physician's recommendation against return to work
Certification by vocational rehabilitation counselor
Certification for available light work (RCW 51.32.090(4))
Compensation
Eligibility
Eligibility where capable of performing light work
Eligibility while attending medical evaluation
Eligibility while undergoing vocational rehabilitation (RCW 51.32.095(3))
Entitlement beyond date condition becomes fixed
Intermittent employment
No presumption of continued eligibility
Orders void ab initio
Provisional time loss compensation (RCW 51.32.190(3) and RCW 51.32.210)
Recovery of overpayment of benefits (RCW 51.32.240(1)) - See DEPARTMENT Authority to recoup overpayment of benefits
Res judicata – See RES JUDICATA Wages at time of injury
Scope of review – See SCOPE OF REVIEW Time loss compensation
Seasonal employment – See also Wages – Intermittent/seasonal, full time or other usual wages paid others
Simultaneous loss of earning power and time-loss compensation
Sporadic employability
Termination from modified position
Wage at time of injury – See RES JUDICATA Wages at time of injury
Wage continuation precludes time loss compensation (RCW 51.32.090(6))
Wages (RCW 51.08.178) - Compensation
Wages – Intermittent/seasonal, full time or other usual wages paid others
Wages - RCW 51.08.178(1), (2), or (4)
TIMELINESS
(See COMMUNICATION OF DEPARTMENT ORDER, NOTICE OF APPEAL, PROTEST AND REQUEST FOR RECONSIDERATION, TIMELINESS OF APPLICATION TO REOPEN CLAIM and TIMELINESS OF CLAIM)
TIMELINESS OF APPLICATION TO REOPEN CLAIM (RCW 51.32.160)
Applicability of 1988 amendments
Calculation of time
Issue of timeliness of application may be raised for first time on appeal
TIMELINESS OF CLAIM (RCW 51.28.050; RCW 51.28.055)
(See also APPLICATION TO REOPEN CLAIM, APPLICATION FOR BENEFITS and RETROACTIVITY OF STATUTORY AMENDMENTS)
Calculation of time
Child's claim for survivors' benefits
Crime victims' compensation
Filing
Hearing Loss
Occupational disease [after 1984 amendment to RCW 51.28.055]
Occupational disease [prior to 1984 amendment to RCW 51.28.055]
Compensable disability
Divisible claims
Notification by physician
Oral reports in self-insured claims
Physician's certification (RCW 51.28.020)
Survivors' benefits
Survivor's benefits where worker dies of occupational disease
TIMELINESS OF NOTICE OF APPEAL
(See NOTICE OF APPEAL AND COMMUNICATION OF DEPARTMENT ORDER)
TREATMENT
After claim closure
Aggravation of preexisting condition
Department guidelines
Failure to obtain prior authorization
Fixity of condition
Hearing aids
Proper and necessary medical and surgical services (RCW 51.336.010)
Recoupment of medical benefits
Spinal column stimulator
Subsequent condition impairing recovery
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U
UNUSUAL EXERTION
(See INJURY and HEART ATTACK)
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V
VOCATIONAL REHABILITATION
Abuse of discretion
Burden of proof
Cooperation of worker relevant
Eligibility for time loss compensation distinguished (RCW 51.32.090)
Jurisdiction of Board – See BOARD Moot Appeals
Option 2 benefits under RCW 51.32.099
Standard of review – See STANDARD OF REVIEW Vocational rehabilitation determinations
Time loss compensation (RCW 51.32.095(3))
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W
WAGES (RCW 51.08.178) – COMPENSATION
Loss of Earning Power
WAIVER OF BENEFITS (RCW 51.04.060)
(See COVERAGE AND EXCLUSIONS and PENALTIES)
WILLFUL MISPREPRESENTATION
(See FRAUD)
WISHA
(See SAFETY AND HEALTH)
WORKER
(See EMPLOYER-EMPLOYEE and INDEPENDENT CONTRACTORS)
X
Y
Z
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Updated 4/2010