STANDARD OF REVIEW
Aggravation
When an application to reopen is filed more than seven years after the first closing order became final, the reopening of the claim for aggravation is not at the discretion of the director. Only the decision to award time-loss compensation or other disability benefits are committed to the director's discretion. ….Michael Bell, 11 15598 (2012)
Claims Administration
When there is a dispute regarding claim administration not related to the actual adjudication of entitlement to benefits, the standard of review is abuse of discretion. ….Gail Connelly, 97 3849 (1998)
Medical bills
The payment or rejection of medical bills is not discretionary with the Department. The test is whether the bills conform to the provisions of RCW 51.04.030, the applicable rules and regulations, and the practices of the director. ....Gary Manley, 66,115 (1986)
Penalty assessments
The Department's decision to assess a penalty under RCW 51.48.010 is not committed to the discretion of the Department. In an appeal from a penalty assessed by the Department pursuant to RCW 51.48.010, the appellant is entitled to a full de novo review, and must prevail if the assessment of the penalty or the amount of the penalty is incorrect based upon a preponderance of the evidence. Citing In re C & R Shingle, BIIA Dec., 88 2823 (1990). ....Sawyers Motor Sports, 90 3344 (1992) [Editor's Note: The Board's decision was appealed to superior court under Franklin County Cause No. 92-2-50196-4.]
The Department's decision to assess a penalty under RCW 51.48.010 for failure to secure the payment of compensation is not discretionary. Board review of the Department's penalty assessment is de novo and based on a preponderance of the evidence, as opposed to an abuse of discretion, standard of review. ....Twin Rivers Inn, 89 0684 (1990) C & R Shingle, 88 2823 (1990)
The decision to assess a penalty pursuant to RCW 51.48.080 is not committed to the discretion of the Department. In an appeal from a penalty assessed by the Department pursuant to RCW 51.48.080, the appellant is entitled to a full de novo review, and must prevail if the assessment of the penalty or the amount of the penalty is incorrect based upon a preponderance of evidence. ....Susan Irmer, 89 0492 (1990)
Pension reserve calculation
The Department's decision on the appropriate pension reserve amount is reviewable on a preponderance of the evidence standard. ....Jose Sanchez, Dec'd., 01 19644 (2004) [Editor's Note: The Board's decision was appealed to superior court under Yakima County Cause No. 04-2-00582-4.]
Provider revocation
A Department decision to revoke a provider's eligibility to treat Washington injured workers and be reimbursed is subject to de novo review based on a preponderance of the evidence since none of the relevant statutes and regulations define the Department's decision making process in terms of being within the "sole discretion" of the director. ….St. Alphonsus Regional Medical Center, 96 P051 (2000)
Removal of physician from approved examiners list
In a physician's appeal of a decision to remove the physician from the approved examiner's list, pursuant to WAC 296-23-26503, the standard of review is a preponderance of evidence. ….Harry S. Reese, M.D., 00 P0044, (2001) [Editor's Note: The Board's decision was appealed to superior court under Thurston County Cause No. 01-2-01713-3(DEPT)and (PROVIDER).]
Retrospective rating adjustments
The Department may have the authority, by regulation, to limit review of retrospective rating and claim valuation decisions at the Department. However, the Department cannot, simply by regulation, restrict or eliminate the Board's review of these types of Department decisions. Absent explicit legislative prohibition, Department orders concerning retrospective ratings are both appealable to and reviewable by the Board under the general terms of Chapter 51.52 RCW. ....Washington Metal Trades Association, 89 2296 (1990)
Time loss compensation benefits as part of vocational rehabilitation plan
When time loss compensation benefits are ordered under RCW 51.32.095(3) as part of a vocational rehabilitation plan, the standard of review is abuse of discretion. ….Michael Pinger, 97 2210 (1998) [Editor's Note: The Board's decision was appealed to superior court under Grays Harbor County Cause No. 98-2-01511-6.]
Vocational rehabilitation determinations
Review of Director's decision that a worker is employable, and therefore not eligible for vocational rehabilitation services, is limited to determining whether or not the exercise of the discretionary authority of RCW 51.32.095 has been abused. ....Todd Eicher, 88 4477 (1990); [Editor's Note: The Board's decision was appealed to superior court under Kitsap County Cause No. 90-2-01106-4.] Armando Flores, 87 3913 (1989)
Vocational rehabilitation vs. time loss compensation
Review of Director's decision that a worker is "employable," and therefore not eligible for vocational rehabilitation services, is limited to whether or not the discretionary authority of RCW 51.32.095 has been abused. However, review of a determination that a worker is "employable," and therefore not eligible for time loss compensation under RCW 51.32.090, is de novo, subject only to a "preponderance of the evidence" standard of review. ....Christine Palodichuk, 90 0252 (1990)
Waiver of time limit for reopening claims
In an appeal of Director's letter refusing to waive the time limit for filing an application to reopen the claim, the standard of review is whether the decision not to waive the time limit constitutes an "abuse of discretion." ....Ernest Therriault, 90 0876 (1990)