What
is the difference between the Board and the Department?
Among other
things, the Department of Labor and Industries (Department) is the
state agency that administers the workers' compensation fund.
The Department determines what benefits are to be provided to an
injured worker.
The Board of
Industrial Insurance Appeals (Board) is a separate
state agency that is independent
from the Department.
It is the
Board's function to review the Department's determinations when
there is an appeal by interested parties. The Board operates like
a court to decide the case.
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Where
do I file my appeal?
By
state law you must file your appeal at our main office in Olympia,
Washington (Filing an Appeal). In
Olympia, we have a staff assigned to process your appeal in the
most efficient manner possible. Our new appeals unit is
dedicated to preparing your case for resolution and is there to
assist you. [See RCW
51.52.050; WAC
263-12-01501(1)(a)]
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Did
you get my appeal?
When
the Board receives your notice of appeal, a docket number is
assigned and a Notice of Receipt of Appeal is mailed to each party
the next working day. If you do not receive a Notice of
Receipt of Appeal, you may call us at (360) 753-6823 to speak with
a Judicial Appeals Analyst in our new appeals section.
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How
many days does the Department have to respond to an appeal once it
has been filed with the Board?
In
workers' benefits appeals, the Department must respond by either:
-
Sending
its record to the BIIA, which permits the appeal to proceed;
or
-
Changing
or reversing the order under appeal; or
-
Advising
the BIIA that they will reconsider their decision.
The
BIIA has 60 days to decide whether the appeal will be granted.
The Department must respond to the appeal within this time frame.
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May
I have a copy of the appeal?
When
the appeal is granted, we will send you a copy of the appeal with
the Order Granting Appeal. If you would like a copy of the
appeal sooner, please call us at 360-753-6823.
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An
appeal has just been filed. I have additional information
that may not be in the Department's file. Should I send it
to the Board?
No.
The Board does not need any additional information to make the
decision to grant or deny the appeal. Once the appeal is
granted, you should provide the new information during the
mediation process.
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I
did not file this appeal. Do I need to come to the
conference or hearing?
If
you did not file the appeal, you may choose whether to participate
in the conferences and/or hearings. If you choose not to participate, it is possible that your
interests could be substantially affected by the outcome of the
appeal. In some
instances, the outcome of the appeal might not have any effect on
you. If you are not
the appealing party and you would like to participate, feel free
to contact our office.
If
you have an opinion concerning the outcome of an appeal, you
should participate in order to voice your opinion.
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If
a provider files an appeal, are they
expected to participate?
It
depends. If the provider filed the appeal on their own
behalf, they are required to participate.
If the provider filed the appeal on
behalf of the worker, they are considered the worker's
representative. If they do not want to represent the worker,
they should inform the Board at its Olympia
address.
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My
employer filed this appeal. Will my
time-loss compensation be cut off?
It
depends on the order under appeal and if the employer is self
insured. A self insured employer may stop all compensation
pending the appeal. If the self-insured employer is not
successful in the appeal, you will be entitled to back time-loss
compensation and interest for the delay in payment.
If
the employer is state fund, the Department has the option to pay
time loss. If the state fund employer wins on the appeal,
the Department would then assess an overpayment against you.
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My
employer filed this appeal. Does that mean I can't go for
medical treatment?
If
an employer appeals from an order permitting a specific medical
procedure, i.e. surgery, the Department may allow the treatment
pending the outcome of the appeal. Check with your claims
manager or health care provider to determine whether the cost of
your medical procedure will be paid by the Department of Labor and
Industries.
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Do
I need an attorney?
If your case
goes to hearing, we strongly suggest that you hire an attorney.
The judge cannot act as your attorney and cannot represent your
interests.
Your
attorney:
-
Can
discuss your case and concerns with you.
-
Can
negotiate with the opposing party to reach an acceptable
settlement.
-
Will
be responsible for scheduling and questioning witnesses.
Once
you hire legal counsel, make sure that all communications with the
BIIA come through your attorney. Your attorney is in the
best position to answer your questions because he or she
understands your case.
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Can
I bring someone with me to a proceeding?
You can bring an attorney to
represent you, or a family member, friend, or union representative
to help you.
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Will
the Board provide an interpreter to parties unable to communicate
in English?
The Board will provide an
interpreter in certain circumstances. If you need an
interpreter, please contact us as soon as possible.
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What
is the difference between mediation and hearings?
Mediation is a
process where a neutral person (mediator) facilitates
communication between the parties, with the goal of resolving
their dispute.
The hearing
process is a formal litigation stage where the judge will make a
decision based on the witness's testimony and the evidence
presented.
Appeal
Process
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Why
do some parties request to attend mediation conferences by
telephone?
Sometimes
parties are not available to travel, but they are still interested
in finding a way to resolve the case. Rather than delay the
case by rescheduling the conference, the BIIA will often allow
parties to appear by phone.
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Can
I submit medical reports instead of having to pay a doctor to
testify?
Providing
medical testimony can be one of the most difficult aspects of
litigation and, because medical witnesses typically charge a fee,
it can also be expensive. However, CR
43 directs that the "testimony of witnesses shall
be taken orally in open court . . .."
You should plan
to present the testimony of your witness. Reports or letters
are generally considered hearsay. Hearsay statements are not
usually admissible because the opposing party cannot cross-examine
the person making the statement to test the statement's accuracy.
There are also many exceptions to the hearsay rule. [See ER 801,
802, 803,
804]
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Can
my employer appeal a Department decision that awarded me benefits?
The
employer's industrial insurance premium may be affected by the
allowance of a claim. Therefore, they have a legal stake in
the filing of a claim by an injured worker. Also, while they
may agree that you were injured at work, they may disagree with
the benefits approved by the Department. Accordingly,
workers, beneficiaries, employers, or other parties affected by a
Department decision may appeal to the Board. [See RCW 51.52.050]
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Why
do I have to call the Olympia office when my
judge is located somewhere else?
We
have judges and staff in several locations around the state.
Judges may be assisted by staff in more than one location.
It is best to call the main office in Olympia to determine who can
assist you.
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Why
is my judge located in Olympia when you have an
office in my area?
The
Board's main office is in Olympia. We have regional offices
around the state, but the majority of our staff is located in
Olympia
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Why
can I speak to the judge in mediation, but not in hearings?
A
mediation judge helps the parties reach an agreement. The
mediator will not decide the case. The mediator may talk to
the parties separately. This is called ex
parte contact. Talking to the parties individually can
often lead to a successful resolution of the case. If the
case does not settle in mediation, it will be given to a hearing
judge, who will conduct a formal hearing.
The
hearing judge will write a decision resolving all issues raised by
the Notice of Appeal. The judge considers only admissible
evidence presented during the hearing. The hearing judge
cannot have ex parte
contact with any party to the case. It would be unfair for
one party to discuss the merits of the case with the hearing judge
without all parties being present.
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May
I speak to a Board member about a case?
The Board
members are the final legal authority on all Board orders. It
would be unfair and unethical for a Board member to speak to any
party about an active case.
After
the last hearing, how long before a decision is made and issued?
It takes a
court reporter approximately four weeks to transcribe a deposition
or hearing. It is the Board's goal that judges issue
decisions as soon as possible after all
transcripts are received. This generally takes between
20-60 days. At times, due to the complexity of the appeal,
it may take longer.
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Now
that the Board has issued its final order, when am I going to
receive my benefits?
If
the Board decides in your favor, it directs the Department of
Labor and Industries or the self-insured employer to pay your
benefits.
The Department
or the self-insured employer is obligated to pay benefits ordered
by the Board within a reasonable processing period from the
receipt of the Board's order. You should contact the
Department immediately after you receive your order to obtain
their payment date.
Follow this
link for information on checking the status of a claim with the
Department: Claim
Status at the Department of Labor and Industries
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Do
I need to send the Board anything regarding my superior court
appeal?
Yes.
Please
send a copy of the superior court appeal, including the superior
court cause number assigned to the appeal. Please check
with us before sending any other documents.
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