Even if your doctor has formally recommended a surgery, getting authorization from L&I can be challenging for injured workers in…
Who Can Propose a CRSSA Settlement?
Any party to an L&I claim may propose that a CRSSA settlement be considered, but only if the injured worker will have reached the age of 50 as of the time the settlement contracts are submitted for review to the Board of Industrial Insurance Appeals. Most often, it is the injured worker or the injured worker’s attorney that proposes a CRSSA settlement, although sometimes it is the Self-Insured Employer or the Department of Labor & Industries.
What Motivates the Department to Enter a CRSSA Settlement?
When deciding whether to enter into a Claim Resolution Structured Settlement Agreement settlement, the Department’s first and foremost thought is how it can save money. Secondarily, the Department is required to consider whether settlement via a Claim Resolution Structured Settlement Agreement will be in the injured worker’s “best interests,” a term of art that has no statutory or commonplace definition so is decided on a case-by-case basis.
What Motivates a Self-Insured Employer to Enter a CRSSA Settlement?
When deciding whether to enter into a CRSSA settlement, the Self-Insured Employer (SIE) considers only the prospects of saving money and whether or not the SIE can obtain Board of Industrial Insurance Appeals approval for the resulting agreement. The savings anticipated by settling are often driven by end-of-claim costs such as vocational retraining and litigation over claim closure orders.
What Factors Does the Department Consider When Entering a CRSSA Settlement?
The Department negotiates CRSSA agreements in State Fund claims pursuant to WAC 296-14A-010. Essentially, the Department assesses the likely costs of the claim to the State Fund and then attempts to negotiate a settlement amount that will be less expensive to the state than the projected costs. If the Department and worker agree, final approval must still be obtained from the Board of Industrial Insurance Appeals.
Can the Employer Prevent a Claim Resolution Structured Settlement Agreement?
Yes. The employer may veto a CRSSA Settlement if the employer remains a party to the claim or claims being settled. According to RCW 51.04.063(2)(b), the employer remains a party unless: the costs of the claim or claims being settled are no longer calculated in the employer’s experience factor used to determine premiums; the employer cannot be located; the employer has gone out of business; or the employer fails to respond or declines to participate after timely notice provided by the Board of Industrial Insurance Appeals and Department.
How Will the Employer Be Impacted By a Claim Resolution Structured Settlement Agreement?
Pursuant to WAC 296-14A-020, the Department provides the employer fourteen days of notice to participate in Claim Resolution Structured Settlement Agreement negotiations. If the employer does not respond within that time period, the Department will consider that the employer has declined to participate and will conduct negotiations without the employer’s involvement. The employer will then be bound by the terms of the agreement, including any impact the settlement may have on the employer’s experience factor or on the employer’s industrial insurance premiums.
Will Ongoing Payments Continue While the CRSSA Settlement is Processed?
The Department or Self-Insured Employer are required pursuant to WAC 296-14A-030 to continue ongoing payments and management of the industrial insurance claim during any settlement negotiation and until the CRSSA agreement is final. Unfortunately, just because they are required by law to continue paying doesn’t mean that they always do.
Can Discrimination Suits Be Settled As Part of a Claim Resolution Structured Settlement Agreement?
No, pursuant to WAC 296-14A-040, there are no legal claims of any kind or nature outside of Industrial Insurance Act (Title 51 RCW) claims that can be settled within a CRSSA Settlement agreement. Even then, only indemnity claims, meaning claims for monetary benefits paid as a result of lost wages or lost wage earning capacity, can be settled. Medical benefits cannot be compromised within a Claim Resolution Structured Settlement Agreement.
How Can an Injured Worker Achieve Maximum CRSSA Settlement Value?
Only the credible threat of litigation drives CRSSA settlement values to their maximums. Self-Insured Employers will typically pay additional money to avoid excess litigation costs. However, it is not always necessary to engage in litigation in order to be considered a credible litigation threat. To do so, one must simply employ the services of an attorney known to readily litigate Labor & Industries conflicts.
If you have more questions about CRSSA settlement potentials in your case, please contact the experienced L&I Attorneys of Washington Law Center for a free consultation today.
ABOUT THE AUTHOR:
Spencer Parr is a litigation and trial attorney at Washington Law Center focused primarily in the areas of Labor & Industries claims and injury pension benefits. Before co-founding Washington Law Center, Spencer served in the U.S. Army. He has litigated major issues in the law, represented clients from coast to coast, and dedicated his professional life to assisting the injured and disabled. Click here to learn more about Spencer. View More Labor & Industries and Work Injury Resources.