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Ways for injured workers to advocate for themselves in workers’ compensation claims

Injured workers advocating for themselves in workers compensation L&I claim

One thing I try to do is to empower my clients to take an active role in the progress of their workers’ compensation claims. So many times, when injured workers meet with me, they express sadness, frustration or anger about their L&I claims. Sometimes those feelings have to do with specific circumstances or decisions that have been made, but usually it is because they feel that they have no say in their own claims. From their perspective they must follow a rigid set of rules and requirements, with the severe penalty for failing to meet expectations being denial of benefits under the claim. However, they feel that treatment providers, claim managers, and vocational counselors get to make all the big decisions and that the injured workers feelings and opinions don’t matter.

 

I disagree. I believe injured workers’ opinions DO matter. However, they often need some coaching on how to effectively advocate for themselves. One of the first places I often encourage injured workers to begin advocating for themselves is regarding the completion of Activity Prescription Forms or APFs.

 

An APF is a Department form that medical providers complete in connection with workers’ compensation office visits. Once complete, these forms contain some very important information about the claim including the primary diagnosis, objective medical findings, treatment recommendations and referrals, prognosis, physical limitations, and an indication of whether the worker is capable of working. These loaded forms are the treating provider’s opinions about most major claim related issues in a nutshell. Some injured workers’ carefully study each APF, but in my experience most injured workers take a copy of the form and don’t give it much thought. I encourage injured workers to read over and digest each APF. If there are things outlined on the form that they weren’t aware of, that seem inconsistent with verbal discussions, or that are confusing, I encourage them to talk to their provider about those things. This simple act can help an injured worker to better understand their providers’ opinions, it can put a spotlight on inadvertent mistakes, and it gives the provider time to think about the information on the form.

 

Medical providers are very busy and L&I paperwork can be burdensome and frustrating. When injured workers ask intelligent questions or point out inadvertent mistakes, it can help the provider better understand the case and avoid potential bigger issues down the road (like me or another attorney questioning them about an error on a form in a deposition). Even better, I find that injured workers who discuss APFs with their medical providers have less claim related frustration and a better understanding of the medical status of their claims.

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