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WASHINGTON
STATE
LABOR & INDUSTRIES
If your current or last
employer, where you were exposed to noise on the job, was in the state of
Washington
, you may be eligible. Current
department rules authorize ONE set of hearing aids they are
expected to last the rest of your life. The department will service
hearing aids they purchased, and provide 40 batteries every 90 days
Depending on the severity of your hearing loss there may also be some
monetary compensation.
It Is
Illegal in
Washington
for a company to charge you
for "processing" a claim. The department considers it unethical
for a company to solicit L&I claims by phone, direct mail, or to
otherwise advertise deceptive claims such as "Hearing Aids For
Life".
Filing A
Claim while easy
does take a little of your time. Depending on how prepared you are it will
take from 6 months to a year to complete the process. The only way to
speed up the time it takes to process the claim is to have all your
documentation ready.
You Will
Need your complete
employment history (starting to ending month & year) for every
employer you have ever had even if they are no longer in business. A copy
of all the audiograms from previous hearing tests and a little patience.
Listed
below are 10 steps to follow if you wish to follow a claim:
1. Contact
your local hearing professional, inquire if they have experience with
L&I most do. It is important to inquire whether they charge a fee to
“process” the paper work, this is illegal under
Washington
state law. If they recommend
you hire an Attorney or Paralegal they are most probably just trying to
skirt the law and waste your money. Regardless of what the company may
tell you in Washington state there is not anything they or a legal
professional can do to speed up the claim process.
2. Your
professional will perform an audiogram to see if you have a ratable
hearing loss. If there appears to be justification to proceed they should
make an appointment with an Ear Nose & Throat (ENT) physician approved
by the state to perform an Independent Medical Evaluation (IME). There are
several forms listed below that should be completed and taken to this
appointment.
3. Labor
and Industries requires a complete Employment History Hearing Loss this is
a two part form. The first page form # F262-013-000 contains your
employment history and information on your last employer http://www.lni.wa.gov/forms/pdf/262013af.pdf
the second part is a continuation of employer information with room for
two per page, you will need enough copies for each employer listed on form
# F262-013-000 http://www.lni.wa.gov/forms/pdf/262013cf.pdf
o
This form
requests information for every job you have ever had.
o
Listing
beginning and ending month and year of employment.
o
What type of
noise, if any, you were exposed to.
o
The amount of
noise and what kind, if any, ear protection was worn.
Often
the Social Security Administration is the only place where this
information is available. Form #SSA-7050 is used to request a work history
you can use to fill out the questionnaire. You may download this at http://www.ssa.gov/online/ssa-7050.pdf.
This information is also available in person a most Social Security
offices. Call your local number for an appointment. You can search for
your local SS office at http://s3abaca.ssa.gov/pro/fol/fol-home.html.
There is a fee based upon the number of years requested.
6. An
Occupational Hearing Loss Interview Checklist from # F262-016-000
available on line at http://www.lni.wa.gov/forms/pdf/262016a0.pdf.
o
This form asks
questions on all of your hearing difficulties.
o
When and
where you have had hearing tests performed
o
Asks about
illness with high fevers.
o
Head injuries.
o
Hearing aid
experience.
This form should also be
completed and brought to the IME.
6. An
Authorization to release information should also be taken to the IME. It
is form # F262-005-000 and available at http://www.lni.wa.gov/forms/pdf/262005a0.pdf.
If you have had any military experience a request for Release of Records
needs to sent to the VA at the
National
Personal
Records
Center
,
St. Louis
,
MO.
The request form is
unavailable on line but you may print a copy
of this and use it.
7. It's
advisable to attach a copy of ANY HEARING TEST you listed on form #F262-016-000,
line 9 with the report. This is where you can save the most time since
your claim will not be processed without a copy of each test. State law
requires any person who has performed a test to keep it for 5 years and
release it to you at no charge. Any documentation of hearing loss while
you were working will help your claim.
8. Gather
all the information listed above and take it to the IME your hearing
professional sets. The physician will write a report to accompany these
forms and forward it to the department.
9. An
adjuster will be assigned to your claim. It's recommended you contact the
adjuster occasionally to check on the status of your claim. How often this
contact is made depends on the adjuster. To frequent and the adjuster may
become annoyed, to infrequent and the claim may get buried. The
adjusters we have consulted with indicated every 4 to 6 weeks is
appropriate.
10.
If your claim is
approved the state will notify you with an award letter and automatically
approve hearing aids recommended by your specialist. CIC style hearing
aids require medical justification included in the IME. We recommend you
acquire your hearing aids from your local hearing professional.
Obtaining
Your Hearing Aids The department
will only purchase ONE set of hearing instruments!!! Obtaining
your hearing aids from a company located out of town is asking for trouble
when it comes time for follow up service. Check how long the company has
been in business at their current facility, offices that are new to the
area or who have recently moved their office may be hard to track down
when you need follow-up care. Make very sure the company has a full time
licensed Hearing Instrument Specialist preferably one who is an
Audioprosthologist, Board Certified in Hearing Instrument Sciences or a
Clinical Audiologist.
They are the only ones that can order
and fit the hearing aids. If a company hires
someone to come in on a weekly or monthly basis, more often than not, you
will have difficulty with appointments for follow-up care, service or adjustments. Once
specialists from out of town receive payment from L&I and fit you with hearing aids you are no longer their priority.
Fraudulent L&I Claims:
The state of Washington is in the process reviewing previously
submitted claims especially those which were solicited by phone. The state
is looking for
fraud. It's unfortunate but a few companies around the state have a
history of providing incorrect information to the department. The
department knows who these companies are and may review it.
We strongly recommend you keep a copy of all information, sent to the
department, regarding
your claim, for your own protection. If you do not have this information
contact the company who "processed the claim for you" and
request copies. State law requires them to provide it free of charge.
If you signed your name to a report that has any incorrect
information on it YOU MAY BE LIABLE for any and all amounts paid
out on the claim and a 50% penalty if it's found to be fraudulent.
- If you have signed a contract with a
company that required you to pay a fee to process your claim.
- If they strongly recommended you hire an attorney or a Paralegal to "fill out
the paper work" and you paid the attorney a fee.
- If they prepared your questionnaire with information you know to be incorrect.
- If they advised you to fudge a little on recreational noise exposure.
- If you signed forms which you did not fill out, or forms that were
incomplete.
Contact the
department at (360) 902-5159 or online at http://www.lni.wa.gov/fraud/workerscomp/Default.htm
to report possible fraud. It is much better to contact the department
regarding a fraudulent claim then have them contact you. The old adage of
letting sleeping dogs lie, can come back to bite you.
We know of an individual who was required to
refund his total award of $35,000.00 to the department, he also had
to return his hearing aids. This person trusted a company to fill out the
paper work. He signed his name to a claim that was prepared for him by a paralegal
with
information he knew to be incorrect .
Because he did not submit himself and had trusted someone, else the
department ruled he did not intentionally commit fraud they did not
require he pay a penalty of 50% which would have been an additional
$17,500.00. The company who processed the claim did not refund the $12,000.00 fee they
charged him for "processing" the claim.
The owner of the
company was eventually convicted on 16 counts of Workers Compensation
Fraud and sentenced to five years in
prison and fined $285,000.00. His license to fit hearing instruments has been permanently suspended, so he can no longer practice in the state of
Washington.
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