Time Limitations for Filing an Industrial Insurance Claim

For a claim to be valid and compensable, an injured worker must file an injury claim with Department of Labor & Industry within one year after the day upon which the injury occurred, or for an occupation disease, within two years following the date the worker had written notice from a physician or licensed advanced registered nurse practitioner of the existence of his/her occupational disease, and that a claim for disability benefits may be filed. Claims for hearing loss due to occupational noise exposure must be filed within two years of the date of the worker’s last injurious exposure to occupational noise in employment or within one year of September 10, 2003, whichever is later. A claim due to hearing loss that is not timely filed can only be allowed for medical aid benefits.

Employers and employees both have the right to appeal the determinations made by the Department to the Board of Industrial Insurance Appeals. The Board is a quasi-judicial agency which operates in the same manner as a court and applies the same rules of civil procedure and evidence. Deadlines are critical and an employer/employee typically has 60 days after receipt to object or appeal a decision or from the Department. Failure to respond will forever bar the employer/employee from challenging the decision/order.

Determining Work-Relatedness for Occupational Diseases

When a sudden traumatic event producing immediate injury occurs on a specific date, work-relatedness is rarely disputed by the Department. However, occupational disease cases generally need a logical, causal link between the diagnosed disease or infection and the worker’s job. Examples of occupational diseases include occupational carpal tunnel syndrome and noise-induced hearing loss. Since these conditions may arise from many sources, including non-work related activities simply identifying an association with workplace activities is not, in itself, adequate evidence of a causal relationship between the job and the injury. To establish a diagnosis of a work-related injury or condition the following criteria must be met:

A physician must present an opinion that work conditions, on a more-probable-than-not basis (a greater than 50 percent chance), are the cause of the illness or have temporarily or permanently aggravated a pre-existing condition; AND
• Objective medical findings must support the diagnosis; AND
• The disease must arise “naturally and proximately” out of employment.

If you have been injured in an accident at work or if you have an occupational illness, you deserve protection.  Call our office today to talk Attorney Mark McClure.

Call 253-631-6484.  We don’t get paid unless you get paid.