Presumptive eligibility for workers’ compensation & unemployment insurance
Posted Jan 25, 2022
On Tuesday, May 11, 2021 Governor Jay Inslee signed Senate Bill 5190 into law — which went into effect immediately and provides presumptive eligibility for workers’ compensation and unemployment insurance.
In April, the Washington State Legislature passed the bill, which provides health care workers with presumptive benefits during a public health emergency. The bill was sponsored by Senator Jeff Holy (R‑Spokane) after he met with WSNA nurses, including our own Shelly Mead, RN, who were told by their employers they didn’t contract COVID-19 on the job; as a result, these nurses were denied benefits like workers’ compensation and unemployment insurance. Senator Holy worked with WSNA on legislation to address this problem. Details of the bill include:
- When a nurse or health care worker contracts the illness that is the subject of a state or federal health emergency, it is presumed they got it at work. This presumption applies to workers’ compensation (for time off work due to illness) and unemployment insurance (for time off work due to quarantine).
- The Washington State Department of Labor & Industries (L&I) decides if a worker qualifies for workers’ compensation — not employers or third-party administrators.
- An employer must have “clear and convincing” evidence (the strongest evidence standard in state law) to rebut this presumption.
Presumptive eligibility has already been available to firefighters for certain work-related diseases, as well as workers at the Hanford nuclear site near the Tri-Cities. This new presumption for nurses and health care workers recognizes the unique hazards we face on the front lines of disease outbreaks while we treat patients who have the illness that is the subject of a state or federal health emergency.
Did you contract COVID-19 at work? File for workers’ compensation now and retroactively
If you were out sick with a COVID-19 infection that you believe was contracted at work, we encourage you to file a workers’ compensation claim with L&I. You have two years from the date of the work-related illness to file a claim.
For healthcare workers once a claim is allowed, workers are eligible for medical and disability benefits. Temporary compensation, or time-loss benefits, begins the earliest of the following:
- The first missed work day due to symptoms
- The day the worker was quarantined by a medical provider or public health official
- The day the worker received a positive test result confirming contraction of the infectious or contagious disease.
You can also receive retroactive time-loss back pay, which is especially valuable to nurses who exhausted their paid time off prior to acquiring COVID-19 and were told they had to take unpaid leave.
Even if you were only out of work for a few days, applying for workers’ compensation now will give you future coverage, including medical, for any long-hauler or long-term side effects of COVID-19. Once it is deemed a work-related illness and your workers’ compensation claim is approved, L&I covers the medical care for life.
PHSW is self-insured.
To file a workers’ compensation claim at St Joes you need to file a SIF-2, which can be found on the hospital intranet. If you are not at the hospital and cannot access a hospital computer, you can also file through the L&I FileFast .
- If you disagree with how your self-insured claim is being managed, contact L&I at 360-902-6901.
The Ombudsman for Self-Insured Injured Workers is available to help with self-insured workers' compensation issues. SIOmbuds@Lni.wa.gov.
If anyone has difficulty with the workers compensation claim, if their employer is self-insured, they can contact the Ombuds Office.
Office of the Self-Insured Ombudsman
Department of Labor & Industries
(888) 317-0493
Questions? Contact WSNA Nurse Representative Mara Kieval at mkieval@wsna.org.