Comment: City’s, county’s self-insurance disadvantages workers

Self-insurance allows claims to be too easily denied. Recent legislation restores some fairness.

By Jennifer Casey / For The Herald

An unfortunate anniversary recently passed. We are remembering Sunny Taylor, an Everett Police Department detective whose unexpected passing on June 9, 2020 came to epitomize the struggle and hardship faced by any injured worker employed by a self-insured employer in the State of Washington.

Specifically, her tragic suicide, the fight for death benefits and the City of Everett’s refusal to accept culpability for the loss of a wife, mother, daughter, sister, aunt, friend and coworker, memorializes the insult and injury added to any claim filed by an injured worker at Snohomish County, another self-insured employer represented by Eberle Vivian, a third-party administrator firm based in Kent (“After cop’s suicide, Everett picked ‘money over people,’ family says,” The Herald, Sept. 25, 2022).

Just like the City of Everett, Snohomish County has been a self-insured employer since 1978. While the decision to be self-insured is described as complex and based on a multitude of factors by government spokespeople, once an injured worker files a claim for benefits the employer’s motivation becomes crystal clear; it’s a simple matter of money. Washington Self-Insurers Association Executive Director Kris Tefft elaborates that choosing to be self-insured is motivated by an employer’s desire to exert more control over worker’s compensation claims by driving outcomes at a more attractive cost than what the state fund may charge by way of the state-run insurance premiums. Obviously, the most efficient way to impact expenses is to deny payment for services or to refuse to approve the claim at all. In 2021, statistics show that only 87 percent of self-insurance claims were accepted by Washington state Department of Labor and Industries.

Attorneys explain that injured workers really don’t stand a chance walking into the system blind. In fact, Andrew Dimmock of Dimmock Law Group says he stays very busy fighting self-insured employers because they fight even without a great argument.

For example, therapy for law enforcement deputies is often denied based on a provider’s professional certification or credentials, even though Snohomish County fails to offer culturally competent, trauma-informed alternatives. Treatment for heart palpitations induced by a critical incident can be denied because “you can’t prove that’s work-related.” Surgery is delayed because the employee’s doctor refuses to provide service as part of a Labor and Industries claim, especially for a patient from a self-insured employer.

All this is by design. Snohomish County weaponizes the system to discourage injured workers from filing claims for deserved benefits, which ultimately builds barriers to care, fails to promote positive outcomes, and compromises the health and wellness for public employees.

This year’s passage of House Bill 1521 offers a glimmer of hope as of July 1. It’s not lost on me that foundational testimony to write these bills was delivered by Vancouver, Wash., firefighters based on their experiences with Eberle Vivian, the same third-party administrator contracted by Snohomish County. That legislation creates a duty of good faith and fair dealing in workers’ compensation programs managed by Snohomish County and Eberle Vivian, a duty that has been abused and often leads to a whole new layer of injury and harm to a claimant through no fault of their own.

Let’s remember a life lost far too soon and a family treated like collateral damage by a system that has tolerated self-insured employers’ mistreatment of injured workers for decades. And let’s hope that new standards for good faith and fair dealing will save lives in the years to come.

Jennifer Casey lives in Culdesac, Idaho.

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