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Hanford Workers Compensation
Workers’ Compensation Claim Process For Hanford Site Employees
Procedure For Filing A Workers' Compensation (WC) Claim
Workers’ Compensation (WC) claims are filed by the injured worker reporting their injury to their company’s WC Representative, personal Physician or CCSI
The Company’s WC Representative assists the worker with completion of SIF-2 form and forwards to CCSI |
CCSI’S Claim Process
- Requests a Physicians Initial Report (PIR) if not already provided
- Investigates claim to determine validity
- Contacts claimant for statement
- Verifies employment data and interviews witnesses, if any
- Obtains information from employer case manager, if appropriate
- Requests additional medical documentation if needed
- Ensures claim details satisfy requirements of the law
- If an investigation does not support claim validity, CCSI requests Order of Denial from WA L&I
- CCSI sends copy of request Order of Denial to employer and claimant
- If claim is denied, WA L&I sends Order of Denial to the worker (copy to CCSI)
- Worker has the right to appeal decision (see Workers Options)
- If claim is allowed, continues to administer the claim
- Maintains open communication with the claimant, the employer, AMH and the attending physician
- Authorizes medical treatment and procedures, in accordance with WA State Laws
- Works with employer’s WC Representative, case manager, and AMH to return the worker to the job of injury if the worker has been off work
- Determines the need for vocational counseling and/or retraining
- For certain “Medical Only” claims, closes the claim when treatment is completed
- Physician determines whether claimant is entitled to permanent partial disability (see Workers Options)
- For all claims, once a physician has determines permanent partial disability and is capable of reasonably continuous gainful employment CCSI submits request for closing order to WA L&I (see Workers Options)
- Closes claim upon receipt of Closing Order from WA L&I
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Workers Options
Protest and Appeal Rights are provided under the WA State Laws. The WA L&I makes a determination and issues a formal Order & Notice which includes a clear explanation of the worker’s rights, responsibilities, and time limits to protest or appeal a decision. The process is as follows:
- State issues Order of Denial
- Worker protests denial to WA L&I
- WA L&I reviews protest and issues new order
- Worker appeals to WA State Board of Industrial Insurance Appeals
- WA State Board of Industrial Insurance Appeals issues decision
- Worker appeals to higher court
- Higher court issues final decision
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