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.

Talk to us

> Give us your news tips.

> Send us a letter to the editor.

> More Herald contact information.

More in Opinion

toon
Editorial cartoons for Saturday, Feb. 22

A sketchy look at the news of the day.… Continue reading

Traffic moves across the US 2 trestle between Everett and Lake Stevens on Wednesday, Oct. 9, 2024. (Olivia Vanni / The Herald)
Editorial: Steer clear of the state’s gas tax dead end

The gas tax is bringing in less revenue for transportation needs. A per-mile fee is the answer.

Comment: Cities needs modest tax hike to meet growing needs

State legislation would allow cities to increase property tax levies by 3% each year, rather than 1%.

Comment: Producers must step up to reduce flood of plastic

Bills in Olympia would incentivize reusable, recycleable packaging and reduce the use of plastic.

Comment: Provide transparency, fairness to drug pricing process

Reforms underway at the state and federal level can help keep medications affordable and accessible.

The Buzz: Hey, wait for us; we love a good beef

Trump attacks Zelensky. Steven Bannon attacks Elon Musk. And a duck draws fire from Don Jr.

Forum: Let Edmonds residents hear RFA facts without city’s spin

The city spent money on a PR campaign about joining the fire authority. Facts should guide the decision.

Herald Forum: Consider benefits of Washington as part of Canada

If Trump can talk of breaking treaties, Canada could just as easily make our state the 11th province.

FILE - In this Friday, Oct. 4, 2019, file photo, a man using an electronic cigarette exhales in Mayfield Heights, Ohio. On Tuesday, Nov. 19, 2019, the American Medical Association said it is calling for an immediate ban on all electronic cigarette and vaping devices. (AP Photo/Tony Dejak, File)
Editorial: Shut down flavored tobacco’s gateway to youths

Legislation in Olympia would bar the use of flavors and menthol in vape products and cigarettes.

Rivian, based in Irvine, Calif., has introduced its new R2 models, smaller and more affordable SUVs. (Rivian)
Editorial: Open electric vehicle market to direct sales

Legislation would allow EV makers to sell directly to customers, making lease or purchase easier.

People walk adjacent to the border with Canada at the Peace Arch in Peace Arch Historical State Park, where cars behind wait to enter Canada at the border crossing Monday, Aug. 9, 2021, in Blaine, Wash. Canada lifted its prohibition on Americans crossing the border to shop, vacation or visit, but America kept similar restrictions in place, part of a bumpy return to normalcy from coronavirus travel bans. (AP Photo/Elaine Thompson)
Editorial: U.S. and Canada better neighbors than housemates

President Trump may be serious about annexing Canada, but it’s a deal fraught with complexities for all.

RGB version
Editorial cartoons for Friday, Feb. 21

A sketchy look at the news of the day.… Continue reading

Support local journalism

If you value local news, make a gift now to support the trusted journalism you get in The Daily Herald. Donations processed in this system are not tax deductible.