Death and Disability Ombudsman WSCFF Educational Seminar April 21-23, 2015

What is an Ombudsman? Consultant Resource Center Advocate Educator 2WSCFF Educational Seminar | April 21-23, 2015

Who can call the Ombudsman? Members Family Union Reps Employers 3WSCFF Educational Seminar | April 21-23, 2015

What questions should I ask? Individual help on all types of disabilities and survivor benefits LEOFF LNI Social Security Other 4WSCFF Educational Seminar | April 21-23, 2015

What happens next? The Ombudsman will listen, ask questions and provide: Answers to your questions Collaboration between agencies Resources as needed 5WSCFF Educational Seminar | April 21-23, 2015

Frequently Asked Questions I got hurt on the job and this is what I’ve done so far…am I following the right process? I don’t think the doctor is going to let me go back to work, what now? What happens for my family if I die? Can you explain the procedure for applying for catastrophic disability? 6WSCFF Educational Seminar | April 21-23, 2015

Questions? Contact Us Tammy Harman Death & Disability Ombudsman (360) WSCFF Educational Seminar | April 21-23, 2015

Ombuds for Self-Insured Injured Workers  Purpose and Duties –Advocate for injured workers of self-insured employers –Provide info on industrial insurance rules and regulations –Identify, investigate and resolve complaints between multiple parties (Injured worker, Labor, Attorney, Employer, TPAs, Providers) –Maintain separate confidential records and toll-free # –Identify policy and practice process improvements –Annual Report to the Governor

Ombuds Self-Insured FAQs  Benefit Delays –Time loss –Medical treatment (surgery, MRIs, chiropractic)  Independent Medical Exams  Claim Suppression  Firefighter Presumption (RCW ) –Presumes certain conditions are a covered occupational disease –Does not include EMTs and Volunteer Firefighters

Firefighter Presumption  Covered conditions, but not limited to: –Respiratory –Heart Problems Experienced within 72 hours of exposure to smoke, fumes, toxic substances Within 24 hours of strenuous physical exertion due to firefighting –Certain infectious diseases Hepatitis HIV/AIDS Meningococcal Meningitis Mycobacterium Tuberculosis

Firefighter Presumption  Covered conditions, but not limited to: –Cancers due to chemical exposure, asbestos, and firefighting Primary Brain Kidney, Ureter, Bladder Leukemia Malignant Melanoma Non-Hodgkin’s Lymphoma Prostate (before age 50) Colorectal Testicular Multiple Myeloma

Firefighter Presumption  Presumption extended following termination of service for 3 months for each year of service, but no more than 60 months following last day of employment  Cancers only apply to any active or former firefighter whose cancer develops after he/she has served at least 10 years and was given a qualifying medical exam upon becoming a firefighter that showed no evidence of cancer

Firefighter Presumption  May be rebutted by preponderance of evidence –Tobacco use –Physical fitness and weight –Lifestyle –Hereditary factors –Exposure from factors unrelated to work  Department L&I Additional Resource: –Wendy Devries