Wash. Admin. Code § 296-16-150

Current through Register Vol. 24-23, December 1, 2024
Section 296-16-150 - [Effective 1/1/2025] What benefits can an eligible employer receive from the preferred worker program?
(1) In the sole discretion of the supervisor of industrial insurance or the supervisor's designee, an eligible employer, insured through the state fund or self-insured, may receive benefits shown in the table below:

A certified preferred worker who is hired by:

Employer

State Fund employer (pays premiums to L&I)

Self-insured employer

(a) Wage, clothing, and equipment reimbursements specified in subsection (2) of this section.

(b) Continuous employment incentive specified in subsection (3) of this section.

X

X

(c) Does not pay accident fund and medical aid fund premiums for hours worked by the preferred worker.

(d) Will not have the cost of any new claim filed by that preferred worker charged to their experience rating.

X

(e) Receives reimbursement from the second injury fund for all benefits paid on any new claim filed by that worker during the certification period.

X

(2)For a preferred worker with a date of injury on or after January 1, 2025:
(a) An eligible employer, insured through the state fund or self-insured, may be reimbursed for the following expenses actually incurred while employing a preferred worker with a date of injury on or after January 1, 2025, at work approved under WAC 296-16-145, performed during the worker's certification period:
(i) Fifty percent of basic gross wages paid to the worker for the work actually performed, for up to 120 days in a 24-month period up to a maximum of $25,000 per worker certification period.
(A) Basic gross wages means the basic hourly wages or salary. Basic gross wages do not include tips, commissions, bonuses, board, housing, fuel, health care, dental care, vision care, per diem, reimbursements for work-related expenses, or any other payments.
(B) A partial day worked counts as one day. Example: The worker works a four-hour shift. This counts as one day out of the 120.
(C) If the worker's single shift spans two calendar days, that shift counts as one day. Example: The worker's single shift starts at 10:00 p.m., November 14th, and continues until 6:30 a.m., November 15th. This counts as one day out of the 120.
(D) The 120 days do not have to be consecutive.
(E) The employer may choose which 120 days to seek reimbursement for.
(F) The employer cannot be reimbursed for dates the employer employed the worker that are more than 24 months after the earliest day the department has already reimbursed on the claim. Example: The first work date for which the employer was reimbursed was February 1, 2016. The 24 month eligibility period ends January 31, 2018.
(G) The employer must submit the request for reimbursement within one year of the date the work was performed.
(H) The employer must submit to the department documentation such as payroll records and time cards that verify the dates worked and basic gross wages paid.
(ii) Clothing the employer purchased for the worker, necessary to perform the approved work, up to $1,000 per worker certification period.
(A) The department will not reimburse the employer for any clothing the employer provided to the worker that the employer normally provides to its workers.
(B) When the work ends, the clothing belongs to the worker.
(C) The employer must submit the request for reimbursement within one year of the date of purchase, and include itemized receipts.
(iii) Tools and equipment the employer purchased to enable the worker to perform the approved work, up to $5,000 per worker certification period.
(A) The department will not reimburse the employer for any tools and equipment the employer provided to the worker that the employer normally provides to its workers.
(B) The employer cannot be reimbursed for tools and equipment purchased prior to offering the job to the worker.
(C) When the work ends, the tools and equipment belong to the employer.
(D) The employer must submit the request for reimbursement within one year of the date of purchase, and include itemized receipts.
(b) An eligible employer who continuously employs a certified preferred worker at the approved job without reduction in base wages for at least 12 consecutive months, beginning on or after January 1, 2025, may receive a one-time continuous employment incentive payment at the sole discretion of the supervisor of industrial insurance or the supervisor's designee.
(i) The 12 months begin the date the worker is certified as a preferred worker or the first date of employment, whichever is later.
(ii) For purposes of this section, "continuous employment" is defined as maintaining the same work pattern as the approved job date of hire. "Same work pattern" generally refers to the number of hours worked per week and the worker's primary shift, for example, days, swing, or graveyard shift, as long as total hours are not reduced. For example, a farm laborer returns to approved work as an employee in the farm's retail outlet, Monday through Thursday, 8:00 a.m. to 4:00 p.m., 32 hours per week. A month later, the schedule changes to Tuesday through Friday, 8:00 a.m. to 4:00 p.m., 32 hours per week. The work pattern is the same as the approved job date of hire. However, a change to shift hours that are 4:00 p.m. to midnight may be a change in work pattern.
(iii) "Without reduction" means the worker receives the same base wage or greater from the date of hire throughout the 12-month period. In addition, the employer must continue any health care benefits the certified preferred worker had at the time of hire, unless these benefits are inconsistent with the employer's current benefit program for workers.
(iv) The one-time payment is $25,000.
(v) Only one continuous employment incentive is payable per worker certification period.
(vi) The employer must submit the request for the continuous employment incentive within one year of the date the 12 months ended.
(c) If the department receives a valid reimbursement or incentive request from different employers within the same worker certification period, the requests will be paid in the order received by the department up to the limits described.
(d) The employer cannot be reimbursed under both the stay at work and preferred worker programs for the same dates worked or expenses incurred.
(3)For a preferred worker with a date of injury prior to January 1, 2025:
(a) An eligible employer, insured through the state fund or self-insured, may be reimbursed for the following expenses actually incurred while employing a preferred worker with a date of injury prior to January 1, 2025, and who was certified on or after January 1, 2016, at work approved under WAC 296-16-145, performed during the worker's certification period:
(i) Fifty percent of basic gross wages paid to the worker for the work actually performed, for up to 66 days in a 24-month period and a maximum of $10,000 per worker certification period.
(A) Basic gross wages means the basic hourly wages or salary. Basic gross wages do not include tips, commissions, bonuses, board, housing, fuel, health care, dental care, vision care, per diem, reimbursements for work-related expenses, or any other payments.
(B) A partial day worked counts as one day. Example: The worker works a four-hour shift. This counts as one day out of the 66.
(C) If the worker's single shift spans two calendar days, that shift counts as one day. Example: The worker's single shift starts at 10:00 p.m., November 14th, and continues until 6:30 a.m., November 15th. This counts as one day out of the 66.
(D) The 66 days do not have to be consecutive.
(E) The employer may choose which 66 days to seek reimbursement for.
(F) The employer cannot be reimbursed for dates the employer employed the worker that are more than 24 months after the earliest day the department has already reimbursed on the claim. Example: The first work date for which the employer was reimbursed was February 1, 2016. The 24-month eligibility period ends January 31, 2018.
(G) The employer must submit the request for reimbursement within one year of the date the work was performed.
(H) The employer must submit to the department documentation such as payroll records and time cards that verify the dates worked and basic gross wages paid.
(ii) Clothing the employer purchased for the worker, necessary to perform the medically approved work, up to $400 per worker certification period.
(A) The department will not reimburse the employer for any clothing the employer provided to the worker that the employer normally provides to its workers.
(B) When the work ends, the clothing belongs to the worker.
(C) The employer must submit the request for reimbursement within one year of the date of purchase, and include itemized receipts.
(iii) Tools and equipment the employer purchased to enable the worker to perform the medically approved work, up to $2,500 per worker certification period.
(A) The department will not reimburse the employer for any tools and equipment the employer provided to the worker that the employer normally provides to its workers.
(B) The employer cannot be reimbursed for tools and equipment purchased prior to offering the job to the worker.
(C) When the work ends, the tools and equipment belong to the employer.
(D) The employer must submit the request for reimbursement within one year of the date of purchase, and include itemized receipts.
(b) An eligible employer who continuously employs a certified preferred worker at the medically approved job without reduction in base wages for at least 12 consecutive months, beginning on or after January 1, 2016, may receive a one-time continuous employment incentive payment at the sole discretion of the supervisor of industrial insurance or the supervisor's designee.
(i) The 12 months begin the date the worker is certified as a preferred worker or the first date of employment, whichever is later.
(ii) For purposes of this section, "continuous employment" is defined as maintaining the same work pattern as the medically approved job date of hire. "Same work pattern" generally refers to the number of hours worked per week and the worker's primary shift, for example, days, swing, or graveyard shift, as long as total hours are not reduced. For example, a farm laborer returns to approved work as an employee in the farm's retail outlet, Monday through Thursday, 8:00 a.m. to 4:00 p.m., 32 hours per week. A month later, the schedule changes to Tuesday through Friday, 8:00 a.m. to 4:00 p.m., 32 hours per week. The work pattern is the same as the medically approved job date of hire. However, a change to shift hours that are 4:00 p.m. to midnight may be a change in work pattern.
(iii) "Without reduction" means the worker receives the same base wage or greater from the date of hire throughout the 12-month period. In addition, the employer must continue any health care benefits the certified preferred worker had at the time of hire, unless these benefits are inconsistent with the employer's current benefit program for workers.
(iv) The one-time payment is equal to the lesser of 10 percent of the worker's wages or $10,000. Wages for the one-time payment include commissions and bonuses paid, but do not include tips, board, housing, fuel, health care, dental care, vision care, per diem, reimbursements for work-related expenses, or any other payments.
(v) Only one continuous employment incentive is payable per worker certification period.
(vi) The employer must submit the request for the continuous employment incentive within one year of the date the 12 months ended.
(c) If the department receives a valid reimbursement or incentive request from different employers within the same worker certification period, the requests will be paid in the order received by the department up to the limits described.
(d) The employer cannot be reimbursed under both the stay at work and preferred worker programs for the same dates worked or expenses incurred.

Wash. Admin. Code § 296-16-150

Amended by WSR 16-13-116, Filed 6/21/2016, effective 7/22/2016
Amended by WSR 24-23-080, Filed 11/19/2024, effective 1/1/2025

Statutory Authority: RCW 51.04.010, 51.04.020 and 2004 c 258. 05-01-105, § 296-16-150, filed 12/15/04, effective 1/15/05.