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Hundreds of COVID-19 workers' comp claims in logjam at Washington Labor & Industries

Following an inquiry from the KING 5 Investigators, L&I changed public policy by creating a team to focus solely on resolving drawn-out pandemic-related cases.

More than 300 workers’ compensation claims filed with the Washington State Department of Labor and Industries (L&I) associated with COVID-19 have been lingering in the system without a decision for six months or longer.

Most are cases where the claimant allegedly got COVID at work, in a job not connected to health care or frontline work. The state says these cases are more complex and require more documentation.

L&I provided the data to the KING 5 Investigators after the reporters inquired about a case involving a Federal Way resident who contracted the disease at a Pierce County RV dealership, where he is a salesman. He filed his claim, as directed by his employer, then got the runaround from L&I claims managers for six months.

According to L&I data, the average time for a decision on a rejected COVID-related claim is 96 days. The average time for a decision on an accepted COVID claim is nine days.

As the months dragged on, medical bills piled up at Danny Quintero’s home. Health care providers wanted to be paid, regardless of L&I’s lack of a decision.

After an ER visit at a Federal Way hospital in March 2021, followed by a week-long stay at Tacoma General Hospital, the bills totaled $156,512.

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“I can’t sustain that. We can’t sustain that. It would ruin us financially,” said Danny Quintero.

“That amount of money is unimaginable to come up with,” Danny’s wife Liz Quintero said. “There is the expectation that [the providers] will get paid. The source doesn’t really matter.”

Quintero submitted the claim to L&I after a co-worker at the dealership took a trip out of town, unknowingly got sick, and brought COVID into the workplace. Nearly every member of the sales department came down with it. At age 31, and in good health, Quintero’s case was the most extreme. He was rushed to the hospital struggling to breathe.

“Every day, despite the treatments they were doing, he wasn’t getting any better,” said Liz.

“It felt like this is what you’ve been seeing on the news for the past year. And [thinking you could die of COVID] is terrifying,” said Danny.

Quintero recovered at home as itemized hospital and doctors’ bills rolled in. They included:

  • $18,000 for a five-hour ER visit
  • $4,000 for an 11-mile ambulance ride
  • $5,100/day for the hospital room
  • $330/day for oxygen
  • $28,771 for one vial of medication for severe COVID-19 pneumonia  

The family received a call from a collection agency, as well as calls and correspondence from creditors urging them to pay.

“The amount is past due,” wrote one health care provider. “Final reminder, your balance is seriously past due,” wrote the hospital billing department. “If we do not hear from you within 10 days, this account will be turned over to our collection agency,” wrote the hospital’s pharmacy department.

“It was hard enough emotionally just getting through this as a family. But to still feel like you’re going through it every day, [it makes you feel] powerless,” Liz said.

Danny’s wife and their two small children contracted COVID-19 as a result of the workplace exposure, as well.

The Quinteros said they provided L&I with all needed documentation, but could never get answers from L&I representatives. State call logs show claims managers communicating they didn’t have enough information, superiors needed to look over the case, and that they didn’t know when a decision would be made.

“Every person has passed it off to someone else who hasn’t been able to give us any information. There hasn’t been any transparency,” Liz said. “It just makes you feel there’s a stack [of paperwork] somewhere that no one is even paying attention to - not knowing how deeply this is affecting people’s lives.”

The top L&I claims executive said the amount of time the Quinteros waited was “absolutely” too long.

“So my first response is ‘I am truly sorry,’” said L&I Chief of Claims Cheri Ward. “That is way too long for an individual, or this family to experience, especially with medical bills coming in. That’s extremely stressful, causing anxiety I’m sure, so that delay is not acceptable at all.”

Ward said she was unaware that some cases involving non-healthcare-related employees were taking six months or longer.

“The inquiry by [KING 5] did not cause us to make a decision to allow the particular claim in question,” said Ward. “It did bring to light, however, we had some problems with our processes and where we needed to re-evaluate and shift our resources so that no one else experiences this delay and the unfortunate circumstances that Mr. Quintero did.”

Ward changed Department policy and organized a team to focus solely on undecided COVID-related claims.

“We didn’t have the appropriate number of resources assigned to manage these pandemic claims and there were unfortunate delays that are not up to our standard or our expectation,” Ward said.

Two days after KING 5 called the state about the Quintero's case, an L&I representative called Danny at work.

“The claim was approved. We got approved, and the weight of the world was lifted off our shoulders,” Danny said. “It’s liberating. I only hope that, starting immediately, everybody else [waiting] starts to get approval.”

According to L&I, they’ve received 9,238 claims since the beginning of the pandemic.  Of that, 56% have been from healthcare workers, 12% from first responders, and 32% from jobs unrelated to the health care/frontline fields.

L&I said decisions have been made on approximately 94% of cases, with 83% allowed and 11% rejected.

Read more from the KING 5 Investigators

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