Washington Administrative Code Title 263 - Industrial Insurance Appeals, Board of
Washington Administrative Code (WAC) Title 263 is specifically dedicated to the Board of Industrial Insurance Appeals (BIIA).
This title lays out the rules and procedures governing how the BIIA operates as an independent, quasi-judicial agency in Washington State. The BIIA's primary purpose is to hear and resolve disputes and appeals related to decisions made by the Washington State Department of Labor and Industries (L&I).
Here's a breakdown of the key aspects covered in WAC Title 263 and the BIIA's role:
Purpose of the BIIA:
Adjudicating Appeals: The BIIA serves as the administrative court for appeals stemming from decisions issued by L&I. These appeals primarily involve:
Industrial insurance (workers' compensation) claims: This is the most common type of appeal, dealing with benefits for injured workers.
Safety citations under the Washington Industrial Safety and Health Act (WISHA): Appeals related to workplace safety violations.
Employer premium (tax assessments and classifications): Disputes over the classification of businesses for industrial insurance premiums.
Crime victim compensation: Appeals concerning compensation for victims of crimes.
Independent Tribunal: The BIIA is separate from L&I. This independence is crucial to ensure impartial and unbiased decisions in appeal cases.
Resolution of Disputes: The BIIA aims to resolve appeals in a consistent, impartial, timely, and efficient manner.
How the BIIA Operates (as outlined in WAC Title 263, particularly Chapter 263-12 - Practice and Procedure):
Board Structure: The BIIA is administered by three full-time Board members appointed by the Governor, typically representing public, labor, and business interests. These members issue the final decisions on appeals and also manage the agency.
Appeal Process:
Filing an Appeal: If an injured worker, employer, or other party disagrees with a written decision from L&I, they can file an appeal with the BIIA (typically within 60 days of the L&I decision).
Granting/Denying Appeals: The BIIA reviews the appeal to determine if it has jurisdiction (the right to hear the appeal). If it does, an "Order Granting Appeal" is issued; otherwise, it's denied.
Mediation Conference: Once an appeal is granted, the case is usually assigned to an Industrial Appeals Judge (IAJ) for a mediation conference. This is an informal process where parties try to reach a settlement without a formal hearing. The mediator facilitates discussions but does not decide the outcome.
Hearings: If mediation fails, the case proceeds to formal hearings. These hearings are like court proceedings, with witnesses testifying under oath and evidence presented. The appealing party generally has the burden of proving that L&I's decision was incorrect.
Proposed Decision and Order (PD&O): After hearings, the IAJ issues a written PD&O, which includes findings of fact and conclusions of law.
Petition for Review: Parties can file a "Petition for Review" if they disagree with the PD&O.
Final Decision and Order (D&O): If a Petition for Review is granted, the three-member Board reviews the case and issues a final D&O, which becomes the BIIA's binding decision. If no Petition for Review is filed or granted, the PD&O becomes the final decision.
Judicial Review: The BIIA's final decisions can be appealed further to the Washington State Superior Court.
In essence, WAC Title 263 provides the detailed rules for navigating the appeals process within the Washington Board of Industrial Insurance Appeals, ensuring due process and a structured approach to resolving disputes related to industrial insurance and other related matters.
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