S-4124.1
SUBSTITUTE SENATE BILL 5784
State of Washington 67th Legislature 2022 Regular Session
By Senate Labor, Commerce & Tribal Affairs (originally sponsored by
Senators Lovelett, Conway, Dhingra, Hasegawa, Nobles, Saldaña,
Stanford, and C. Wilson; by request of Department of Labor &
Industries)
READ FIRST TIME 02/01/22.
1 AN ACT Relating to defining attending provider for all workers'
2 compensation claims and adding psychologists as attending providers
3 for mental health only claims; amending RCW 51.04.050, 51.28.010,
4 51.28.020, 51.28.030, 51.32.055, 51.32.090, 51.32.095, 51.36.010,
5 51.36.022, 51.36.060, and 51.36.070; adding a new section to chapter
6 51.08 RCW; and providing an effective date.
7 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF WASHINGTON:
8 Sec. 1. RCW 51.04.050 and 2004 c 65 s 2 are each amended to read
9 as follows:
10 In all hearings, actions or proceedings before the department or
11 the board of industrial insurance appeals, or before any court on
12 appeal from the board, any ((physician or licensed advanced
13 registered nurse practitioner)) health services provider having
14 theretofore examined or treated the claimant may be required to
15 testify fully regarding such examination or treatment, and shall not
16 be exempt from so testifying by reason of the relation of the
17 ((physician or licensed advanced registered nurse practitioner))
18 health services provider to patient.
19 NEW SECTION. Sec. 2. A new section is added to chapter 51.08
20 RCW to read as follows:
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 1 "Attending provider" means a person who is a member of the health
2 care provider network established under chapter 51.36 RCW, is
3 treating injured workers within the person's scope of practice, and
4 is licensed under Title 18 RCW in one of the following professions:
5 Physicians, chapter 18.71 RCW; osteopathy, chapter 18.57 RCW;
6 chiropractic, chapter 18.25 RCW; naturopathy, chapter 18.36A RCW;
7 podiatric medicine and surgery, chapter 18.22 RCW; dentistry, chapter
8 18.32 RCW; optometry, chapter 18.53 RCW; in the case of claims solely
9 for mental health conditions, psychology, chapter 18.83 RCW;
10 physician assistants, chapter 18.71A RCW; and licensed advanced
11 registered nurse practitioners, chapter 18.79 RCW.
12 Sec. 3. RCW 51.28.010 and 2007 c 77 s 1 are each amended to read
13 as follows:
14 (1) Whenever any accident occurs to any worker it shall be the
15 duty of such worker or someone in his or her behalf to forthwith
16 report such accident to his or her employer, superintendent, or
17 supervisor in charge of the work, and of the employer to at once
18 report such accident and the injury resulting therefrom to the
19 department pursuant to RCW 51.28.025 where the worker has received
20 treatment from a physician ((or a)), osteopathic physician,
21 chiropractor, naturopath, podiatric physician, optometrist, dentist,
22 licensed advanced registered nurse practitioner, physician assistant,
23 or psychologist in claims solely for mental health conditions, has
24 been hospitalized, disabled from work, or has died as the apparent
25 result of such accident and injury.
26 (2) Upon receipt of such notice of accident, the department shall
27 immediately forward to the worker or his or her beneficiaries or
28 dependents notification, in nontechnical language, of their rights
29 under this title. The notice must specify the worker's right to
30 receive health services from a ((physician or a licensed advanced
31 registered nurse practitioner)) provider of the worker's choice under
32 RCW 51.36.010(2)(a), including chiropractic services under RCW
33 51.36.015, and must list the types of providers authorized to provide
34 these services.
35 (3) Employers shall not engage in claim suppression.
36 (4) For the purposes of this section, "claim suppression" means
37 intentionally:
38 (a) Inducing employees to fail to report injuries;
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 1 (b) Inducing employees to treat injuries in the course of
2 employment as off-the-job injuries; or
3 (c) Acting otherwise to suppress legitimate industrial insurance
4 claims.
5 (5) In determining whether an employer has engaged in claim
6 suppression, the department shall consider the employer's history of
7 compliance with industrial insurance reporting requirements, and
8 whether the employer has discouraged employees from reporting
9 injuries or filing claims. The department has the burden of proving
10 claim suppression by a preponderance of the evidence.
11 (6) Claim suppression does not include bona fide workplace safety
12 and accident prevention programs or an employer's provision at the
13 worksite of first aid as defined by the department. The department
14 shall adopt rules defining bona fide workplace safety and accident
15 prevention programs and defining first aid.
16 Sec. 4. RCW 51.28.020 and 2005 c 108 s 3 are each amended to
17 read as follows:
18 (1)(a) Where a worker is entitled to compensation under this
19 title he or she shall file with the department or his or her self-
20 insured employer, as the case may be, his or her application for
21 such, together with the certificate of the physician ((or)),
22 osteopathic physician, chiropractor, naturopath, podiatric physician,
23 optometrist, dentist, licensed advanced registered nurse
24 practitioner, physician assistant, or psychologist in claims solely
25 for mental health conditions, who attended him or her. An application
26 form developed by the department shall include a notice specifying
27 the worker's right to receive health services from a ((physician or
28 licensed advanced registered nurse practitioner)) provider of the
29 worker's choice under RCW 51.36.010(2)(a), ((including chiropractic
30 services under RCW 51.36.015,)) and listing the types of providers
31 authorized to provide these services.
32 (b) The physician ((or)), osteopathic physician, chiropractor,
33 naturopath, podiatric physician, optometrist, dentist, licensed
34 advanced registered nurse practitioner, physician assistant, or
35 psychologist in claims solely for mental health conditions, who
36 attended the injured worker shall inform the injured worker of his or
37 her rights under this title and lend all necessary assistance in
38 making this application for compensation and such proof of other
39 matters as required by the rules of the department without charge to
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 1 the worker. The department shall provide ((physicians with)) a manual
2 which outlines the procedures to be followed in applications for
3 compensation involving occupational diseases, and which describes
4 claimants' rights and responsibilities related to occupational
5 disease claims.
6 (2) If the application required by this section is:
7 (a) ((Filed on behalf of the worker by the physician who attended
8 the worker, the physician may transmit the application to the
9 department electronically using facsimile mail;
10 (b))) Made to the department and the employer has not received a
11 copy of the application, the department shall immediately send a copy
12 of the application to the employer; or
13 (((c))) (b) Made to a self-insured employer, the employer shall
14 forthwith send a copy of the application to the department.
15 (3) The application required by this section may be transmitted
16 to the department electronically.
17 Sec. 5. RCW 51.28.030 and 2004 c 65 s 6 are each amended to read
18 as follows:
19 Where death results from injury the parties entitled to
20 compensation under this title, or someone in their behalf, shall make
21 application for the same to the department or self-insurer as the
22 case may be, which application must be accompanied with proof of
23 death and proof of relationship showing the parties to be entitled to
24 compensation under this title, certificates of attending ((physician
25 or licensed advanced registered nurse practitioner)) provider, if
26 any, and such proof as required by the rules of the department.
27 Upon receipt of notice of accident under RCW 51.28.010, the
28 director shall immediately forward to the party or parties required
29 to make application for compensation under this section,
30 notification, in nontechnical language, of their rights under this
31 title.
32 Sec. 6. RCW 51.32.055 and 2004 c 65 s 8 are each amended to read
33 as follows:
34 (1) One purpose of this title is to restore the injured worker as
35 nearly as possible to the condition of self-support as an able-bodied
36 worker. Benefits for permanent disability shall be determined under
37 the director's supervision, except as otherwise authorized in
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 1 subsection (9) of this section, only after the injured worker's
2 condition becomes fixed.
3 (2) All determinations of permanent disabilities shall be made by
4 the department, except as otherwise authorized in subsection (9) of
5 this section. Either the worker, employer, or self-insurer may make a
6 request or the inquiry may be initiated by the director or, as
7 authorized in subsection (9) of this section, by the self-insurer on
8 the director or the self-insurer's own motion. Determinations shall
9 be required in every instance where permanent disability is likely to
10 be present. All medical reports and other pertinent information in
11 the possession of or under the control of the employer or, if the
12 self-insurer has made a request to the department, in the possession
13 of or under the control of the self-insurer shall be forwarded to the
14 director with the request.
15 (3) A request for determination of permanent disability shall be
16 examined by the department or, if authorized in subsection (9) of
17 this section, the self-insurer, and the department shall issue an
18 order in accordance with RCW 51.52.050 or, in the case of a self-
19 insured employer, the self-insurer may: (a) Enter a written order,
20 communicated to the worker and the department self-insurance section
21 in accordance with subsection (9) of this section, or (b) request the
22 department to issue an order in accordance with RCW 51.52.050.
23 (4) The department or, in cases authorized in subsection (9) of
24 this section, the self-insurer may require that the worker present
25 himself or herself for a special medical examination by a physician
26 or physicians selected by the department, and the department or, in
27 cases authorized in subsection (9) of this section, the self-insurer
28 may require that the worker present himself or herself for a personal
29 interview. The costs of the examination or interview, including
30 payment of any reasonable travel expenses, shall be paid by the
31 department or self-insurer, as the case may be.
32 (5) The director may establish a medical bureau within the
33 department to perform medical examinations under this section.
34 Physicians hired or retained for this purpose shall be grounded in
35 industrial medicine and in the assessment of industrial physical
36 impairment. Self-insurers shall bear a proportionate share of the
37 cost of the medical bureau in a manner to be determined by the
38 department.
39 (6) Where a dispute arises from the handling of any claim before
40 the condition of the injured worker becomes fixed, the worker,
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 1 employer, or self-insurer may request the department to resolve the
2 dispute or the director may initiate an inquiry on his or her own
3 motion. In these cases, the department shall proceed as provided in
4 this section and an order shall issue in accordance with RCW
5 51.52.050.
6 (7)(a) If a claim (i) is accepted by a self-insurer after June
7 30, 1986, and before August 1, 1997, (ii) involves only medical
8 treatment and the payment of temporary disability compensation under
9 RCW 51.32.090 or only the payment of temporary disability
10 compensation under RCW 51.32.090, (iii) at the time medical treatment
11 is concluded does not involve permanent disability, (iv) is one with
12 respect to which the department has not intervened under subsection
13 (6) of this section, and (v) the injured worker has returned to work
14 with the self-insured employer of record, whether at the worker's
15 previous job or at a job that has comparable wages and benefits, the
16 claim may be closed by the self-insurer, subject to reporting of
17 claims to the department in a manner prescribed by department rules
18 adopted under chapter 34.05 RCW.
19 (b) All determinations of permanent disability for claims
20 accepted under this subsection (7) by self-insurers shall be made by
21 the self-insured section of the department under subsections (1)
22 through (4) of this section.
23 (c) Upon closure of a claim under (a) of this subsection, the
24 self-insurer shall enter a written order, communicated to the worker
25 and the department self-insurance section, which contains the
26 following statement clearly set forth in bold face type: "This order
27 constitutes notification that your claim is being closed with medical
28 benefits and temporary disability compensation only as provided, and
29 with the condition you have returned to work with the self-insured
30 employer. If for any reason you disagree with the conditions or
31 duration of your return to work or the medical benefits or the
32 temporary disability compensation that has been provided, you must
33 protest in writing to the department of labor and industries, self-
34 insurance section, within sixty days of the date you received this
35 order."
36 (8)(a) If a claim (i) is accepted by a self-insurer after June
37 30, 1990, and before August 1, 1997, (ii) involves only medical
38 treatment, (iii) does not involve payment of temporary disability
39 compensation under RCW 51.32.090, and (iv) at the time medical
40 treatment is concluded does not involve permanent disability, the
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 1 claim may be closed by the self-insurer, subject to reporting of
2 claims to the department in a manner prescribed by department rules
3 adopted under chapter 34.05 RCW. Upon closure of a claim, the self-
4 insurer shall enter a written order, communicated to the worker,
5 which contains the following statement clearly set forth in bold-face
6 type: "This order constitutes notification that your claim is being
7 closed with medical benefits only, as provided. If for any reason you
8 disagree with this closure, you must protest in writing to the
9 Department of Labor and Industries, Olympia, within 60 days of the
10 date you received this order. The department will then review your
11 claim and enter a further determinative order."
12 (b) All determinations of permanent disability for claims
13 accepted under this subsection (8) by self-insurers shall be made by
14 the self-insured section of the department under subsections (1)
15 through (4) of this section.
16 (9)(a) If a claim: (i) Is accepted by a self-insurer after July
17 31, 1997; (ii)(A) involves only medical treatment, or medical
18 treatment and the payment of temporary disability compensation under
19 RCW 51.32.090, and a determination of permanent partial disability,
20 if applicable, has been made by the self-insurer as authorized in
21 this subsection; or (B) involves only the payment of temporary
22 disability compensation under RCW 51.32.090 and a determination of
23 permanent partial disability, if applicable, has been made by the
24 self-insurer as authorized in this subsection; (iii) is one with
25 respect to which the department has not intervened under subsection
26 (6) of this section; and (iv) concerns an injured worker who has
27 returned to work with the self-insured employer of record, whether at
28 the worker's previous job or at a job that has comparable wages and
29 benefits, the claim may be closed by the self-insurer, subject to
30 reporting of claims to the department in a manner prescribed by
31 department rules adopted under chapter 34.05 RCW.
32 (b) If a ((physician or licensed advanced registered nurse
33 practitioner submits a)) medical report submitted to the self-insurer
34 ((that)) concludes that the worker's condition is fixed and stable
35 and supports payment of a permanent partial disability award, and, if
36 within fourteen days from the date the self-insurer mailed the report
37 to the attending ((or treating physician or licensed advanced
38 registered nurse practitioner)) provider, the worker's attending ((or
39 treating physician or licensed advanced registered nurse
40 practitioner)) provider disagrees in writing that the worker's
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 1 condition is fixed and stable, the self-insurer must get a
2 supplemental medical opinion from a provider on the department's
3 approved examiner's list before closing the claim. In the
4 alternative, the self-insurer may forward the claim to the
5 department, which must review the claim and enter a final order as
6 provided for in RCW 51.52.050.
7 (c) Upon closure of a claim under this subsection (9), the self-
8 insurer shall enter a written order,