WSR 23-05-074
PERMANENT RULES
DEPARTMENT OF
LABOR AND INDUSTRIES
[Filed February 14, 2023, 8:36 a.m., effective March 17, 2023]
Effective Date of Rule: Thirty-one days after filing.
Purpose: The 2022 legislative session amended RCW
51.28.040 Application for change in compensation, by passing SHB 1902. As a result of the legislation, WAC 296-20-097 Reopenings, needed amending to be consistent with the change in the statute.
Based on the legislation passed in 2022 adjusting the number of days prior to receipt of a reopening application for workers' compensation claim, the department or self-insured employer can consider setting the effective date from 60 days up to 120 days when the provider does not complete and file the application within 60 days of medical services, and the worker submits the application within 30 days of medical services without medical completion. The worker must prove the application was received by the department or self-insurer. Allowing the date to be set beyond 60 days up to 120 days may result in additional time-loss or medical benefits.
Citation of Rules Affected by this Order: Amending WAC 296-20-097.
Adopted under notice filed as WSR 22-24-087 on December 6, 2022.
Changes Other than Editing from Proposed to Adopted Version: One minor change was made to the title of the form referenced in the rule from "Application to Reopen Claim for Aggravation of Condition" to "Application to Reopen Claim Due to Worsening of Condition."
Number of Sections Adopted in Order to Comply with Federal Statute: New 0, Amended 0, Repealed 0; Federal Rules or Standards: New 0, Amended 0, Repealed 0; or Recently Enacted State Statutes: New 0, Amended 0, Repealed 0.
Number of Sections Adopted at the Request of a Nongovernmental Entity: New 0, Amended 0, Repealed 0.
Number of Sections Adopted on the Agency's own Initiative: New 0, Amended 0, Repealed 0.
Number of Sections Adopted in Order to Clarify, Streamline, or Reform Agency Procedures: New 0, Amended 1, Repealed 0.
Number of Sections Adopted using Negotiated Rule Making: New 0, Amended 0, Repealed 0; Pilot Rule Making: New 0, Amended 0, Repealed 0; or Other Alternative Rule Making: New 0, Amended 0, Repealed 0.
Date Adopted: February 14, 2023.
Joel Sacks
Director
OTS-4146.2
AMENDATORY SECTION(Amending WSR 08-24-047, filed 11/25/08, effective 12/26/08)
WAC 296-20-097Reopenings.
When a claim has been closed by the department or self-insurer by written order and notice for ((
sixty))
60 days, submission of a formal "application to reopen claim ((
for aggravation))
due to worsening of condition" form # F242-079-000 is ((
necessary))
preferred. The department or self-insurer is responsible for customary charges for examinations, diagnostic studies, and determining whether or not time-loss is payable regardless of the final action taken on the reopening application. Reopening applications should be submitted immediately. When reopening is granted, the department or self-insurer can pay time loss and treatment benefits only for a period not to exceed ((
sixty))
60 days
prior to date the application is received by the department or self-insurer.
The 60 days may be extended up to 120 days consistent with RCW 51.28.040. Necessary treatment should not be deferred pending a department or self-insurer adjudication decision. However, should reopening be denied treatment costs become the financial responsibility of the worker.