S‑1914.2   _____________________________________________

 

SUBSTITUTE SENATE BILL 5195

 

           _____________________________________________

 

State of Washington      57th Legislature     2001 Regular Session

 

By Senate Committee on Labor, Commerce & Financial Institutions (originally sponsored by Senators Prentice, Winsley, Kline, Gardner and Franklin)

 

READ FIRST TIME 02/28/01. 

_1      AN ACT Relating to medical examinations under the industrial

_2  insurance system; amending 51.32.112; adding a new section to

_3  chapter 51.36 RCW; creating a new section; recodifying RCW

_4  51.32.112; and repealing RCW 51.32.114.

     

_5  BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF WASHINGTON:

     

_6      Sec. 1.  RCW 51.32.112 and 1993 c 515 s 4 are each amended to read

_7  as follows:

_8      (1) The department shall ((develop standards for)) adopt rules

_9  governing the conduct of ((special)) medical examinations ((to

10  determine permanent disabilities)) pursuant to RCW 51.36.070,

11  including, but not limited to:

12      (a) The qualifications of persons conducting the examinations.

13  To conduct an examination, a medical provider must, at a minimum,

14  be licensed to practice at the time of the examination:

15      (i) Medicine or surgery under chapter 18.71 RCW, osteopathic

16  medicine and surgery under chapter 18.57 RCW, podiatric medicine

17  and surgery under chapter 18.22 RCW, dentistry under chapter 18.30

18  RCW, or chiropractic under chapter 18.25 RCW; and

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_1      (ii) To the extent possible, the qualifications of the examiner

_2  should match the clinical condition for which the worker is being

_3  examined;

_4      (b) The criteria for removing examiners from the list of

_5  approved examiners, including but not limited to the department

_6  determining that the provider:

_7      (i) Committed any violation of this title, or department rules

_8  or policies under this title;

_9      (ii) Committed professional or other misconduct, or

10  demonstrated incompetency in connection with providing medical

11  examinations under this title;

12      (iii) Exceeded the limits of his or her professional competence

13  in conducting medical examinations or made materially false

14  statements regarding his or her qualifications in his or her

15  application as an examiner;

16      (iv) Failed to transmit copies of medical reports, or failed to

17  submit full and truthful medical reports of his or her findings,

18  as required by this title;

19      (v) Knowingly made a false statement or representation as to a

20  material fact in any medical report made under this title or in

21  testifying or otherwise providing information for the purposes of

22  this title; or

23      (vi) Refused to appear before, testify, submit to deposition,

24  or answer a material question of the department, or board of

25  industrial insurance appeals, or produce a material document

26  concerning his or her provision of services under this title;

27      (((b))) (c) The criteria for conducting the examinations,

28  including guidelines for the appropriate treatment of injured

29  workers during the examination; and

30      (((c))) (d) The content of examination reports.

31      (2) Within the appropriate scope of practice, chiropractors

32  licensed under chapter 18.25 RCW may conduct special medical

33  examinations to determine permanent disabilities under RCW

34  51.32.055 in consultation with physicians licensed under chapter

35  18.57 or 18.71 RCW.  The depart­ment, in its discretion, may request

36  that a special medical examination be conducted by a single

37  chiroprac­tor if the department determines that the sole issues

38  involved in the examination are within the scope of practice under

SSB 5195                       p. 2

_1  chapter 18.25 RCW.  However, nothing in this section authorizes the

_2  use as evidence before the board of a chiropractor's determination

_3  of the extent of a worker's permanent disability if the

_4  determination is not requested by the department.

_5      (3) The department must examine the credentials of providers

_6  conducting medical examinations pursuant to RCW 51.36.070 and must

_7  monitor the quality and objectivity of the examinations and

_8  examination reports obtained by the department and self-insured

_9  employers.  The department's rules must ensure that examinations

10  pursuant to RCW 51.36.070 are performed only by qualified

11  providers meeting department standards.

12      (4) The department shall keep and maintain a record of all

13  complaints regarding the conduct of an examiner in the performance

14  and reporting of medical examinations, and all department

15  responses to these complaints, for ten years.  The department shall

16  make complaints regarding the conduct of an examiner in the

17  performance and reporting of a worker's medical examination, and

18  all department responses to these complaints, available to the

19  worker or worker's representative upon request.  The department

20  shall make complaints regarding the conduct of an examiner in the

21  performance and reporting of another worker's medical examination,

22  and all department responses to these complaints, available to a

23  worker or worker's representative upon request, provided that

24  other workers' names and claim numbers are deleted and that no

25  medical records are released.  This section shall not be interpreted

26  to allow a worker or worker's representative to view the claim

27  file or medical records of another worker, or to allow the

28  department to withhold information pursuant to an appropriate

29  legal order or action.

30      (5) The department shall investigate the amount of examination

31  fees received by persons conducting ((special)) medical

32  examinations ((to determine permanent disabili­ties))pursuant to

33  RCW 51.36.070, including total compensation received for

34  examina­tions of department and self-insured claimants, and

35  establish compensation guidelines and compensation reporting

36  criteria.

37      (((4))) (6) The department shall investigate the level of

38  compliance of self-insurers with the require­ment of full reporting

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_1  of claims information to the department, particularly with respect

_2  to medical examinations, and develop effective enforcement

_3  proce­dures or recommendations for legislation if needed.

     

_4      NEW SECTION.  Sec. 2.  RCW 51.32.112 is recodified as a new

_5  section in chapter 51.36 RCW.

     

_6     NEW SECTION.  Sec. 3.  RCW 51.32.114 (Medical examination‑-

_7  Department to monitor quality and objectivity) and 1988 c 114 s 3

_8  are each repealed.

     

_9      NEW SECTION.  Sec. 4.  This act applies to all medical

10  examinations pursuant to RCW 51.36.070 on or after the effective

11  date of this act.

 

‑‑‑ END ‑‑‑

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