BILL REQ. #:  H-0893.1 

Read first time 01/20/09.   Referred to Committee on Commerce & Labor.

     AN ACT Relating to contact with medical providers after appeals have been filed under industrial insurance; adding a new section to chapter 51.52 RCW; and creating new sections.

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

NEW SECTION.  Sec. 1   The worker's compensation act, Title 51 RCW, is impressed with a trust with workers as beneficiaries of the state accident and medical aid funds and the department of labor and industries, as trustee of the funds, has a duty toward these beneficiaries. A trustee relationship does not exist between employers and workers. It is therefore recognized that different rules, obligations, and standards are applied to employers and their representatives than those applied to the department of labor and industries and its representatives.

NEW SECTION.  Sec. 2   A new section is added to chapter 51.52 RCW to read as follows:
     (1)(a) Except as provided in (c) and (d) of this subsection, after the filing of a notice of an appeal under RCW 51.52.060(2), the employer and its representatives shall not have contact to discuss the issues in question in the appeal with any medical provider who has examined or treated the claimant at the request of the claimant or treating medical provider, unless written authorization for contact is given by the claimant or the claimant's representative. Written authorization is only valid if given after the date that the appeal is filed and expires ninety days after it is signed.
     (b) Contact is permitted as necessary for the ongoing management of the claim, including but not limited to communication regarding the worker's treatment needs and the provider's treatment plan, vocational and return-to-work issues and assistance, and certification of the worker's inability to work, unless these issues are in question in the appeal.
     (c) If the employer or its representatives wish to communicate with the examining or treating medical providers concerning the issues in question in the appeal, and no written authorization from the claimant or the claimant's representative has been obtained, the communication must either be:
     (i) In writing, sent contemporaneously to all parties with a notice to the provider in bold type that any response must be in writing;
     (ii) In person, by telephone, or by videoconference, at a date and time mutually agreed to by all parties, with the claimant or the claimant's representative given the opportunity to fully participate; or
     (iii) Pursuant to a properly scheduled and noted deposition.
     (d) Written authorization is not required if the claimant fails to identify or confirm the examining or treating medical provider as a witness as required by the board.
     (2)(a) Except as provided in (b) and (c) of this subsection, after the filing of a notice of an appeal under RCW 51.52.060(2), the claimant and the representative for the claimant, if any, shall not have contact to discuss the issues in question in the appeal with any medical provider who has examined the claimant at the request of the employer pursuant to RCW 51.36.070, unless written authorization for contact is given by the employer or its representative. Written authorization is only valid if given after the date that the appeal is filed and expires ninety days after it is signed.
     (b) If the claimant or the claimant's representative wishes to communicate with a medical provider who has examined the claimant pursuant to RCW 51.36.070, and no written authorization from the employer or its representative has been obtained, the communication must either be:
     (i) In writing, sent contemporaneously to all parties with a notice to the provider in bold type that any response must be in writing;
     (ii) In person, by telephone, or by videoconference, at a date and time mutually agreed to by all parties, with the department, employer, and their representatives given the opportunity to fully participate; or
     (iii) Pursuant to a properly scheduled and noted deposition.
     (c) Written authorization is not required if the employer fails to identify or confirm the examining medical provider as a witness as required by the board.
     (3) Subsections (1) and (2) of this section do not apply to the department.
     (a) Except as provided in (c) and (d) of this subsection, after an appeal has been filed under RCW 51.52.060(2), a conference has been held to schedule hearings, and the claimant has named his or her witnesses, the department and its representatives shall not have contact to discuss the issues in question in the appeal with any medical provider who has examined or treated the claimant at the request of the claimant or treating medical provider and has been named as a witness by the claimant or their representative unless written authorization for contact is given by the claimant or the claimant's representative. Written authorization is only valid if given after the date that the appeal is filed and expires ninety days after it is signed.
     (b) Contact is permitted as necessary for the ongoing management of the claim, including but not limited to communication regarding the worker's treatment needs and the provider's treatment plan, vocational and return-to-work issues and assistance, and certification of the worker's inability to work, unless these issues are in question in the appeal.
     (c) If the department or its representatives wish to communicate with the examining or treating medical providers concerning the issues in question in the appeal, and no written authorization from the claimant or the claimant's representative has been obtained, the communication must either be:
     (i) In writing, sent contemporaneously to all parties with a notice to the provider in bold type that any response must be in writing;
     (ii) In person, by telephone, or by videoconference, at a date and time mutually agreed to by all parties, with the claimant or the claimant's representative given the opportunity to fully participate; or
     (iii) Pursuant to a properly scheduled and noted deposition.
     (d) Written authorization is not required if the claimant fails to identify or confirm the examining or treating medical provider as a witness as required by the board.
     (4)(a) Except as provided in (b) and (c) of this subsection, after an appeal has been filed under RCW 51.52.060(2), a conference has been held to schedule hearings, and the claimant has named his or her witnesses, the claimant and the representative for the claimant, if any, shall not have contact to discuss the issues in question in the appeal with any medical provider who has examined the claimant at the request of the department pursuant to RCW 51.36.070, unless written authorization for contact is given by the department or its representatives. Written authorization is only valid if given after the date that the appeal is filed and expires ninety days after it is signed.
     (b) If the claimant or the claimant's representative wishes to communicate with a medical provider who has examined the claimant pursuant to RCW 51.36.070, and no written authorization from the department or its representative has been obtained, the communication must either be:
     (i) In writing, sent contemporaneously to all parties with a notice to the provider in bold type that any response must be in writing;
     (ii) In person, by telephone, or by videoconference, at a date and time mutually agreed to by all parties, with the department or its representatives given the opportunity to fully participate; or
     (iii) Pursuant to a properly scheduled and noted deposition.
     (c) Written authorization is not required if the department fails to identify or confirm the examining medical provider as a witness as required by the board.
     (5) The board may determine whether the parties have made themselves reasonably available to participate in telephone or videoconference communications as provided in subsections (1)(c)(ii), (2)(b)(ii), (3)(c)(ii), and (4)(b)(ii) of this section.
     (6) This section only applies to issues set forth in a notice of appeal under RCW 51.52.060(2).
     (7) This section does not limit the reporting requirements under RCW 51.04.050 and 51.36.060 for issues not set forth in a notice of appeal.
     (8) The department may adopt rules as necessary to implement the provisions of this section.

NEW SECTION.  Sec. 3   This act applies to orders entered on or after the effective date of this section.