Under Washington's industrial insurance program (workers' compensation), a worker who is injured or suffers a disability from an occupational disease in the course of employment is entitled to certain benefits.  Employers in Washington must obtain coverage either through the industrial insurance fund administered by the Department of Labor and Industries (Department) or by qualifying to self-insure.  Self-insured employers cover costs associated with an on-the-job injury or occupational disease and administer claims.

Depending on a worker's occupation, treatment for post-traumatic stress disorder (PTSD) may be covered by workers' compensation as an injury from exposure to a single traumatic event, or as an occupational disease, from repeated exposure over time.  For all workers, PTSD may be covered as an occupational injury when a worker is exposed to a single traumatic event that causes them to develop PTSD.  For public safety telecommunicators, like 911 operators, a PTSD claim may be covered as an occupational injury or an occupational disease.  For firefighters, fire investigators, emergency medical technicians, law enforcement officers, and direct care registered nurses, PTSD may be covered as either an occupational injury or an occupational disease, and there is a presumption that PTSD is caused by the work.

To receive workers' compensation coverage for treatment, a workers' compensation claim must be filed with and adjudicated by the Department.  A workers' compensation claim is closed when a worker reaches maximum medical improvement, meaning the worker's condition is fixed and stable.  In most cases, a closed claim may be reopened if the condition worsens and the worker submits an application within seven years of claim closure.

The Department of Labor and Industries (Department) is authorized to use funds allocated for return-to-work programs to provide funding for workplace behavioral health programs focused on occupations that have a high risk of post-traumatic stress disorder (PTSD).  The Department may determine appropriate organizations eligible for awards.

A pilot program is established to increase access to care for workers seeking workers' compensation coverage for post-traumatic stress disorder as an occupational disease.  The Department and self-insured employers may authorize treatment for PTSD prior to claim adjudication, regardless of whether the claim for benefits is ultimately allowed.  Authorized treatment is limited to a diagnostic interview and up to 11 treatment sessions within 90 days of diagnosis.  Costs for treatment prior to adjudication on state-fund claims that are ultimately rejected will be spread across all risk classes for which there is a presumption of coverage for PTSD as an occupational disease.  Costs for treatment on self-insured claims that are ultimately rejected will be paid by the self-insured employer.

The Department and self-insured employers may authorize up to six additional PTSD treatment sessions within one year of claim closure, when necessary to maintain the employee's level of functioning at the time of claim closure.

The Department and self-insurers may enter into agreements with healthcare organizations and providers for workers to receive services and may modify administrative requirements such as documentation, timelines, reporting, or prior authorization for workers and treating providers participating in the pilot program.

Self-insured employers must produce upon request a report of all workers' compensation claims subject to the pilot.

If the pilot program provisions conflict with an existing statute, the pilot program supersedes the conflicting statute for the duration of the pilot.  The Department has rulemaking authority to implement the program.

By July 1, 2030, the Department will provide recommendations to the Legislature based on the pilot.