H-3644              _______________________________________________

                                                   HOUSE BILL NO. 1611

                        _______________________________________________

State of Washington                              50th Legislature                              1988 Regular Session

By Representatives Sayan, Wang and Patrick

Read first time 1/20/88 and referred to Committee on Commerce & Labor.

AN ACT Relating to self-insured industrial insurance claims; and adding new sections to chapter 51.28 RCW.

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

NEW SECTION. Sec. 1.     (1) The self-insurer shall provide a copy of the employee's claim file at no cost upon request by the employee or the employee's representative within fifteen days of receipt of the request.  The self-insurer shall provide the entire contents of the claim file unless the request is for only a particular portion thereof.

          (2) The self-insurer shall provide notice of any protest by an employee relating to the administration of an industrial injury claim under this chapter which shall be transmitted by the end of the next working day to the department.  Failure of a self-insurer to comply with this notification requirement shall subject the self- insurer to the penalty provisions of RCW 51.48.017.

NEW SECTION. Sec. 2.     Self-insurers may require medical examinations, including panel examinations, of employees submitting a claim under this chapter only in the following circumstances:

          (1) To determine medical causal relationship questions upon the filing of a claim;

          (2) To determine issues relating to medical treatment of the claimant;

          (3) To determine issues relating to ability to work as governed by any restrictions imposed by the claimant's physician;

          (4) To determine questions concerning permanent partial disability or benefits at the conclusion of the claim evaluation process.

          Absent a change in the medical management of the claimant's condition, the self-insurer shall not require the claimant to undergo additional medical examinations during the pendency of the claim.

NEW SECTION. Sec. 3.     (1) Physicians who serve as members of a panel used by self-insurers to evaluate the medical condition of claimants under this chapter shall provide periodic notification as required by the department concerning compensation received for examinations performed or as witness fees or retainers in connection with all publicly administered benefit programs.

          (2) Physicians who serve as members of a panel established by self-insurers to evaluate the medical condition of claimants under this chapter shall be licensed to practice in the state of Washington, be engaged in the active practice of medicine, and possess such professional medical credentials as may be required by the department.

NEW SECTION. Sec. 4.     In carrying out their responsibilities to administer fairly the industrial insurance laws of this state as authorized under this chapter, self-insurers shall not restrict the ability of employees submitting claims under this chapter to choose the physician who will provide their medical care.

NEW SECTION. Sec. 5.     Any violation of sections 1 through 4 of this act or any rule adopted thereunder constitutes a violation of chapter  19.86 RCW.

NEW SECTION. Sec. 6.     Sections 1 through 5 of this act are each added to chapter 51.28 RCW.