WSR 98-19-149

PROPOSED RULES

DEPARTMENT OF

LABOR AND INDUSTRIES

[Filed September 23, 1998, 11:50 a.m.]



Original Notice.

Preproposal statement of inquiry was filed as WSR 98-14-141.

Title of Rule: WAC 296-31-069 Independent assessments.

Purpose: To inform crime victims of the reasons that independent assessments can be ordered and to ensure that needed information is included in independent assessment report.

Statutory Authority for Adoption: RCW 7.68.030, 7.68.070.

Statute Being Implemented: Chapter 7.68 RCW, Crime Victims Act.

Summary: The rule was selected for priority intensive review in carrying out the Governor's Executive Order 97-02 on regulatory improvement. The conclusion of the review was that the rule should be rewritten so that it can be more easily understood.

Reasons Supporting Proposal: The conditions under which independent assessments can be requested and the information required on reports will be clearer to victims and service providers.

Name of Agency Personnel Responsible for Drafting, Implementation, and Enforcement: Cletus Nnanabu, CVC Program Manager, 7273 Linderson Way S.W., Tumwater, (360) 902-5340.

Name of Proponent: Washington State Department of Labor and Industries, governmental.

Rule is not necessitated by federal law, federal or state court decision.

Explanation of Rule, its Purpose, and Anticipated Effects: The rule defines conditions under which independent assessments can be requested and contains the information required in independent assessment reports. The rule was selected for priority intensive review as a result of a crime victims program stakeholder survey conducted in connection with the Governor's Executive Order 97-02 on regulatory improvement.

The conclusion following the intensive review was that the rule requires few substantive changes, but that it can be rewritten to be clearer to victims and to service providers. The purpose and anticipated effect is that the rule will be easier to understand to those parties.

Proposal Changes the Following Existing Rules: (1) An obsolete reason for requesting independent assessments is eliminated.

(2) An obsolete reporting requirement is eliminated.

(3) A thirty day time period for submitting independent assessment reports is added.

No small business economic impact statement has been prepared under chapter 19.85 RCW. The proposed amendments clarify the language of the rule without changing its effect. There are no additional compliance requirements creating costs to businesses.

RCW 34.05.328 does not apply to this rule adoption. The rule does not adopt a significant provision of law, does not pertain to a license or permit and does not adopt or significantly amend a policy or regulatory program.

Hearing Location: Labor and Industries Building, Room S216, 7273 Linderson Way S.W., Tumwater, WA, on October 27, 1998, at 1:30 p.m.

Assistance for Persons with Disabilities: Contact Nancy Reubens, by October 14, 1998, TDD (360) 902-5797, or 1-800-762-3716.

Submit Written Comments to: Brian Huseby, P.O. Box 44520, Olympia, WA 98506, fax (260) [360] 902-5333, e-mail HUSE235@LNI.WA.GOV, by November 2, 1998.

Date of Intended Adoption: December 1, 1998.

September 21, 1998

Gary Moore

Director

OTS-2265.4

AMENDATORY SECTION (Amending WSR 95-15-004, filed 7/5/95, effective 8/5/95)



WAC 296-31-069  ((Independent assessments.)) For what reasons may independent mental health or independent medical assessments be obtained? (((1) Independent assessments may be ordered by the department or requested of the department by the attending provider. Such assessments are usually ordered or requested after consultations for one of the following purposes:

(a) To establish a diagnosis. Prior diagnoses may be controversial or ill-defined.

(b) To outline the treatment rationale, where treatment or progress is vague or controversial.

(c) To establish therapeutic data to determine if the condition requiring treatment is related to conditions sustained and allowed by the department as a result of a specific criminal act.

(d) To determine the extent and duration of aggravation of any preexisting mental health condition.

(e) To establish when the claimant has reached maximum benefit from treatment.

(f) To establish a percentage rating of any permanent impairment, for mental health conditions when maximum recovery is reached.

(g) To determine indications for reopening of a claim for further treatment on basis of the aggravation of the accepted condition.

(h) To determine eligibility qualifications of claimants applying under RCW 7.68.060(3), the repressed memory provision of the Crime Victims Act.

(2) Independent assessments for mental health conditions may be ordered by claims adjudicators without supervisory approval to rate permanent impairment when treatment has been completed, to determine the department's responsibility for treatment that has been rendered retroactively where significant causal relationship questions exist and to determine eligibility qualifications of claimants applying under RCW 7.68.060(3), the repressed memory provision of the Crime Victims Act. All other reasons for ordering independent assessments for mental health conditions require supervisory approval.

(3) The following shall be reported by the assessing practitioner:

(a) Independent assessments must be specific and factual.

(b) The claimant's medical and mental health history must be checked for accuracy, variation or exaggeration compared to documented history provided to the examiner for this assessment.

(c) Diagnosis: Must be specific and describe the mental health condition and symptomatology found using DSM III-R, or DSM IV, and be substantiated by history.

(d) Conclusions: Must be specific and must definitely express an opinion concerning the purpose for which the assessment was requested, and should be consistent with the history and diagnosis reported.

(e) Permanent disability: Ratings must be supported by sufficient data to establish the category disability rating; also the report must demonstrate and articulate a definite causal relationship to the accepted condition(s) on a more probable than not basis.)) What is required in independent assessment reports?

(1) Independent medical and mental health assessments may be obtained when requested by the provider, or on the department's initiative, for the following reasons:

(a) To rate permanent impairment when treatment has been concluded; or

(b) To evaluate an application to reopen a claim; or

(c) To determine if there are conditions related to the effects of the crime or preexisting conditions aggravated by the crime for which the claim was filed and if treatment remains necessary for those conditions; or

(d) To determine if crime-related treatment is still necessary and if present treatment is effective; or

(e) To determine if treatment is still leading to recovery; or

(f) To obtain other information that may be necessary for the department to make decisions on the victim's claim.

(2) Practitioners participating in an independent mental health assessment ordered by the department must provide us with a report within thirty days following the last assessment date. The report must:

(a) Be identified as an independent assessment report;

(b) Be specific and factual;

(c) Specify the mental health condition(s) and symptoms found and their relationship to the crime for which the claim was filed. Use the codes contained in the currently accepted DSM;

(d) Provide specific conclusions drawn from the assessment and state opinions that respond to the questions included in the examination request;

(e) If applicable, include the category of permanent impairment that the assessor finds most nearly describes his or her findings.

(3) Independent medical assessment reports are governed by WAC 296-23-260.



[Statutory Authority: RCW 7.68.030, 51.04.020(1) and 51.04.030. 95-15-004, § 296-31-069, filed 7/5/95, effective 8/5/95. Statutory Authority: RCW 43.22.050. 92-23-033, § 296-31-069, filed 11/13/92, effective 12/14/92.]

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