WSR 13-02-022

INTERPRETIVE AND POLICY STATEMENT

DEPARTMENT OF

LABOR AND INDUSTRIES

[ Filed December 20, 2012, 3:06 p.m. ]

     Pursuant to RCW 34.05.230, following are policy and interpretive statements issued by the department of labor and industries regarding the insurance services division policies.

     If you have any questions or need additional information, please call Tamara Jones at (360) 902-6805.

     Insurance services division: Integrated claims services.

     Interim Policy 6.52: Authorizing vocational retraining programs.

     This policy applies whenever a department vocational services specialist (VSS) authorizes expenses in a vocational rehabilitation retraining plan. This policy is updated to reflect training benefit changes provided by the 2007 changes in the RCW 51.32.099 pilot project increasing time and money for retraining.

     Contact Nancy James, P.O. Box 44208, Olympia, WA 98504, (360) 902-4379, nancy.james@lni.wa.gov.

     Insurance services division: Integrated claims services.

     Interim Policy 1.35: Releasing claim information: Employer requests.

     This is an interim policy change to insurance services, claims administration, Policy 1.35, releasing claim information. Effective immediately, state fund and self-insured employers or their authorized representatives may review any claims of their own injured workers as long as there is a claim pending with the requesting employer. This includes claims against other employers regardless of whether the pending claim involves the same condition or area of the body.

     Contact Nancy James, P.O. Box 44208, Olympia, WA 98504, (360) 902-4379, nancy.james@lni.wa.gov.

     Insurance services division: Integrated claims services.

     Amended Policy 6.53: Authorizing housing and board for vocational retraining.

     This policy applies whenever a department vocational services specialist (VSS) authorizes board and lodging as part of an approved vocational rehabilitation retraining plan. This policy is updated to reflect current practice because responsibility for approving vocational retraining plans and housing and board expenses transitioned from claims' management staff to the department's vocational services specialist staff.

     Contact Nancy James, P.O. Box 44208, Olympia, WA 98504, (360) 902-4379, nancy.james@lni.wa.gov.

     Insurance services division: Integrated claims services.

     Amended Policy 6.54: Authorizing transportation for vocational retraining.

     This policy applies whenever the department or self-insured employer authorizes transportation in approved vocational rehabilitation retraining plans. This policy is updated to reflect the change in travel reimbursement in WAC 296-20-1103(4) (travel expense). The first and last fifteen miles of a round trip commute from a worker's residence to a training site will not be paid. Only mileage exceeding the fifteen miles from the worker's residence will be paid. The policy also reflects that temporarily relocated workers will not be reimbursed for weekend or holiday travel to and from the worker's permanent residence.

     Contact Nancy James, P.O. Box 44208, Olympia, WA 98504, (360) 902-4379, nancy.james@lni.wa.gov.

     Insurance services division: Integrated claims services.

     Amended Policy 13.07: Failure to appear for independent medical examinations.

     This policy applies when a worker of a state fund or self-insured employer fails to appear for an independent medical examination (IME). State law allows state fund and self-insured employers the authority to require workers to attend. The department pays providers for the exams, including any no-show fee. When a worker misses an exam, and fails to show "good cause," the department can assess a no-show fee to the worker. This policy provides interpretation of "good cause" (undefined in statute or rule) and provides guidance when to assess a no-show fee and guidance on how/when to collect it.

     Contact Nancy James, P.O. Box 44208, Olympia, WA 98504, (360) 902-4379, nancy.james@lni.wa.gov.

     Insurance services division: Integrated claims services.

     Amended Policy 15.01: Statutory pensions.

     This policy applies to claims of workers who may be entitled to statutory pensions resulting from an industrial injury or occupational disease. The policy has been updated for clarity. A statement has been added that partial disability award advances should not be granted because a worker entitled to a statutory pension will not receive a permanent partial disability award.

     Contact Nancy James, P.O. Box 44208, Olympia, WA 98504, (360) 902-4379, nancy.james@lni.wa.gov.

     Insurance services division: Employer services.

     New Policy 74.05: Correcting unappealed premium assessments, related penalties, interest, and/or warrants.

     This policy applies when correcting unappealed premium assessments, related penalties, interest, and/or warrants that have become final. The director or director's designee may adjust the amount of premium assessments, related penalties, interest, and/or warrants that have become final if recovery of these would be against equity and good conscience or if the final premium assessments were incorrect due to mistake, employer inadvertence or excusable neglect, or newly discovered facts by the department or employer. The request for adjustment must be made within three years of the date the department issued the premium assessment.

     Contact Nancy James, P.O. Box 44208, Olympia, WA 98504, (360) 902-4379, nancy.james@lni.wa.gov.

Tamara Jones

Assistant Director

of Legislative

and Government Affairs