BILL REQ. #:  S-3440.1 

Read first time 01/16/2004.   Referred to Committee on Commerce & Trade.

     AN ACT Relating to authorizing self-insurers to make claim decisions and actively participate in workers' compensation claims; amending RCW 51.04.020, 51.04.030, 51.04.040, 51.04.085, 51.08.040, 51.08.173, 51.14.110, 51.14.120, 51.14.130, 51.16.120, 51.24.030, 51.24.050, 51.24.060, 51.24.070, 51.24.080, 51.24.090, 51.28.010, 51.28.020, 51.28.030, 51.28.040, 51.28.055, 51.28.060, 51.28.070, 51.32.010, 51.32.040, 51.32.055, 51.32.060, 51.32.067, 51.32.075, 51.32.080, 51.32.095, 51.32.110, 51.32.130, 51.32.150, 51.32.160, 51.32.195, 51.32.210, 51.32.220, 51.32.225, 51.32.230, 51.32.240, 51.32.250, 51.36.010, 51.36.015, 51.36.020, 51.36.060, 51.36.070, 51.48.017, 51.48.040, 51.48.080, 51.52.050, 51.52.070, and 51.52.080; reenacting and amending RCW 51.52.060; adding new sections to chapter 51.14 RCW; repealing RCW 51.32.190; and providing an effective date.

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

Sec. 1   RCW 51.04.020 and 2000 c 5 s 14 are each amended to read as follows:
     (1) The director shall:
     (((1))) (a) Establish and adopt rules governing the administration of this title and the periodic auditing of self-insured employers under RCW 51.48.040 (4) through (6);
     (((2))) (b) Ascertain and establish the amounts to be paid into and out of the accident fund;
     (((3))) (c) Regulate the proof of accident and extent thereof, the proof of death and the proof of relationship and the extent of dependency;
     (((4))) (d) Supervise the medical, surgical, and hospital treatment to the intent that it may be in all cases efficient and up to the recognized standard of modern surgery;
     (((5))) (e) Issue proper receipts for moneys received and certificates for benefits accrued or accruing;
     (((6))) (f) Investigate the cause of all serious injuries and report to the governor from time to time any violations or laxity in performance of protective statutes or regulations coming under the observation of the department;
     (((7))) (g) Compile statistics which will afford reliable information upon which to base operations of all divisions under the department;
     (((8))) (h) Make an annual report to the governor of the workings of the department;
     (((9))) (i) Be empowered to enter into agreements with the appropriate agencies of other states relating to conflicts of jurisdiction where the contract of employment is in one state and injuries are received in the other state, and insofar as permitted by the Constitution and laws of the United States, to enter into similar agreements with the provinces of Canada; and
     (((10))) (j) Designate a medical director who is licensed under chapter 18.57 or 18.71 RCW.
     (2) Self-insured employers shall be vested with the powers and duties necessary to process all aspects of industrial injury or occupational disease claims of their injured workers without prior approval or consent of the department subject to the provisions of this title.

Sec. 2   RCW 51.04.030 and 1998 c 230 s 1 are each amended to read as follows:
     (1) The director shall supervise the providing of prompt and efficient care and treatment, including care provided by physician assistants governed by the provisions of chapters 18.57A and 18.71A RCW, acting under a supervising physician, and including chiropractic care, to workers injured during the course of their employment at the least cost consistent with promptness and efficiency, without discrimination or favoritism, and with as great uniformity as the various and diverse surrounding circumstances and locations of industries will permit and to that end shall, from time to time, establish and adopt and supervise the administration of printed forms, rules, ((regulations,)) and practices for the furnishing of such care and treatment((: PROVIDED, That)). However, the medical coverage decisions of the department do not constitute a "rule" as used in RCW 34.05.010(16), nor are such decisions subject to the rule-making provisions of chapter 34.05 RCW except that criteria for establishing medical coverage decisions shall be adopted by rule after consultation with the workers' compensation advisory committee established in RCW 51.04.110((: PROVIDED FURTHER, That)). The department or self-insurer, as the case may be, may recommend to an injured worker particular health care services and providers where specialized treatment is indicated or where cost-effective payment levels or rates are obtained by the department((: AND PROVIDED FURTHER, That)) or self-insurer. The department may enter into contracts for goods and services including, but not limited to, durable medical equipment so long as statewide access to quality service is maintained for injured workers.
     (2) The director shall, in consultation with interested persons, establish and, in his or her discretion, periodically change as may be necessary, and make available a fee schedule of the maximum charges to be made by any physician, surgeon, chiropractor, hospital, druggist, physicians' assistants as defined in chapters 18.57A and 18.71A RCW, acting under a supervising physician or other agency or person rendering services to injured workers. The department shall coordinate with other state purchasers of health care services to establish as much consistency and uniformity in billing and coding practices as possible, taking into account the unique requirements and differences between programs. No service covered under this title, including services provided to injured workers, whether aliens or other injured workers, who are not residing in the United States at the time of receiving the services, shall be charged or paid at a rate or rates exceeding those specified in such fee schedule, and no contract providing for greater fees shall be valid as to the excess. The establishment of such a schedule, exclusive of conversion factors, does not constitute "agency action" as used in RCW 34.05.010(3), nor does such a fee schedule constitute a "rule" as used in RCW 34.05.010(16).
     (3) The director or self-insurer, as the case may be, shall make a record of the commencement of every disability and the termination thereof and, when bills are rendered for the care and treatment of injured workers, shall approve and pay those which conform to the adopted rules, ((regulations,)) established fee schedules, and practices of the director and may reject any bill or item thereof incurred in violation of the principles laid down in this section or the rules, regulations, or the established fee schedules and rules and regulations adopted under it.

Sec. 3   RCW 51.04.040 and 1987 c 316 s 1 are each amended to read as follows:
     The director ((and his or her)), the director's authorized assistants ((shall have power to)), or the self-insurer, as the case may be, may issue subpoenas to enforce the attendance and testimony of witnesses and the production and examination of books, papers, photographs, tapes, and records before the department or self-insurer in connection with any claim made to the department or self-insurer, any billing submitted to the department or self-insurer, or the assessment or collection of premiums. The superior court shall have the power to enforce any such subpoena by proper proceedings.

Sec. 4   RCW 51.04.085 and 1977 ex.s. c 323 s 26 are each amended to read as follows:
     The department or the self-insurer, as the case may be, may, at any time, on receipt of written authorization, transmit amounts payable to a claimant, beneficiary, or any supplier of goods or services to the account of such person in a bank or other financial institution regulated by state or federal authority.

Sec. 5   RCW 51.08.040 and 1961 c 23 s 51.08.040 are each amended to read as follows:
     "Department" means the department of labor and industries, its director, and its director's appointees and employees.

Sec. 6   RCW 51.08.173 and 1983 c 174 s 1 are each amended to read as follows:
     "Self-insurer" or "self-insured employer" means an employer or group of employers which has been authorized under this title to carry its own liability to its employees covered by this title and includes their designated agents.

Sec. 7   RCW 51.14.110 and 1971 ex.s. c 289 s 35 are each amended to read as follows:
     Every self-insurer shall maintain a record of all payments of compensation made under this title. In the event of periodic audit by the department or protest by the injured worker, the self-insurer shall furnish to the ((director)) department all information ((he)) it has in ((his)) its possession ((as to any disputed claim)), upon forms approved by the ((director)) department.

Sec. 8   RCW 51.14.120 and 2001 c 152 s 1 are each amended to read as follows:
     (1) The self-insurer shall provide, when authorized under RCW 51.28.070, a copy of the employee's claim file at no cost within fifteen days of receipt of a request by the employee or the employee's representative, and shall provide the physician performing an examination with all relevant medical records from the worker's claim file, but only to the extent required of the department under RCW 51.36.070. If the self-insured employer determines that release of the claim file to an unrepresented worker in whole or in part((,)) may not be in the worker's best interests, the employer must ((submit a request for denial with)) issue an order under section 10 of this act that includes an explanation ((along with a copy of that portion of the claim file not previously provided within twenty days after the request from)) to the worker. In the case of second or subsequent requests, a reasonable charge for copying may be made. The self-insurer shall provide the entire contents of the claim file unless the request is for only a particular portion of the file. Any new material added to the claim file after the initial request shall be provided under the same terms and conditions as the initial request.
     (2) The self-insurer shall transmit notice to the department of any protest or appeal by an employee relating to the administration of an industrial injury or occupational disease claim under this chapter within five working days of receipt. The date that the protest or appeal is received by the self-insurer shall be deemed to be the date the protest is received by the department for the purpose of RCW 51.52.050.
     (((3) The self-insurer shall submit a medical report with the request for closure of a claim under this chapter.))

Sec. 9   RCW 51.14.130 and 1993 c 122 s 3 are each amended to read as follows:
     The self-insurer shall ((request allowance or denial of)) allow or deny a claim within sixty days from the date that the claim is filed((. If the self-insurer fails to act within sixty days, the department shall promptly intervene and adjudicate the claim)) unless extended for up to ninety days by notice to the worker for good cause.

NEW SECTION.  Sec. 10   A new section is added to chapter 51.14 RCW to read as follows:
     (1) Self-insured employers shall issue orders encompassing their claims decisions under the same circumstances and parameters and to the same force and effect as orders issued by the department so long as such orders conform to the requirements of RCW 51.52.050. This includes but is not limited to allowance, denial and reopening of claims, payment of monthly compensation, provision of medical care and treatment, specification of conditions allowed, denied, or segregated under the claim, closure of claims with or without award for permanent disability, reduction, suspension, or denial of benefits pursuant to RCW 51.32.110, and eligibility for vocational services pursuant to RCW 51.32.095.
     (2) If a worker or beneficiary requests reconsideration or appeals a self-insurer order, the department may reconsider the order under RCW 51.52.050, or may direct submission of further evidence under RCW 51.52.050 and 51.52.060. A subsequent order issued by the department may be appealed by any aggrieved party.

Sec. 11   RCW 51.16.120 and 1984 c 63 s 1 are each amended to read as follows:
     (1) Whenever a worker has a previous bodily disability from any previous injury or disease, whether known or unknown to the employer, and shall suffer a further disability from injury or occupational disease in employment covered by this title and become totally and permanently disabled from the combined effects thereof or die when death was substantially accelerated by the combined effects thereof, then the experience record of an employer insured with the state fund at the time of said further injury or disease shall be charged and a self-insured employer shall pay directly into the reserve fund only the accident cost which would have resulted solely from said further injury or disease, had there been no preexisting disability, and which accident cost shall be based upon an evaluation of the disability by medical experts. The difference between the charge thus assessed to such employer at the time of said further injury or disease and the total cost of the pension reserve shall be assessed against the second injury fund. The department shall pass upon the application of this section in all state fund cases where benefits are paid for total permanent disability or death and issue an order thereon appealable by the employer. Pending outcome of such appeal the transfer or payment shall be made as required by such order. In cases involving self-insurers, the department shall issue an order appealable by the employer passing on the application of this section within sixty days of a written request by the self-insurer. If the department fails to issue an order passing on the application of this section within sixty days, this section applies. When this section applies, the department shall reimburse the self-insurer from the second injury fund all monthly compensation paid to the worker or beneficiary beginning with the first date of permanent total disability or death of the worker.
     (2) The department shall, in cases of claims of workers sustaining injuries or occupational diseases in the employ of state fund employers, recompute the experience record of such employers when the claims of workers injured in their employ have been found to qualify for payments from the second injury fund after the regular time for computation of such experience records and the department may make appropriate adjustments in such cases including cash refunds or credits to such employers.
     (3) To encourage employment of injured workers who are not reemployed by the employer at the time of injury, the department may adopt rules providing for the reduction or elimination of premiums or assessments from subsequent employers of such workers and may also adopt rules for the reduction or elimination of charges against such employers in the event of further injury to such workers in their employ.

Sec. 12   RCW 51.24.030 and 1995 c 199 s 2 are each amended to read as follows:
     (1) If a third person, not in a worker's same employ, is or may become liable to pay damages on account of a worker's injury for which benefits and compensation are provided under this title, the injured worker or beneficiary may elect to seek damages from the third person.
     (2) In every action brought under this section, the plaintiff shall give notice to the department or self-insurer, as the case may be, when the action is filed. The department or self-insurer may file a notice of statutory interest in recovery. When such notice has been filed by the department or self-insurer, the parties shall thereafter serve copies of all notices, motions, pleadings, and other process on the department or self-insurer. The department or self-insurer may then intervene as a party in the action to protect its statutory interest in recovery.
     (3) For the purposes of this chapter, "injury" shall include any physical or mental condition, disease, ailment or loss, including death, for which compensation and benefits are paid or payable under this title.
     (4) Damages recoverable by a worker or beneficiary pursuant to the underinsured motorist coverage of an insurance policy shall be subject to this chapter only if the owner of the policy is the employer of the injured worker.
     (5) For the purposes of this chapter, "recovery" includes all damages except loss of consortium.

Sec. 13   RCW 51.24.050 and 1995 c 199 s 3 are each amended to read as follows:
     (1) An election not to proceed against the third person operates as an assignment of the cause of action to the department or self-insurer, as the case may be, which may prosecute or compromise the action in its discretion in the name of the injured worker, beneficiary or legal representative.
     (2) If an injury to a worker results in the worker's death, the department or self-insurer to which the cause of action has been assigned may petition a court for the appointment of a special personal representative for the limited purpose of maintaining an action under this chapter and chapter 4.20 RCW.
     (3) If a beneficiary is a minor child, an election not to proceed against a third person on such beneficiary's cause of action may be exercised by the beneficiary's legal custodian or guardian.
     (4) Any recovery made by the department or self-insurer shall be distributed as follows:
     (a) The department or self-insurer, as the case may be, shall be paid the expenses incurred in making the recovery including reasonable costs of legal services;
     (b) The injured worker or beneficiary shall be paid twenty-five percent of the balance of the recovery made, which shall not be subject to subsection (5) of this section: PROVIDED, That in the event of a compromise and settlement by the parties, the injured worker or beneficiary may agree to a sum less than twenty-five percent;
     (c) The department and/or self-insurer shall be paid the compensation and benefits paid to or on behalf of the injured worker or beneficiary by the department and/or self-insurer; and
     (d) The injured worker or beneficiary shall be paid any remaining balance.
     (5) Thereafter no payment shall be made to or on behalf of a worker or beneficiary by the department ((and/or)) or self-insurer, as the case may be, for such injury until the amount of any further compensation and benefits shall equal any such remaining balance. Thereafter, such benefits shall be paid by the department ((and/or)) or self-insurer, as the case may be, to or on behalf of the worker or beneficiary as though no recovery had been made from a third person.
     (6) When the cause of action has been assigned to the self-insurer and compensation and benefits have been paid and/or are payable from state funds for the same injury:
     (a) The prosecution of such cause of action shall also be for the benefit of the department to the extent of compensation and benefits paid and payable from state funds;
     (b) Any compromise or settlement of such cause of action which results in less than the entitlement under this title is void unless made with the written approval of the department;
     (c) The department shall be reimbursed for compensation and benefits paid from state funds;
     (d) The department shall bear its proportionate share of the costs and reasonable attorneys' fees incurred by the self-insurer in obtaining the award or settlement; and
     (e) Any remaining balance under subsection (4)(d) of this section shall be applied, under subsection (5) of this section, to reduce the obligations of the department and self-insurer to pay further compensation and benefits in proportion to which the obligations of each bear to the remaining entitlement of the worker or beneficiary.

Sec. 14   RCW 51.24.060 and 2001 c 146 s 9 are each amended to read as follows:
     (1) If the injured worker or beneficiary elects to seek damages from the third person, any recovery made shall be distributed as follows:
     (a) The costs and reasonable attorneys' fees shall be paid proportionately by the injured worker or beneficiary and the department and/or self-insurer((: PROVIDED, That)), as the case may be. However, the department and/or self-insurer may require court approval of costs and attorneys' fees or may petition a court for determination of the reasonableness of costs and attorneys' fees;
     (b) The injured worker or beneficiary shall be paid twenty-five percent of the balance of the award((: PROVIDED, That)). However, in the event of a compromise and settlement by the parties, the injured worker or beneficiary may agree to a sum less than twenty-five percent;
     (c) The department and/or self-insurer shall be paid the balance of the recovery made, but only to the extent necessary to reimburse the department and/or self-insurer for benefits paid;
     (i) The department and/or self-insurer shall bear its proportionate share of the costs and reasonable attorneys' fees incurred by the worker or beneficiary to the extent of the benefits paid under this title((: PROVIDED, That)). However, the department's and/or self-insurer's proportionate share shall not exceed one hundred percent of the costs and reasonable attorneys' fees;
     (ii) The department's and/or self-insurer's proportionate share of the costs and reasonable attorneys' fees shall be determined by dividing the gross recovery amount into the benefits paid amount and multiplying this percentage times the costs and reasonable attorneys' fees incurred by the worker or beneficiary;
     (iii) The department's and/or self-insurer's reimbursement share shall be determined by subtracting their proportionate share of the costs and reasonable attorneys' fees from the benefits paid amount;
     (d) Any remaining balance shall be paid to the injured worker or beneficiary; and
     (e) Thereafter no payment shall be made to or on behalf of a worker or beneficiary by the department and/or self-insurer for such injury until the amount of any further compensation and benefits shall equal any such remaining balance minus the department's and/or self-insurer's proportionate share of the costs and reasonable attorneys' fees in regards to the remaining balance. This proportionate share shall be determined by dividing the gross recovery amount into the remaining balance amount and multiplying this percentage times the costs and reasonable attorneys' fees incurred by the worker or beneficiary. Thereafter, such benefits shall be paid by the department and/or self-insurer to or on behalf of the worker or beneficiary as though no recovery had been made from a third person.
     (2) The recovery made shall be subject to a lien by the department and/or self-insurer for its share under this section.
     (3) The department or self-insurer, as the case may be, has sole discretion to compromise the amount of its lien. In deciding whether or to what extent to compromise its lien, the department or self-insurer shall consider at least the following:
     (a) The likelihood of collection of the award or settlement as may be affected by insurance coverage, solvency, or other factors relating to the third person;
     (b) Factual and legal issues of liability as between the injured worker or beneficiary and the third person. Such issues include but are not limited to possible contributory negligence and novel theories of liability; and
     (c) Problems of proof faced in obtaining the award or settlement.
     (4) In an action under this section, the self-insurer may act on behalf and for the benefit of the department to the extent of any compensation and benefits paid or payable from state funds.
     (5) It shall be the duty of the person to whom any recovery is paid before distribution under this section to advise the department or self-insurer, as the case may be, of the fact and amount of such recovery, the costs and reasonable attorneys' fees associated with the recovery, and to distribute the recovery in compliance with this section.
     (6) The distribution of any recovery made by award or settlement of the third party action shall be confirmed by ((department)) order of the department or self-insurer, as the case may be, served by registered or certified mail, and shall be subject to chapter 51.52 RCW. In the event the order of distribution becomes final under chapter 51.52 RCW, the ((director or the director's designee)) department or self-insurer, as the case may be, may file with the clerk of any county within the state a warrant in the amount of the sum representing the unpaid lien plus interest accruing from the date the order became final. The clerk of the county in which the warrant is filed shall immediately designate a superior court cause number for such warrant and the clerk shall cause to be entered in the judgment docket under the superior court cause number assigned to the warrant, the name of such worker or beneficiary mentioned in the warrant, the amount of the unpaid lien plus interest accrued and the date when the warrant was filed. The amount of such warrant as docketed shall become a lien upon the title to and interest in all real and personal property of the injured worker or beneficiary against whom the warrant is issued, the same as a judgment in a civil case docketed in the office of such clerk. The sheriff shall then proceed in the same manner and with like effect as prescribed by law with respect to execution or other process issued against rights or property upon judgment in the superior court. Such warrant so docketed shall be sufficient to support the issuance of writs of garnishment in favor of the department or self-insurer, as the case may be, in the manner provided by law in the case of judgment, wholly or partially unsatisfied. The clerk of the court shall be entitled to a filing fee under RCW 36.18.012(10), which shall be added to the amount of the warrant. A copy of such warrant shall be mailed to the injured worker or beneficiary within three days of filing with the clerk.
     (7) The ((director, or the director's designee,)) department or self-insurer, as the case may be, may issue to any person, firm, corporation, municipal corporation, political subdivision of the state, public corporation, or agency of the state, a notice and order to withhold and deliver property of any kind if he or she has reason to believe that there is in the possession of such person, firm, corporation, municipal corporation, political subdivision of the state, public corporation, or agency of the state, property which is due, owing, or belonging to any worker or beneficiary upon whom a warrant has been served by the department or self-insurer for payments due to the state fund or self-insurer. The notice and order to withhold and deliver shall be served by the sheriff of the county or by the sheriff's deputy; by certified mail, return receipt requested; or by any authorized representatives of the ((director)) department or self-insurer. Any person, firm, corporation, municipal corporation, political subdivision of the state, public corporation, or agency of the state upon whom service has been made shall answer the notice within twenty days exclusive of the day of service, under oath and in writing, and shall make true answers to the matters inquired of in the notice and order to withhold and deliver. In the event there is in the possession of the party named and served with such notice and order, any property which may be subject to the claim of the department or self-insurer, such property shall be delivered forthwith to the ((director or the director's authorized representative)) department or self-insurer, as the case may be, upon demand. If the party served and named in the notice and order fails to answer the notice and order within the time prescribed in this section, the court may, after the time to answer such order has expired, render judgment by default against the party named in the notice for the full amount claimed by the director or self-insurer in the notice together with costs. In the event that a notice to withhold and deliver is served upon an employer and the property found to be subject thereto is wages, the employer may assert in the answer to all exemptions provided for by chapter 6.27 RCW to which the wage earner may be entitled.

Sec. 15   RCW 51.24.070 and 1984 c 218 s 6 are each amended to read as follows:
     (1) The department or self-insurer, as the case may be, may require the injured worker or beneficiary to exercise the right of election under this chapter by serving a written demand by registered mail, certified mail, or personal service on the worker or beneficiary.
     (2) Unless an election is made within sixty days of the receipt of the demand, and unless an action is instituted or settled within the time granted by the department or self-insurer, the injured worker or beneficiary is deemed to have assigned the action to the department or self-insurer, as the case may be. The department or self-insurer shall allow the worker or beneficiary at least ninety days from the election to institute or settle the action. When a beneficiary is a minor child the demand shall be served upon the legal custodian or guardian of such beneficiary.
     (3) If an action which has been filed is not diligently prosecuted, the department or self-insurer, as the case may be, may petition the court in which the action is pending for an order assigning the cause of action to the department or self-insurer. Upon a sufficient showing of a lack of diligent prosecution the court in its discretion may issue the order.
     (4) If the department or self-insurer has taken an assignment of the third party cause of action under subsection (2) of this section, the injured worker or beneficiary may, at the discretion of the department or self-insurer, exercise a right of reelection and assume the cause of action subject to reimbursement of litigation expenses incurred by the department or self-insurer.

Sec. 16   RCW 51.24.080 and 1977 ex.s. c 85 s 6 are each amended to read as follows:
     (1) If the injured worker or beneficiary elects to seek damages from the third person, notice of the election must be given to the department or self-insurer, as the case may be. The notice shall be by registered mail, certified mail, or personal service. If an action is filed by the injured worker or beneficiary, a copy of the complaint must be sent by registered mail to the department or self-insurer, as the case may be.
     (2) A return showing service of the notice on the department or self-insurer shall be filed with the court but shall not be part of the record except as necessary to give notice to the defendant of the lien imposed by RCW 51.24.060(2).

Sec. 17   RCW 51.24.090 and 1995 c 199 s 5 are each amended to read as follows:
     (1) Any compromise or settlement of the third party cause of action by the injured worker or beneficiary which results in less than the entitlement under this title is void unless made with the written approval of the department or self-insurer((: PROVIDED, That)), as the case may be. However, for the purposes of this chapter, "entitlement" means benefits and compensation paid and estimated by the department or self-insurer, as the case may be, to be paid in the future.
     (2) If a compromise or settlement is void because of subsection (1) of this section, the department or self-insurer, as the case may be, may petition the court in which the action was filed for an order assigning the cause of action to the department or self-insurer. If an action has not been filed, the department or self-insurer may proceed as provided in chapter 7.24 RCW.

Sec. 18   RCW 51.28.010 and 2001 c 231 s 1 are each amended to read as follows:
     (1) Whenever any accident occurs to any worker it shall be the duty of such worker or someone in his or her behalf to forthwith report such accident to his or her employer, superintendent, or supervisor in charge of the work, and of the employer to at once report such accident and the injury resulting therefrom to the department pursuant to RCW 51.28.025 where the worker has received treatment from a physician, has been hospitalized, disabled from work, or has died as the apparent result of such accident and injury.
     (2) Upon receipt of such notice of accident, the department or self-insurer, as the case may be, shall immediately forward to the worker or his or her beneficiaries or dependents notification, in nontechnical language, of their rights under this title. The notice must specify the worker's right to receive health services from a physician of the worker's choice under RCW 51.36.010, including chiropractic services under RCW 51.36.015, and must list the types of providers authorized to provide these services. The notice must be given on department forms.

Sec. 19   RCW 51.28.020 and 2001 c 231 s 2 are each amended to read as follows:
     (1)(((a))) Where a worker is entitled to compensation under this title he or she shall file with the department or his or her self-insured employer, as the case may be, his or her application for such, together with the certificate of the physician who attended him or her. An application form developed by the department shall include a notice specifying the worker's right to receive health services from a physician of the worker's choice under RCW 51.36.010, including chiropractic services under RCW 51.36.015, and listing the types of providers authorized to provide these services.
     (((b))) (2) The physician who attended the injured worker shall inform the injured worker of his or her rights under this title and lend all necessary assistance in making this application for compensation and such proof of other matters as required by the rules of the department without charge to the worker. The department shall provide physicians with a manual which outlines the procedures to be followed in applications for compensation involving occupational diseases, and which describes claimants' rights and responsibilities related to occupational disease claims.
     (((2) If application for compensation is made to a self-insured employer, he or she shall forthwith send a copy of the application to the department.))

Sec. 20   RCW 51.28.030 and 1972 ex.s. c 43 s 17 are each amended to read as follows:
     Where death results from injury the parties entitled to compensation under this title, or someone in their behalf, shall make application for the same to the department or self-insurer as the case may be, which application must be accompanied with proof of death and proof of relationship showing the parties to be entitled to compensation under this title, certificates of attending physician, if any, and such proof as required by the rules of the department.
     Upon receipt of notice of accident under RCW 51.28.010, the director or self-insurer, as the case may be, shall immediately forward to the party or parties required to make application for compensation under this section, notification on department forms, in nontechnical language, of their rights under this title.

Sec. 21   RCW 51.28.040 and 1977 ex.s. c 199 s 1 are each amended to read as follows:
     If change of circumstances warrants an increase or rearrangement of compensation, like application shall be made therefor to the department or self-insurer, as the case may be. Where the application has been granted, compensation and other benefits if in order shall be allowed for periods of time up to sixty days prior to the receipt of such application.

Sec. 22   RCW 51.28.055 and 2003 2nd sp.s. c 2 s 1 are each amended to read as follows:
     (1) Except as provided in subsection (2) of this section for claims filed for occupational hearing loss, claims for occupational disease or infection to be valid and compensable must be filed within two years following the date the worker had written notice from a physician: (a) Of the existence of his or her occupational disease, and (b) that a claim for disability benefits may be filed. The notice shall also contain a statement that the worker has two years from the date of the notice to file a claim. If the employer is self-insured, the physician shall file the notice with the self-insurer. If the employer is a state fund employer, the physician shall file the notice with the department. The department or self-insurer shall send a copy to the worker ((and to the self-insurer if the worker's employer is self-insured)). However, a claim is valid if it is filed within two years from the date of death of the worker suffering from an occupational disease.
     (2)(a) Except as provided in (b) of this subsection, to be valid and compensable, claims for hearing loss due to occupational noise exposure must be filed within two years of the date of the worker's last injurious exposure to occupational noise in employment covered under this title or within one year of September 10, 2003, whichever is later.
     (b) A claim for hearing loss due to occupational noise exposure that is not timely filed under (a) of this subsection can only be allowed for medical aid benefits under chapter 51.36 RCW.
     (3) The department may adopt rules to implement this section.

Sec. 23   RCW 51.28.060 and 1977 ex.s. c 350 s 35 are each amended to read as follows:
     A dependent shall at all times furnish the department or self-insurer, as the case may be, with proof satisfactory to the ((director)) department or self-insurer of the nature, amount and extent of the contribution made by the deceased worker.
     Proof of dependency by any beneficiary residing without the United States shall be made before the nearest United States consul or consular agency, under the seal of such consul or consular agent, and the department or self-insurer may cause any warrant or warrants to which such beneficiary is entitled to be transmitted to the beneficiary through the nearest United States consul or consular agent.

Sec. 24   RCW 51.28.070 and 1990 c 209 s 2 are each amended to read as follows:
     Information contained in the claim files and records of injured workers, under the provisions of this title, shall be deemed confidential and shall not be open to public inspection (other than to public employees in the performance of their official duties), but representatives of a claimant, be it an individual or an organization, may review a claim file or receive specific information therefrom upon the presentation of the signed authorization of the claimant. A claimant may review his or her claim file if the ((director)) department or self-insurer, as the case may be, determines, pursuant to criteria adopted by rule, that the review is in the claimant's interest. Employers or their duly authorized representatives may review any files of their own injured workers in connection with any pending claims. Physicians treating or examining workers claiming benefits under this title, or physicians giving medical advice to the department or self-insurer regarding any claim may, at the discretion of the department or self-insurer, inspect the claim files and records of injured workers, and other persons may make such inspection, at the department's or self-insurer's discretion, when such persons are rendering assistance to the department or self-insurer at any stage of the proceedings on any matter pertaining to the administration of this title.

Sec. 25   RCW 51.32.010 and 1977 ex.s. c 350 s 37 are each amended to read as follows:
     Each worker injured in the course of his or her employment, or his or her family or dependents in case of death of the worker, shall receive compensation in accordance with this chapter, and, except as in this title otherwise provided, such payment shall be in lieu of any and all rights of action whatsoever against any person whomsoever((: PROVIDED, That)). However, if an injured worker, or the surviving spouse of an injured worker shall not have the legal custody of a child for, or on account of whom payments are required to be made under this title, such payment or payments shall be made to the person or persons having the legal custody of such child but only for the periods of time after the department or self-insurer, as the case may be, has been notified of the fact of such legal custody, and it shall be the duty of any such person or persons receiving payments because of legal custody of any child immediately to notify the department or self-insurer, as the case may be, of any change in such legal custody.

Sec. 26   RCW 51.32.040 and 2003 c 379 s 27 are each amended to read as follows:
     (1) Except as provided in RCW 43.20B.720, 72.09.111, 74.20A.260, and 51.32.380, no money paid or payable under this title shall, before the issuance and delivery of the check or warrant, be assigned, charged, or taken in execution, attached, garnished, or pass or be paid to any other person by operation of law, any form of voluntary assignment, or power of attorney. Any such assignment or charge is void unless the transfer is to a financial institution at the request of a worker or other beneficiary and made in accordance with RCW 51.32.045.
     (2)(a) If any worker suffers (i) a permanent partial injury and dies from some other cause than the accident which produced the injury before he or she receives payment of the award for the permanent partial injury or (ii) any other injury before he or she receives payment of any monthly installment covering any period of time before his or her death, the amount of the permanent partial disability award or the monthly payment, or both, shall be paid to the surviving spouse or the child or children if there is no surviving spouse. If there is no surviving spouse and no child or children, the award or the amount of the monthly payment shall be paid by the department or self-insurer, as the case may be, and distributed consistent with the terms of the decedent's will or, if the decedent dies intestate, consistent with the terms of RCW 11.04.015.
     (b) If any worker suffers an injury and dies from it before he or she receives payment of any monthly installment covering time loss for any period of time before his or her death, the amount of the monthly payment shall be paid to the surviving spouse or the child or children if there is no surviving spouse. If there is no surviving spouse and no child or children, the amount of the monthly payment shall be paid by the department or self-insurer, as the case may be, and distributed consistent with the terms of the decedent's will or, if the decedent dies intestate, consistent with the terms of RCW 11.04.015.
     (c) Any application for compensation under this subsection (2) shall be filed with the department or self-insuring employer, as the case may be, within one year of the date of death. The department or self-insurer may satisfy its responsibilities under this subsection (2) by sending any payment due in the name of the decedent and to the last known address of the decedent.
     (3)(a) Any worker or beneficiary receiving benefits under this title who is subsequently confined in, or who subsequently becomes eligible for benefits under this title while confined in, any institution under conviction and sentence shall have all payments of the compensation canceled during the period of confinement. After discharge from the institution, payment of benefits due afterward shall be paid if the worker or beneficiary would, except for the provisions of this subsection (3), otherwise be entitled to them.
     (b) If any prisoner is injured in the course of his or her employment while participating in a work or training release program authorized by chapter 72.65 RCW and is subject to the provisions of this title, he or she is entitled to payments under this title, subject to the requirements of chapter 72.65 RCW, unless his or her participation in the program has been canceled, or unless he or she is returned to a state correctional institution, as defined in RCW 72.65.010(3), as a result of revocation of parole or new sentence.
     (c) If the confined worker has any beneficiaries during the confinement period during which benefits are canceled under (a) or (b) of this subsection, they shall be paid directly the monthly benefits which would have been paid to the worker for himself or herself and the worker's beneficiaries had the worker not been confined.
     (4) Any lump sum benefits to which a worker would otherwise be entitled but for the provisions of this section shall be paid on a monthly basis to his or her beneficiaries.

Sec. 27   RCW 51.32.055 and 1997 c 416 s 1 are each amended to read as follows:
     (1) One purpose of this title is to restore the injured worker as nearly as possible to the condition of self-support as an able-bodied worker. Claims shall be closed and benefits for permanent disability shall be determined ((under the director's supervision, except as otherwise authorized in subsection (9) of this section,)) only after the injured worker's condition becomes fixed or the worker has abandoned the claim.
     (2) ((All determinations of permanent disabilities shall be made by the department, except as otherwise authorized in subsection (9) of this section. Either the worker, employer, or self-insurer may make a request or the inquiry may be initiated by the director or, as authorized in subsection (9) of this section, by the self-insurer on the director or the self-insurer's own motion. Determinations shall be required in every instance where permanent disability is likely to be present. All medical reports and other pertinent information in the possession of or under the control of the employer or, if the self-insurer has made a request to the department, in the possession of or under the control of the self-insurer shall be forwarded to the director with the request.
     (3) A request for determination of permanent disability shall be examined by the department or, if authorized in subsection (9) of this section, the self-insurer, and the department shall issue an order in accordance with RCW 51.52.050 or, in the case of a self-insured employer, the self-insurer may: (a) Enter a written order, communicated to the worker and the department self-insurance section in accordance with subsection (9) of this section, or (b) request the department to issue an order in accordance with RCW 51.52.050.
     (4) The department or, in cases authorized in subsection (9) of this section, the self-insurer may require that the worker present himself or herself for a special medical examination by a physician or physicians selected by the department, and the department or, in cases authorized in subsection (9) of this section,)) The department or the self-insurer, as the case may be, may require that the worker present himself or herself for a special medical examination by a physician or physicians selected by the department or the self-insurer and may require that the worker present himself or herself for a personal interview. The costs of the examination or interview, including payment of any reasonable travel expenses, shall be paid by the department or self-insurer, as the case may be.
     (((5) The director may establish a medical bureau within the department to perform medical examinations under this section. Physicians hired or retained for this purpose shall be grounded in industrial medicine and in the assessment of industrial physical impairment. Self-insurers shall bear a proportionate share of the cost of the medical bureau in a manner to be determined by the department.
     (6) Where a dispute arises from the handling of any claim before the condition of the injured worker becomes fixed, the worker, employer, or self-insurer may request the department to resolve the dispute or the director may initiate an inquiry on his or her own motion. In these cases, the department shall proceed as provided in this section and an order shall issue in accordance with RCW 51.52.050.
     (7)(a) If a claim (i) is accepted by a self-insurer after June 30, 1986, and before August 1, 1997, (ii) involves only medical treatment and the payment of temporary disability compensation under RCW 51.32.090 or only the payment of temporary disability compensation under RCW 51.32.090, (iii) at the time medical treatment is concluded does not involve permanent disability, (iv) is one with respect to which the department has not intervened under subsection (6) of this section, and (v) the injured worker has returned to work with the self-insured employer of record, whether at the worker's previous job or at a job that has comparable wages and benefits, the claim may be closed by the self-insurer, subject to reporting of claims to the department in a manner prescribed by department rules adopted under chapter 34.05 RCW.
     (b) All determinations of permanent disability for claims accepted under this subsection (7) by self-insurers shall be made by the self-insured section of the department under subsections (1) through (4) of this section.
     (c) Upon closure of a claim under (a) of this subsection, the self-insurer shall enter a written order, communicated to the worker and the department self-insurance section, which contains the following statement clearly set forth in bold face type: "This order constitutes notification that your claim is being closed with medical benefits and temporary disability compensation only as provided, and with the condition you have returned to work with the self-insured employer. If for any reason you disagree with the conditions or duration of your return to work or the medical benefits or the temporary disability compensation that has been provided, you must protest in writing to the department of labor and industries, self-insurance section, within sixty days of the date you received this order."
     (8)(a) If a claim (i) is accepted by a self-insurer after June 30, 1990, and before August 1, 1997, (ii) involves only medical treatment, (iii) does not involve payment of temporary disability compensation under RCW 51.32.090, and (iv) at the time medical treatment is concluded does not involve permanent disability, the claim may be closed by the self-insurer, subject to reporting of claims to the department in a manner prescribed by department rules adopted under chapter 34.05 RCW. Upon closure of a claim, the self-insurer shall enter a written order, communicated to the worker, which contains the following statement clearly set forth in bold-face type: "This order constitutes notification that your claim is being closed with medical benefits only, as provided. If for any reason you disagree with this closure, you must protest in writing to the Department of Labor and Industries, Olympia, within 60 days of the date you received this order. The department will then review your claim and enter a further determinative order."
     (b) All determinations of permanent disability for claims accepted under this subsection (8) by self-insurers shall be made by the self- insured section of the department under subsections (1) through (4) of this section.
     (9)(a) If a claim: (i) Is accepted by a self-insurer after July 31, 1997; (ii)(A) involves only medical treatment, or medical treatment and the payment of temporary disability compensation under RCW 51.32.090, and a determination of permanent partial disability, if applicable, has been made by the self-insurer as authorized in this subsection; or (B) involves only the payment of temporary disability compensation under RCW 51.32.090 and a determination of permanent partial disability, if applicable, has been made by the self-insurer as authorized in this subsection; (iii) is one with respect to which the department has not intervened under subsection (6) of this section; and (iv) concerns an injured worker who has returned to work with the self-insured employer of record, whether at the worker's previous job or at a job that has comparable wages and benefits, the claim may be closed by the self-insurer, subject to reporting of claims to the department in a manner prescribed by department rules adopted under chapter 34.05 RCW.
     (b) If a physician submits a report to the self-insurer that concludes that the worker's condition is fixed and stable and supports payment of a permanent partial disability award, and if within fourteen days from the date the self-insurer mailed the report to the attending or treating physician, the worker's attending or treating physician disagrees in writing that the worker's condition is fixed and stable, the self-insurer must get a supplemental medical opinion from a provider on the department's approved examiner's list before closing the claim. In the alternative, the self-insurer may forward the claim to the department, which must review the claim and enter a final order as provided for in RCW 51.52.050.
     (c) Upon closure of a claim under this subsection (9), the self-insurer shall enter a written order, communicated to the worker and the department self-insurance section, which contains the following statement clearly set forth in bold-face type: "This order constitutes notification that your claim is being closed with such medical benefits and temporary disability compensation as provided to date and with such award for permanent partial disability, if any, as set forth below, and with the condition that you have returned to work with the self-insured employer. If for any reason you disagree with the conditions or duration of your return to work or the medical benefits, temporary disability compensation provided, or permanent partial disability that has been awarded, you must protest in writing to the Department of Labor and Industries, Self-Insurance Section, within sixty days of the date you received this order. If you do not protest this order to the department, this order will become final."
     (d) All determinations of permanent partial disability for claims accepted by self-insurers under this subsection (9) may be made by the self-insurer or the self-insurer may request a determination by the self-insured section of the department. All determinations shall be made under subsections (1) through (4) of this section.
     (10) If the department receives a protest of an order issued by a self-insurer under subsections (7) through (9) of this section, the self-insurer's closure order must be held in abeyance. The department shall review the claim closure action and enter a further determinative order as provided for in RCW 51.52.050. If no protest is timely filed, the closing order issued by the self-insurer shall become final and shall have the same force and effect as a department order that has become final under RCW 51.52.050.
     (11) If within two years of claim closure under subsections (7) through (9) of this section, the department determines that the self-insurer has made payment of benefits because of clerical error, mistake of identity, or innocent misrepresentation or the department discovers a violation of the conditions of claim closure, the department may require the self-insurer to correct the benefits paid or payable. This subsection (11) does not limit in any way the application of RCW 51.32.240.
     (12) For the purposes of this section, "comparable wages and benefits" means wages and benefits that are at least ninety-five percent of the wages and benefits received by the worker at the time of injury.))

Sec. 28   RCW 51.32.060 and 1993 c 521 s 2 are each amended to read as follows:
     (1) When the ((supervisor of industrial insurance shall)) department or the self-insurer, as the case may be, determines that permanent total disability results from the injury, the worker shall receive monthly during the period of such disability:
     (a) If married at the time of injury, sixty-five percent of his or her wages but not less than two hundred fifteen dollars per month.
     (b) If married with one child at the time of injury, sixty-seven percent of his or her wages but not less than two hundred fifty-two dollars per month.
     (c) If married with two children at the time of injury, sixty-nine percent of his or her wages but not less than two hundred eighty-three dollars.
     (d) If married with three children at the time of injury, seventy-one percent of his or her wages but not less than three hundred six dollars per month.
     (e) If married with four children at the time of injury, seventy-three percent of his or her wages but not less than three hundred twenty-nine dollars per month.
     (f) If married with five or more children at the time of injury, seventy-five percent of his or her wages but not less than three hundred fifty-two dollars per month.
     (g) If unmarried at the time of the injury, sixty percent of his or her wages but not less than one hundred eighty-five dollars per month.
     (h) If unmarried with one child at the time of injury, sixty-two percent of his or her wages but not less than two hundred twenty-two dollars per month.
     (i) If unmarried with two children at the time of injury, sixty-four percent of his or her wages but not less than two hundred fifty-three dollars per month.
     (j) If unmarried with three children at the time of injury, sixty-six percent of his or her wages but not less than two hundred seventy-six dollars per month.
     (k) If unmarried with four children at the time of injury, sixty-eight percent of his or her wages but not less than two hundred ninety-nine dollars per month.
     (l) If unmarried with five or more children at the time of injury, seventy percent of his or her wages but not less than three hundred twenty-two dollars per month.
     (2) For any period of time where both husband and wife are entitled to compensation as temporarily or totally disabled workers, only that spouse having the higher wages of the two shall be entitled to claim their child or children for compensation purposes.
     (3) In case of permanent total disability, if the character of the injury is such as to render the worker so physically helpless as to require the hiring of the services of an attendant, the department shall make monthly payments to such attendant for such services as long as such requirement continues, but such payments shall not obtain or be operative while the worker is receiving care under or pursuant to the provisions of chapter 51.36 RCW and RCW 51.04.105.
     (4) Should any further accident result in the permanent total disability of an injured worker, he or she shall receive the pension to which he or she would be entitled, notwithstanding the payment of a lump sum for his or her prior injury.
     (5) In no event shall the monthly payments provided in this section exceed the applicable percentage of the average monthly wage in the state as computed under the provisions of RCW 51.08.018 as follows:

Sec. 29   RCW 51.32.067 and 1986 c 58 s 4 are each amended to read as follows:
     (1) After a worker elects one of the options in (a), (b), or (c) of this subsection, that option shall apply only if the worker dies during a period of permanent total disability from a cause unrelated to the injury, leaving a surviving spouse, child, children, or other dependent. If, after making an election under this subsection, a worker dies from a cause related to the injury during a period of permanent total disability, his or her beneficiaries shall receive benefits under RCW 51.32.050 (2) through (5).
     (a) Option I. An injured worker selecting this option shall receive the benefits provided by RCW 51.32.060, with no benefits being paid to the worker's surviving spouse, children, or others.
     (b) Option II. An injured worker selecting this option shall receive an actuarially reduced benefit which upon death shall be continued throughout the life of and paid to the surviving spouse, child, or other dependent as the worker has nominated by written designation duly executed and filed with the department or self-insurer, as the case may be.
     (c) Option III. An injured worker selecting this option shall receive an actuarially reduced benefit and, upon death, one-half of the reduced benefit shall be continued throughout the life of and paid to the surviving spouse, child, or other dependent as the worker has nominated by written designation duly executed and filed with the department or self-insurer, as the case may be.
     (2) The worker shall make the election in writing and the worker's spouse, if any, shall consent in writing as a prerequisite to the election of Option I.
     (3) The department shall adopt such rules as may be necessary to implement this section.

Sec. 30   RCW 51.32.075 and 1988 c 161 s 7 are each amended to read as follows:
     The compensation or death benefits payable pursuant to the provisions of this chapter for temporary total disability, permanent total disability, or death arising out of injuries or occupational diseases shall be adjusted as follows:
     (1) On July 1, 1982, there shall be an adjustment for those whose right to compensation was established on or after July 1, 1971, and before July 1, 1982. The adjustment shall be determined by multiplying the amount of compensation to which they are entitled by a fraction, the denominator of which shall be the average monthly wage in the state under RCW 51.08.018 for the fiscal year in which such person's right to compensation was established, and the numerator of which shall be the average monthly wage in the state under RCW 51.08.018 on July 1, 1982.
     (2) In addition to the adjustment established by subsection (1) of this section, there shall be another adjustment on July 1, 1983, for those whose right to compensation was established on or after July 1, 1971, and before July 1983, which shall be determined by multiplying the amount of compensation to which they are entitled by a fraction, the denominator of which shall be the average monthly wage in the state under RCW 51.08.018 for the fiscal year in which such person's right to compensation was established, and the numerator of which shall be the average monthly wage in the state under RCW 51.08.018 on July 1, 1983.
     (3) In addition to the adjustments under subsections (1) and (2) of this section, further adjustments shall be made beginning on July 1, 1984, and on each July 1st thereafter for those whose right to compensation was established on or after July 1, 1971. The adjustment shall be determined by multiplying the amount of compensation to which they are entitled by a fraction, the denominator of which shall be the average monthly wage in the state under RCW 51.08.018 for the fiscal year in which such person's right to compensation was established, and the numerator of which shall be the average monthly wage in the state under RCW 51.08.018 on July 1st of the year in which the adjustment is being made. The department or self-insurer, as the case may be, shall adjust the resulting compensation rate to the nearest whole cent, not to exceed the average monthly wage in the state as computed under RCW 51.08.018.

Sec. 31   RCW 51.32.080 and 1993 c 520 s 1 are each amended to read as follows:
     (1)(a) Until July 1, 1993, for the permanent partial disabilities here specifically described, the injured worker shall receive compensation as follows:

Sec. 32   RCW 51.32.095 and 1999 c 110 s 1 are each amended to read as follows:
     (1) One of the primary purposes of this title is to enable the injured worker to become employable at gainful employment. To this end, the department or self-insurers, as the case may be, shall utilize the services of individuals and organizations, public or private, whose experience, training, and interests in vocational rehabilitation and retraining qualify them to lend expert assistance ((to the supervisor of industrial insurance)) in such programs of vocational rehabilitation as may be reasonable to make the worker employable consistent with his or her physical and mental status. ((Where, after evaluation and recommendation by such individuals or organizations and prior to final evaluation of the worker's permanent disability and in the sole opinion of the supervisor or supervisor's designee, whether or not medical treatment has been concluded, vocational rehabilitation is both necessary and likely to enable the injured worker to become employable at gainful employment, the supervisor or supervisor's designee may, in his or her sole discretion, pay or, if the employer is a self-insurer, direct the self-insurer to pay the cost as provided in subsection (3) of this section.)) The department or self-insurer, as the case may be, may pay the costs as provided in subsection (3) of this section if vocational rehabilitation is both necessary and likely to enable the injured worker to become employable at gainful employment. Such costs may be approved before final evaluation of the worker's permanent disability, whether or not medical treatment has been concluded.
     (2) When in the ((sole)) discretion of the ((supervisor or the supervisor's designee)) department or self-insurer, as the case may be, vocational rehabilitation is both necessary and likely to make the worker employable at gainful employment, then the following order of priorities shall be used:
     (a) Return to the previous job with the same employer;
     (b) Modification of the previous job with the same employer including transitional return to work;
     (c) A new job with the same employer in keeping with any limitations or restrictions;
     (d) Modification of a new job with the same employer including transitional return to work;
     (e) Modification of the previous job with a new employer;
     (f) A new job with a new employer or self-employment based upon transferable skills;
     (g) Modification of a new job with a new employer;
     (h) A new job with a new employer or self-employment involving on-the-job training;
     (i) Short-term retraining and job placement.
     (3)(a) Except as provided in (b) of this subsection, costs for vocational rehabilitation benefits allowed ((by the supervisor or supervisor's designee)) under subsection (1) of this section may include the cost of books, tuition, fees, supplies, equipment, transportation, child or dependent care, and other necessary expenses for any such worker in an amount not to exceed three thousand dollars in any fifty-two week period ((except as authorized by RCW 51.60.060)), and the cost of continuing the temporary total disability compensation under RCW 51.32.090 while the worker is actively and successfully undergoing a formal program of vocational rehabilitation.
     (b) Beginning with vocational rehabilitation plans approved on or after July 1, 1999, costs for vocational rehabilitation benefits allowed ((by the supervisor or supervisor's designee)) under subsection (1) of this section may include the cost of books, tuition, fees, supplies, equipment, child or dependent care, and other necessary expenses for any such worker in an amount not to exceed four thousand dollars in any fifty-two week period ((except as authorized by RCW 51.60.060)), and the cost of transportation and continuing the temporary total disability compensation under RCW 51.32.090 while the worker is actively and successfully undergoing a formal program of vocational rehabilitation.
     (c) The expenses allowed under (a) or (b) of this subsection may include training fees for on-the-job training and the cost of furnishing tools and other equipment necessary for self-employment or reemployment. However, compensation or payment of retraining with job placement expenses under (a) or (b) of this subsection may not be authorized for a period of more than fifty-two weeks, except that such period may, in the sole discretion of the ((supervisor after his or her review)) department or self-insurer, as the case may be, be extended for an additional fifty-two weeks or portion thereof by written order of the ((supervisor)) department or self-insurer, as the case may be.
     (d) In cases where the worker is required to reside away from his or her customary residence, the reasonable cost of board and lodging shall also be paid.
     (e) Costs paid under this subsection shall be chargeable to the employer's cost experience or shall be paid by the self-insurer as the case may be.
     (4) In addition to the vocational rehabilitation expenditures provided for under subsection (3) of this section, an additional five thousand dollars may, upon authorization of the ((supervisor or the supervisor's designee)) department or self-insurer, as the case may be, be expended for: (a) Accommodations for an injured worker that are medically necessary for the worker to participate in an approved retraining plan; and (b) accommodations necessary to perform the essential functions of an occupation in which an injured worker is seeking employment, consistent with the retraining plan or the recommendations of a vocational evaluation. The injured worker's attending physician must verify the necessity of the modifications or accommodations. The total expenditures authorized in this subsection and the expenditures authorized under RCW 51.32.250 shall not exceed five thousand dollars.
     (5) The department shall establish criteria to monitor the quality and effectiveness of rehabilitation services provided by the individuals and organizations used under subsection (1) of this section. The state fund shall make referrals for vocational rehabilitation services based on these performance criteria.
     (6) The department shall engage in, where feasible and cost-effective, a cooperative program with the state employment security department to provide job placement services under this section.
     (7) ((The benefits in this section shall be provided for the injured workers of self-insured employers.)) Self-insurers shall ((report both benefits provided and benefits denied under this section in the manner prescribed by the department by rule adopted under chapter 34.05 RCW)) issue orders under RCW 51.52.050 providing or denying benefits under this section. If a worker timely protests an order issued by a self-insured employer under this section, the director may((, in his or her sole discretion and upon his or her own initiative or at any time that a dispute arises under this section,)) promptly make such inquiries as circumstances require ((and)), take such other action as he or she considers will properly determine the matter and protect the rights of the parties, and issue an order deciding whether, in the director's sole discretion, vocational rehabilitation is both necessary and likely to make the worker employable at gainful employment. If the director does not issue an order reversing or modifying a self-insured employer's order within thirty calendar days of the worker's protest, the director shall be deemed to have exercised his or her discretion and the self-insured employer's order shall be deemed affirmed.
     (8) Except as otherwise provided in this section, the benefits provided for in this section are available to any otherwise eligible worker regardless of the date of industrial injury. However, claims shall not be reopened solely for vocational rehabilitation purposes.

Sec. 33   RCW 51.32.110 and 1997 c 325 s 3 are each amended to read as follows:
     (1) Any worker entitled to receive any benefits or claiming such under this title shall, if requested by the department or self-insurer, submit himself or herself for medical examination, at a time and from time to time, at a place reasonably convenient for the worker and as may be provided by the rules of the department. An injured worker, whether an alien or other injured worker, who is not residing in the United States at the time that a medical examination is requested may be required to submit to an examination at any location in the United States determined by the department or self-insurer.
     (2) If the worker refuses to submit to medical examination, or obstructs the same, or, if any injured worker shall persist in unsanitary or injurious practices which tend to imperil or retard his or her recovery, or shall refuse to submit to such medical or surgical treatment as is reasonably essential to his or her recovery or refuse or obstruct evaluation or examination for the purpose of vocational rehabilitation or does not cooperate in reasonable efforts at such rehabilitation, the department or the self-insurer ((upon approval by the department)), as the case may be, with notice to the worker may suspend any further action on any claim of such worker so long as such refusal, obstruction, noncooperation, or practice continues and reduce, suspend, or deny any compensation for such period((: PROVIDED, That)). However, the department or the self-insurer shall not suspend any further action on any claim of a worker or reduce, suspend, or deny any compensation if a worker has good cause for refusing to submit to or to obstruct any examination, evaluation, treatment, or practice requested by the department or self-insurer or required under this section.
     (3) If the worker necessarily incurs traveling expenses in attending the examination pursuant to the request of the department or the self-insurer, such traveling expenses shall be repaid to him or her out of the accident fund upon proper voucher and audit or shall be repaid by the self-insurer, as the case may be.
     (4)(a) If the medical examination required by this section causes the worker to be absent from his or her work without pay:
     (i) In the case of a worker insured by the department, the worker shall be paid compensation out of the accident fund in an amount equal to his or her usual wages for the time lost from work while attending the medical examination; or
     (ii) In the case of a worker of a self-insurer, the self-insurer shall pay the worker an amount equal to his or her usual wages for the time lost from work while attending the medical examination.
     (b) This subsection (4) shall apply prospectively to all claims regardless of the date of injury.

Sec. 34   RCW 51.32.130 and 1961 c 23 s 51.32.130 are each amended to read as follows:
     In case of death or permanent total disability, the monthly payment provided may be converted, in whole or in part, into a lump sum payment, not in any case to exceed eight thousand five hundred dollars, equal or proportionate, as the case may be, to the value of the annuity then remaining, to be fixed and certified by the state insurance commissioner, in which event the monthly payments shall cease in whole or in part accordingly or proportionately. Such conversion may be made only upon written application (in case of minor children the application may be by either parent) to the department or self-insurer, as the case may be, and shall rest in the discretion of the department or self-insurer, as the case may be. Within the rule aforesaid the amount and value of the lump sum payment may be agreed upon between the department or self-insurer, as the case may be, and applicant. In the event any payment shall be due to an alien residing in a foreign country, the department or self-insurer, as the case may be, may settle the same by making a lump sum payment in such amount as may be agreed to by such alien, not to exceed fifty percent of the value of the annuity then remaining.
     ((Nothing herein shall preclude)) The department ((from making, and authority is hereby given it to)) or self-insurer, as the case may be, may make, on its own motion, lump sum payments equal or proportionate, as the case may be, to the value of the annuity then remaining, in full satisfaction of claims due to dependents.

Sec. 35   RCW 51.32.150 and 1977 ex.s. c 323 s 18 are each amended to read as follows:
     If a beneficiary ((shall)) resides or moves out of the state, the department or self-insurer, as the case may be, may, with the written consent of the beneficiary, convert any monthly payments provided for such cases into a lump sum payment (not in any case to exceed the value of the annuity then remaining, to be fixed and certified by the state insurance commissioner, but in no case to exceed the sum provided in RCW 51.32.130 ((as now or hereafter amended))).

Sec. 36   RCW 51.32.160 and 1995 c 253 s 2 are each amended to read as follows:
     (1)(a) If aggravation, diminution, or termination of disability takes place, the ((director)) department or self-insurer, as the case may be, may, upon the application of the beneficiary to the department or self-insurer, as the case may be, made within seven years from the date the first closing order becomes final, or at any time upon ((his or her own)) the director's or self-insurer's motion, as the case may be, readjust the rate of compensation in accordance with the rules in this section provided for the same, or in a proper case terminate the payment((: PROVIDED, That)). However, the ((director)) department or self-insurer, as the case may be, may, upon application of the worker made at any time, provide proper and necessary medical and surgical services as authorized under RCW 51.36.010. The department shall promptly mail a copy of the application to the state fund employer at the employer's last known address as shown by the records of the department.
     (b) "Closing order" as used in this section means an order based on factors which include medical recommendation, advice, ((or)) examination, or the worker abandoning the claim.
     (c) Applications for benefits where the claim has been closed without medical recommendation, advice, or examination are not subject to the seven year limitation of this section. The preceding sentence shall not apply to any closing order issued prior to July 1, 1981. First closing orders issued between July 1, 1981, and July 1, 1985, shall, for the purposes of this section only, be deemed issued on July 1, 1985. The time limitation of this section shall be ten years in claims involving loss of vision or function of the eyes.
     (d) If an order denying an application to reopen filed on or after July 1, 1988, is not issued within ninety days of receipt of such application by the self-insured employer or the department, as the case may be, such application shall be deemed granted. However, for good cause, the department or self-insurer, as the case may be, may extend the time for making the final determination on the application for an additional sixty days.
     (2) If a worker receiving a pension for total disability returns to gainful employment for wages, the director or self-insurer, as the case may be, may suspend or terminate the rate of compensation established for the disability without producing medical evidence that shows that a diminution of the disability has occurred.
     (3) No act done or ordered to be done by ((the director, or)) the department ((prior to)) or the self-insurer before the ((signing and filing in the matter)) issuing of a written order for such readjustment shall be grounds for such readjustment.

Sec. 37   RCW 51.32.195 and 1987 c 290 s 1 are each amended to read as follows:
     On any industrial injury claim where ((the)) a self-insured ((employer or injured worker has requested a determination by the department)) employer's order has been protested, the self-insurer must submit ((all medical reports and any other specified information not previously submitted)) the claim file to the department. When the department requests information from a self-insurer by certified mail, the self-insurer shall submit all information in its possession concerning a claim within ten working days from the date of receipt of such certified notice.

Sec. 38   RCW 51.32.210 and 1977 ex.s. c 350 s 55 are each amended to read as follows:
     Claims of injured workers ((of employers who have secured the payment of compensation by insuring with the department)) shall be promptly acted upon by the department or self-insurer, as the case may be. Where temporary disability compensation is payable, the first payment thereof shall be mailed within fourteen days after receipt of the claim at the department(('s offices in Olympia)) or self-insurer, as the case may be, and shall continue at regular semimonthly intervals. The payment of this or any other benefits under this title, prior to the entry of an order ((by the department)) in accordance with RCW 51.52.050 ((as now or hereafter amended)), shall be not considered a binding determination of the obligations of the department or self-insurer, as the case may be, under this title. The acceptance of compensation by the worker or his or her beneficiaries prior to such order shall likewise not be considered a binding determination of their rights under this title.

Sec. 39   RCW 51.32.220 and 1982 c 63 s 19 are each amended to read as follows:
     (1) For persons under the age of sixty-five receiving compensation for temporary or permanent total disability pursuant to the provisions of chapter 51.32 RCW, such compensation shall be reduced by an amount equal to the benefits payable under the federal old-age, survivors and disability insurance act as now or hereafter amended not to exceed the amount of the reduction established pursuant to 42 USC 424a. However, such reduction shall not apply when the combined compensation provided pursuant to chapter 51.32 RCW and the federal old-age, survivors and disability insurance act is less than the total benefits to which the federal reduction would apply, pursuant to 42 USC 424a. Where any person described in this section refuses to authorize the release of information concerning the amount of benefits payable under said federal act the department(('s)) or self-insurer's estimate, as the case may be, of said amount shall be deemed to be correct unless and until the actual amount is established and no adjustment shall be made for any period of time covered by any such refusal.
     (2) Any reduction under subsection (1) of this section shall be effective the month following the month in which the department or self-insurer, as the case may be, is notified by the federal social security administration that the person is receiving disability benefits under the federal old-age, survivors and disability insurance act((: PROVIDED, That)). However, in the event of an overpayment of benefits the department or self-insurer, as the case may be, may not recover more than the overpayments for the six months immediately preceding the date the department or self-insurer notifies the worker that an overpayment has occurred((: PROVIDED FURTHER, That)). Upon determining that there has been an overpayment, the department or self-insurer, as the case may be, shall immediately notify the person who received the overpayment that he or she shall be required to make repayment pursuant to this section and RCW 51.32.230.
     (3) Recovery of any overpayment must be taken from future temporary or permanent total disability benefits or permanent partial disability benefits provided by this title. In the case of temporary or permanent total disability benefits, the recovery shall not exceed twenty-five percent of the monthly amount due from the department or self-insurer, as the case may be, or one-sixth of the total overpayment, whichever is the lesser.
     (4) No reduction may be made unless the worker receives notice of the reduction prior to the month in which the reduction is made.
     (5) In no event shall the reduction reduce total benefits to less than the greater amount the worker may be entitled to under this title or the federal old-age, survivors and disability insurance act.
     (6) The ((director)) department or self-insurer, as the case may be, pursuant to rules adopted in accordance with the procedures provided in the administrative procedure act, chapter 34.05 RCW, may exercise ((his)) discretion to waive, in whole or in part, the amount of any overpayment where the recovery would be against equity and good conscience.
     (7) The amendment in subsection (1) of this section by chapter 63, Laws of 1982 raising the age limit during which the reduction shall be made from age sixty-two to age sixty-five shall apply with respect to workers whose effective entitlement to total disability compensation begins after January 1, 1983.

Sec. 40   RCW 51.32.225 and 1986 c 59 s 5 are each amended to read as follows:
     (1) For persons receiving compensation for temporary or permanent total disability under this title, the compensation shall be reduced by the department or self-insurer, as the case may be, to allow an offset for social security retirement benefits payable under the federal social security, old age survivors, and disability insurance act, 42 U.S.C. This reduction shall not apply to any worker who is receiving permanent total disability benefits prior to July 1, 1986.
     (2) Reductions for social security retirement benefits under this section shall comply with the procedures in RCW 51.32.220 (1) through (6), except those that relate to computation, and with any other procedures established by the department to administer this section.
     (3) Any reduction in compensation made under chapter 58, Laws of 1986, shall be made before the reduction established in this section.

Sec. 41   RCW 51.32.230 and 1979 ex.s. c 151 s 2 are each amended to read as follows:
     Notwithstanding any other provisions of law, any overpayments previously recovered under the provisions of RCW 51.32.220 ((as now or hereafter amended)) shall be limited to six months' overpayments. Where greater recovery has already been made, the director((, in his)) or the self-insurer, as the case may be, has the discretion((, may)) to make restitution in those cases where an extraordinary hardship has been created.

Sec. 42   RCW 51.32.240 and 2001 c 146 s 10 are each amended to read as follows:
     (1) Whenever any payment of benefits under this title is made because of clerical error, mistake of identity, innocent misrepresentation by or on behalf of the recipient thereof mistakenly acted upon, or any other circumstance of a similar nature, all not induced by fraud, the recipient thereof shall repay it and recoupment may be made from any future payments due to the recipient on any claim with the state fund or self-insurer, as the case may be. The department or self-insurer, as the case may be, must make claim for such repayment or recoupment within one year of the making of any such payment or it will be deemed any claim therefor has been waived. The ((director)) department or self-insurer, as the case may be, pursuant to rules adopted in accordance with the procedures provided in the administrative procedure act, chapter 34.05 RCW, may exercise ((his)) discretion to waive, in whole or in part, the amount of any such timely claim where the recovery would be against equity and good conscience.
     (2) Whenever the department or self-insurer, as the case may be, fails to pay benefits because of clerical error, mistake of identity, or innocent misrepresentation, all not induced by recipient fraud, the recipient may request an adjustment of benefits to be paid from the state fund or by the self-insurer, as the case may be, subject to the following:
     (a) The recipient must request an adjustment in benefits within one year from the date of the incorrect payment, whether the payment was made by order or otherwise, or it will be deemed any claim therefore has been waived.
     (b) The recipient may not seek an adjustment of benefits because of adjudicator error whether the payment was made by order or otherwise. "Adjudicator error" includes the failure to consider information in the claim file, failure to secure adequate information, or an error in judgment.
     (3) Whenever the department or self-insurer issues an order rejecting a claim for benefits paid pursuant to RCW ((51.32.190 or)) 51.32.210, after payment for temporary disability benefits has been paid ((by a self-insurer pursuant to RCW 51.32.190(3) or by the department pursuant to RCW 51.32.210)), the recipient thereof shall repay such benefits and recoupment may be made from any future payments due to the recipient on any claim with the state fund or self-insurer, as the case may be. The ((director)) department or self-insurer, as the case may be, under rules adopted in accordance with the procedures provided in the administrative procedure act, chapter 34.05 RCW, may exercise discretion to waive, in whole or in part, the amount of any such payments where the recovery would be against equity and good conscience.
     (4) Whenever any payment of benefits under this title has been made pursuant to an adjudication by the department or self-insurer or by order of the board or any court and timely appeal therefrom has been made where the final decision is that any such payment was made pursuant to an erroneous adjudication, the recipient thereof shall repay it and recoupment may be made from any future payments due to the recipient on any claim with the state fund or self-insurer, as the case may be. The ((director)) department or self-insurer, as the case may be, pursuant to rules adopted in accordance with the procedures provided in the administrative procedure act, chapter 34.05 RCW, may exercise ((his)) discretion to waive, in whole or in part, the amount of any such payments where the recovery would be against equity and good conscience.
     (5) Whenever any payment of benefits under this title has been induced by fraud the recipient thereof shall repay any such payment together with a penalty of fifty percent of the total of any such payments and the amount of such total sum may be recouped from any future payments due to the recipient on any claim with the state fund or self-insurer against whom the fraud was committed, as the case may be, and the amount of such penalty shall be placed in the supplemental pension fund. Such repayment or recoupment must be demanded or ordered within three years of the discovery of the fraud.
     (6) The worker, beneficiary, or other person affected thereby shall have the right to contest an order assessing an overpayment pursuant to this section in the same manner and to the same extent as provided under RCW 51.52.050 and 51.52.060. In the event such an order becomes final under chapter 51.52 RCW and notwithstanding the provisions of subsections (1) through (5) of this section, the ((director, director's designee,)) department or self-insurer, as the case may be, may file with the clerk in any county within the state a warrant in the amount of the sum representing the unpaid overpayment and/or penalty plus interest accruing from the date the order became final. The clerk of the county in which the warrant is filed shall immediately designate a superior court cause number for such warrant and the clerk shall cause to be entered in the judgment docket under the superior court cause number assigned to the warrant, the name of the worker, beneficiary, or other person mentioned in the warrant, the amount of the unpaid overpayment and/or penalty plus interest accrued, and the date the warrant was filed. The amount of the warrant as docketed shall become a lien upon the title to and interest in all real and personal property of the worker, beneficiary, or other person against whom the warrant is issued, the same as a judgment in a civil case docketed in the office of such clerk. The sheriff shall then proceed in the same manner and with like effect as prescribed by law with respect to execution or other process issued against rights or property upon judgment in the superior court. Such warrant so docketed shall be sufficient to support the issuance of writs of garnishment in favor of the department or self-insurer, as the case may be, in the manner provided by law in the case of judgment, wholly or partially unsatisfied. The clerk of the court shall be entitled to a filing fee under RCW 36.18.012(10), which shall be added to the amount of the warrant. A copy of such warrant shall be mailed to the worker, beneficiary, or other person within three days of filing with the clerk.
     The ((director, director's designee,)) department or self-insurer, as the case may be, may issue to any person, firm, corporation, municipal corporation, political subdivision of the state, public corporation, or agency of the state, a notice to withhold and deliver property of any kind if there is reason to believe that there is in the possession of such person, firm, corporation, municipal corporation, political subdivision of the state, public corporation, or agency of the state, property that is due, owing, or belonging to any worker, beneficiary, or other person upon whom a warrant has been served for payments due the department or self-insurer. The notice and order to withhold and deliver shall be served by certified mail accompanied by an affidavit of service by mailing or served by the sheriff of the county, or by the sheriff's deputy, or by any authorized representative of the ((director, director's designee,)) department or self-insurer. Any person, firm, corporation, municipal corporation, political subdivision of the state, public corporation, or agency of the state upon whom service has been made shall answer the notice within twenty days exclusive of the day of service, under oath and in writing, and shall make true answers to the matters inquired or in the notice and order to withhold and deliver. In the event there is in the possession of the party named and served with such notice and order, any property that may be subject to the claim of the department or self-insurer, such property shall be delivered forthwith to the ((director, the director's authorized representative,)) department or self-insurer upon demand. If the party served and named in the notice and order fails to answer the notice and order within the time prescribed in this section, the court may, after the time to answer such order has expired, render judgment by default against the party named in the notice for the full amount, plus costs, claimed by the ((director, director's designee,)) department or self-insurer in the notice. In the event that a notice to withhold and deliver is served upon an employer and the property found to be subject thereto is wages, the employer may assert in the answer all exemptions provided for by chapter 6.27 RCW to which the wage earner may be entitled.
     This subsection shall only apply to orders assessing an overpayment which are issued on or after July 28, 1991: PROVIDED, That this subsection shall apply retroactively to all orders assessing an overpayment resulting from fraud, civil or criminal.
     (7) Orders assessing an overpayment which are issued on or after July 28, 1991, shall include a conspicuous notice of the collection methods available to the department or self-insurer.

Sec. 43   RCW 51.32.250 and 1988 c 161 s 10 are each amended to read as follows:
     Modification of the injured worker's previous job or modification of a new job is recognized as a desirable method of returning the injured worker to gainful employment. In order to assist employers in meeting the costs of job modification, and to encourage employers to modify jobs to accommodate retaining or hiring workers with disabilities resulting from work-related injury, the ((supervisor or the supervisor's designee)) department, in ((his or her)) its discretion, may pay job modification costs in an amount not to exceed five thousand dollars per worker per job modification. This payment is intended to be a cooperative participation with the employer and funds shall be taken from the appropriate account within the second injury fund.
     The benefits provided for in this section are available to any otherwise eligible worker regardless of the date of industrial injury.

Sec. 44   RCW 51.36.010 and 1986 c 58 s 6 are each amended to read as follows:
     Upon the occurrence of any injury to a worker entitled to compensation under the provisions of this title, he or she shall receive proper and necessary medical and surgical services at the hands of a physician of his or her own choice, if conveniently located, and proper and necessary hospital care and services during the period of his or her disability from such injury, but the same shall be limited in point of duration as follows:
     In the case of permanent partial disability, not to extend beyond the date when compensation shall be awarded him or her, except when the worker returned to work before permanent partial disability award is made, in such case not to extend beyond the time when monthly allowances to him or her shall cease; in case of temporary disability not to extend beyond the time when monthly allowances to him or her shall cease((: PROVIDED, That)). However, after any injured worker has returned to his or her work his or her medical and surgical treatment may be continued if, and so long as, such continuation is deemed necessary by the ((supervisor of industrial insurance)) department or self-insurer, as the case may be, to be necessary to his or her more complete recovery; in case of a permanent total disability not to extend beyond the date on which a lump sum settlement is made with him or her or he or she is placed upon the permanent pension roll((: PROVIDED, HOWEVER, That)). The ((supervisor of industrial insurance)) department or self-insurer, as the case may be, solely in ((his or her)) its discretion, may authorize continued medical and surgical treatment for conditions previously accepted ((by the department)) when such medical and surgical treatment is deemed necessary by the ((supervisor of industrial insurance)) department or self-insurer, as the case may be, to protect such worker's life or provide for the administration of medical and therapeutic measures including payment of prescription medications, but not including those controlled substances currently scheduled by the state board of pharmacy as Schedule I, II, III, or IV substances under chapter 69.50 RCW, which are necessary to alleviate continuing pain which results from the industrial injury. In order to authorize such continued treatment the written order of the ((supervisor of industrial insurance)) department or self-insurer, as the case may be, issued in advance of the continuation shall be necessary.
     The ((supervisor of industrial insurance, the supervisor's designee,)) department or a self-insurer, as the case may be, in ((his or her)) its sole discretion, may authorize inoculation or other immunological treatment in cases in which a work-related activity has resulted in probable exposure of the worker to a potential infectious occupational disease. Authorization of such treatment does not bind the department or self-insurer in any adjudication of a claim by the same worker or the worker's beneficiary for an occupational disease.

Sec. 45   RCW 51.36.015 and 1994 c 94 s 1 are each amended to read as follows:
     Subject to the other provisions of this title, the health services that are available to an injured worker under RCW 51.36.010 include chiropractic care and evaluation. For the purposes of assisting the department or self-insurer in making claims determinations, an injured worker may be required by the department or self-insurer, as the case may be, to undergo examination by a chiropractor licensed under chapter 18.25 RCW.

Sec. 46   RCW 51.36.020 and 1999 c 395 s 1 are each amended to read as follows:
     (1) When the injury to any worker is so serious as to require his or her being taken from the place of injury to a place of treatment, his or her employer shall, at the expense of the medical aid fund, or self-insurer, as the case may be, furnish transportation to the nearest place of proper treatment.
     (2) Every worker whose injury results in the loss of one or more limbs or eyes shall be provided with proper artificial substitutes and every worker, who suffers an injury to an eye producing an error of refraction, shall be once provided proper and properly equipped lenses to correct such error of refraction and his or her disability rating shall be based upon the loss of sight before correction.
     (3) Every worker whose accident results in damage to or destruction of an artificial limb, eye, or tooth, shall have same repaired or replaced.
     (4) Every worker whose hearing aid or eyeglasses or lenses are damaged, destroyed, or lost as a result of an industrial accident shall have the same restored or replaced. The department or self-insurer, as the case may be, shall be liable only for the cost of restoring damaged hearing aids or eyeglasses to their condition at the time of the accident.
     (5) All mechanical appliances necessary in the treatment of an injured worker, such as braces, belts, casts, and crutches, shall be provided and all mechanical appliances required as permanent equipment after treatment has been completed shall continue to be provided or replaced without regard to the date of injury or date treatment was completed, notwithstanding any other provision of law.
     (6) A worker, whose injury is of such short duration as to bring him or her within the time limit provisions of RCW 51.32.090, shall nevertheless receive during the omitted period medical, surgical, and hospital care and service and transportation under the provisions of this chapter.
     (7) Whenever in the sole discretion of the ((supervisor)) department or self-insurer, as the case may be, it is reasonable and necessary to provide residence modifications necessary to meet the needs and requirements of the worker who has sustained catastrophic injury, the department or self-insurer may ((be ordered to)) pay an amount not to exceed the state's average annual wage for one year as determined under RCW 50.04.355((, as now existing or hereafter amended,)) toward the cost of such modifications or construction. Such payment shall only be made for the construction or modification of a residence in which the injured worker resides. Only one residence of any worker may be modified or constructed under this subsection, although ((the supervisor may order)) there may be more than one payment for any one home, up to the maximum amount permitted by this section.
     (8)(a) Whenever in the sole discretion of the ((supervisor)) department or self-insurer, as the case may be, it is reasonable and necessary to modify a motor vehicle owned by a worker who has become an amputee or becomes paralyzed because of an industrial injury, the ((supervisor may order)) department or self-insurer may pay up to fifty percent of the state's average annual wage for one year, as determined under RCW 50.04.355, ((to be paid by the department or self-insurer)) toward the costs thereof.
     (b) In the sole discretion of the ((supervisor)) department or self-insurer, as the case may be, after ((his or her)) its review, the amount paid under this subsection may be increased by no more than four thousand dollars by written order ((of the supervisor)).
     (9) The benefits provided by subsections (7) and (8) of this section are available to any otherwise eligible worker regardless of the date of industrial injury.

Sec. 47   RCW 51.36.060 and 1991 c 89 s 3 are each amended to read as follows:
     Physicians examining or attending injured workers under this title shall comply with rules and regulations adopted by the director, and shall make such reports as may be requested by the department or self-insurer upon the condition or treatment of any such worker, or upon any other matters concerning such workers in their care. Except under RCW 49.17.210 and 49.17.250, all medical information in the possession or control of any person and relevant to the particular injury in the opinion of the department or self-insurer pertaining to any worker whose injury or occupational disease is the basis of a claim under this title shall be made available at any stage of the proceedings to the employer, the claimant's representative, and the department upon request, and no person shall incur any legal liability by reason of releasing such information.

Sec. 48   RCW 51.36.070 and 2001 c 152 s 2 are each amended to read as follows:
     Whenever the ((director)) department or the self-insurer, as the case may be, deems it necessary in order to resolve any medical issue, a worker shall submit to examination by a physician or physicians selected by the ((director)) department or self-insurer, with the rendition of a report to the person ordering the examination. The department or self-insurer shall provide the physician performing an examination with all relevant medical records from the worker's claim file. ((The director, in his or her discretion, may charge)) The cost of such examination ((or examinations to the self-insurer or to the medical aid fund as the case may be)) shall be borne by the requester. The cost of said examination shall include payment to the worker of reasonable expenses connected therewith.

Sec. 49   RCW 51.48.017 and 1985 c 347 s 3 are each amended to read as follows:
     (1) If a self-insurer unreasonably delays or refuses to pay monetary benefits to the worker as they become due ((there shall be paid by the self-insurer upon order of the director)), the department may order the self-insured employer to pay an additional amount equal to five hundred dollars or twenty-five percent of the amount then due, whichever is greater, which shall accrue for the benefit of the claimant and shall be paid to him with the benefits which may be assessed under this title. The ((director)) department shall issue an order determining whether there was an unreasonable delay or refusal to pay benefits within ((thirty)) sixty days ((upon)) after receipt of the request of the claimant, before claim closure or at the time of reconsideration of claim closure but not after an order closing the claim has become final by operation of law. ((Such an order))
     (2) The department may summarily deny a request for penalties if on its face it is deemed frivolous or may require the self-insured employer to file a written, substantive response. In such event, the self-insured employer shall have twenty working days to provide relevant documents to the department and respond to the request for penalties by the claimant. Failure of the department to review the request and issue an order within sixty days from the receipt of the worker's request for penalties shall result in the issuance of a default order denying the request for penalties. Any order under this section shall conform to the requirements of RCW 51.52.050.

Sec. 50   RCW 51.48.040 and 2003 c 53 s 282 are each amended to read as follows:
     (1) The books, records and payrolls of the employer pertinent to the administration of this title shall always be open to inspection by the department or its traveling auditor, agent or assistant, for the purpose of ascertaining the correctness of the payroll, the persons employed, and such other information as may be necessary for the department and its management under this title.
     (2) Refusal on the part of the employer to submit his or her books, records and payrolls for such inspection to the department, or any assistant presenting written authority from the director, shall subject the offending employer to a penalty determined by the director but not to exceed two hundred fifty dollars for each offense and the individual who personally gives such refusal is guilty of a misdemeanor.
     (3) Any employer who fails to allow adequate inspection in accordance with the requirements of this section is subject to having its certificate of coverage revoked by order of the department and is forever barred from questioning in any proceeding in front of the board of industrial insurance appeals or any court, the correctness of any assessment by the department based on any period for which such records have not been produced for inspection.
     (4) Claims processing practices of self-insured employers are subject to periodic audit by the department. Supporting documentation and records shall be maintained in accordance with RCW 51.14.110.
     (5) Audits of self-insured employers by the department shall be conducted as necessary to determine compliance with this title and rules adopted by the department to carry out the purposes of this title, but shall not disturb any prior final orders issued in good faith by the self-insured employer that have become final by operation of law.
     (6) The director may assess penalties against a self-insured employer as set forth in RCW 51.48.080.

Sec. 51   RCW 51.48.080 and 1985 c 347 s 7 are each amended to read as follows:
     (1) Every person, firm or corporation who intentionally or repeatedly violates or fails to obey, observe or comply with any rule of the department ((promulgated)) adopted under authority of this title, ((shall be)) is subject to a penalty of not to exceed five hundred dollars. The department shall adopt a schedule of penalties that will take into account the severity and number of violations.
     (2) The department may impose penalties against a self-insured employer when it determines by audit pursuant to RCW 51.48.040 that the self-insured employer has intentionally or repeatedly:
     (a) Failed to pay its injured workers monetary benefits on a timely basis;
     (b) Paid its injured workers monetary benefits in incorrect amounts;
     (c) Failed to issue allowance or rejection orders on a timely basis;
     (d) Failed to issue orders closing a claim within sixty days after the attending physician has found an injured worker to be fixed and stable and a permanent disability level has been established by a preponderance of the medical evidence.
     (3) Self-insured employer audits discovering claims processing and clerical errors not affecting the payment of monetary benefits or violations set forth in subsection (2)(a) through (d) of this section are not subject to assessment of penalties.
     (4) The definitions in this subsection apply throughout this section unless the context clearly requires otherwise.
     (a) "Intentionally" means the employer or self-insured employer has acted with a conscious objective to violate, or recklessly disregard this title and rules adopted by the department.
     (b) "Repeatedly" means the self-insured employer violates the same law or rule more than once in every three-month period, or shows a demonstrated pattern of noncompliance.
     (c) "Incorrect amounts" means that the difference between the self- insured employer's calculation of monetary benefits payable to an injured worker and the amount determined to be correct during a department audit is equal to or greater than twenty-five percent.
     (5) Orders imposing penalties for violations described in this section shall conform to the requirements of RCW 51.52.050.

Sec. 52   RCW 51.52.050 and 1987 c 151 s 1 are each amended to read as follows:
     (1) Whenever the department or self-insurer has made any order, decision, or award, it shall promptly serve the worker, beneficiary, employer, or other person affected thereby, with a copy thereof by mail, which shall be addressed to such person at his or her last known address as shown by the records of the department or self-insurer, as the case may be. The copy, in case the same is a final order, decision, or award, shall bear on the same side of the same page on which is found the amount of the award, a statement, set in black faced type of at least ten point body or size, that such final order, decision, or award shall become final within sixty days from the date the order is communicated to the parties unless a written request for reconsideration is filed with the department of labor and industries, Olympia, and in cases involving a self-insurer with the self-insurer, or an appeal is filed with the board of industrial insurance appeals, Olympia((: PROVIDED, That)). However, a department order or decision making demand, whether with or without penalty, for repayment of sums paid to a provider of medical, dental, vocational, or other health services rendered to an industrially injured worker, shall state that such order or decision shall become final within twenty days from the date the order or decision is communicated to the parties unless a written request for reconsideration is filed with the department of labor and industries, Olympia, or an appeal is filed with the board of industrial insurance appeals, Olympia.
     (2) Whenever the department or self-insurer has taken any action or made any decision relating to any phase of the administration of this title the worker, beneficiary, employer, or other person aggrieved thereby may request reconsideration ((of the department)), or may appeal to the board. In an appeal before the board, the appellant shall have the burden of proceeding with the evidence to establish a prima facie case for the relief sought in such appeal((: PROVIDED, That)). However, in an appeal from an order of ((the department)) that alleges fraud, the department or self-insured employer shall initially introduce all evidence in its case in chief. Any such person aggrieved by the decision and order of the board may thereafter appeal to the superior court, as prescribed in this chapter.
     (3) If the department is requested to reconsider an order issued by a self-insurer, the department must issue an order affirming, modifying, reversing, or remanding the order within sixty days of receipt of the request. The self-insurer's order shall be affirmed if it is supported by substantial evidence in the claim file. If the department fails to issue an order within sixty days, the self-insurer's order is deemed affirmed, subject to appeal. Upon receipt of a request for reconsideration, the department shall notify all parties of the date the department received the request and the date upon which the self-insurer's order will be deemed affirmed if the department fails to take action. The notice shall also inform the parties that any appeal pursuant to RCW 51.52.060 must be filed within sixty days from the date the order is deemed affirmed. If such appeal is filed, the department may not direct submission of further evidence under RCW 51.52.060.

Sec. 53   RCW 51.52.060 and 1995 c 253 s 1 and 1995 c 199 s 7 are each reenacted and amended to read as follows:
     (1)(a) Except as otherwise specifically provided in this section, a worker, beneficiary, employer, health services provider, or other person aggrieved by an order, decision, or award of the department or self-insurer must, before he or she appeals to the courts, file with the board and the director, by mail or personally, and in cases involving a self-insurer, with the self-insurer, within sixty days from the day on which a copy of the order, decision, or award was communicated to such person, a notice of appeal to the board. However, a health services provider or other person aggrieved by a department order or decision making demand, whether with or without penalty, solely for repayment of sums paid to a provider of medical, dental, vocational, or other health services rendered to an industrially injured worker must, before he or she appeals to the courts, file with the board and the director, by mail or personally, within twenty days from the day on which a copy of the order or decision was communicated to the health services provider upon whom the department order or decision was served, a notice of appeal to the board.
     (b) Failure to file a notice of appeal with ((both)) the board ((and)), the department, and the self-insurer, if applicable, shall not be grounds for denying the appeal if the notice of appeal is filed with ((either)) the board ((or)), the department, or the self-insurer. If the notice of appeal does not demonstrate, on its face, that it was sent to the department, the board, and the self-insurer, if applicable, the recipient shall forward a copy of the notice to the other parties not served.
     (2) Within ten days of the date on which an appeal has been granted by the board, the board shall notify the other interested parties to the appeal of the receipt of the appeal and shall forward a copy of the notice of appeal to the other interested parties. Within twenty days of the receipt of such notice of the board, the worker or the employer may file with the board a cross-appeal from the order ((of the department)) from which the original appeal was taken.
     (3) If within the time limited for filing a notice of appeal to the board from an order, decision, or award ((of the department)), the department directs the submission of further evidence or the investigation of any further fact, the time for filing the notice of appeal shall not commence to run until the person has been advised in writing of the final decision of the department in the matter. In the event the department directs the submission of further evidence or the investigation of any further fact, as provided in this section, the department shall render a final order, decision, or award within ninety days from the date further submission of evidence or investigation of further fact is ordered which time period may be extended by the department for good cause stated in writing to all interested parties for an additional ninety days.
     (4) The department, either within the time limited for appeal, or within thirty days after receiving a notice of appeal, may:
     (a) Modify, reverse, or change any order, decision, or award; or
     (b)(i) Except as provided in (b)(ii) of this subsection, hold an order, decision, or award in abeyance for a period of ninety days which time period may be extended by the department for good cause stated in writing to all interested parties for an additional ninety days pending further investigation in light of the allegations of the notice of appeal; or
     (ii) Hold an order, decision, or award issued under RCW 51.32.160 in abeyance for a period not to exceed ninety days from the date of receipt of an application under RCW 51.32.160. The department may extend the ninety-day time period for an additional sixty days for good cause.
     For purposes of this subsection, good cause includes delay that results from conduct of the claimant that is subject to sanction under RCW 51.32.110.
     The board shall deny the appeal upon the issuance of an order under (b)(i) or (ii) of this subsection holding an earlier order, decision, or award in abeyance, without prejudice to the appellant's right to appeal from any subsequent determinative order issued by the department.
     This subsection (4)(b) does not apply to applications deemed granted under RCW 51.32.160.
     (5) An employer shall have the right to appeal an application deemed granted under RCW 51.32.160 on the same basis as any other application adjudicated pursuant to that section.
     (6) A provision of this section shall not be deemed to change, alter, or modify the practice or procedure of the department for the payment of awards pending appeal.

Sec. 54   RCW 51.52.070 and 1977 ex.s. c 350 s 77 are each amended to read as follows:
     The notice of appeal to the board shall set forth in full detail the grounds upon which the person appealing considers such order, decision, or award is unjust or unlawful, and shall include every issue to be considered by the board, and it must contain a detailed statement of facts upon which such worker, beneficiary, employer, or other person relies in support thereof. The worker, beneficiary, employer, or other person shall be deemed to have waived all objections or irregularities concerning the matter on which such appeal is taken other than those specifically set forth in such notice of appeal or appearing in the records of the department or self-insurer. The department or self- insurer shall promptly transmit its original record, or a legible copy thereof produced by mechanical, photographic, or electronic means, in such matter to the board.

Sec. 55   RCW 51.52.080 and 1971 ex.s. c 289 s 69 are each amended to read as follows:
     If the notice of appeal raises no issue or issues of fact and the board finds that the department or self-insurer properly and lawfully decided all matters raised by such appeal it may, without further hearing, deny the same and confirm the ((department's)) decision or award, or if the ((department's)) record sustains the contention of the person appealing to the board, it may, without further hearing, allow the relief asked in such appeal; otherwise, it shall grant the appeal.

NEW SECTION.  Sec. 56   A new section is added to chapter 51.14 RCW to read as follows:
     For purposes of this title, "department or self-insurer, as the case may be," means the department in claims insured by the state fund, and the self-insurer in claims self-insured by the employer.

NEW SECTION.  Sec. 57   RCW 51.32.190 (Self-insurers -- Notice of denial of claim, reasons -- Procedure -- Powers and duties of director) and 1996 c 58 s 2, 1982 1st ex.s. c 20 s 3, 1977 ex.s. c 350 s 54, 1972 ex.s. c 43 s 25, & 1971 ex.s. c 289 s 47 are each repealed.

NEW SECTION.  Sec. 58   This act takes effect January 1, 2005.