"Sec. 1   RCW 51.04.050 and 1961 c 23 s 51.04.050 are each amended to read as follows:
     In all ((hearings, actions or)) proceedings before the department ((or the board of industrial insurance appeals, or before any court on appeal from the board,)) any physician or licensed advanced registered nurse practitioner having theretofore examined or treated the claimant may be required to ((testify fully)) make reports requested by the department or self-insurer regarding such examination or treatment, and shall not be exempt from ((so testifying)) making reports by reason of the relation of the physician or licensed advanced registered nurse practitioner to patient. In all hearings, actions, or proceedings before the board of industrial insurance appeals, or before any court on appeal from the board of industrial insurance appeals, the claimant shall be deemed to waive the physician-patient privilege under RCW 5.60.060, subject to the limitations imposed pursuant to court rules and section 3 of this act.

Sec. 2   RCW 51.36.060 and 1991 c 89 s 3 are each amended to read as follows:
     Physicians or licensed advanced registered nurse practitioners 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, and section 3 of this act, all medical information in the possession or control of any person and relevant to the particular injury in the opinion of the department 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. In all hearings, actions, or proceedings before the board of industrial insurance appeals, or before any court on appeal from the board of industrial insurance appeals, requests for medical information under this subsection are subject to limitations imposed pursuant to court rules and section 3 of this act.
     

NEW SECTION.  Sec. 3   A new section is added to chapter 51.52 RCW to read as follows:
     (1)(a) After notice of appeal under RCW 51.52.060 with a preliminary list of witnesses, the department, the employer, and the representatives of each, shall not have ex parte contact, to discuss the facts or issues in question in the appeal, with any medical provider who:
     (i) Has examined or treated the claimant at the request of the claimant or a treating medical provider; and
     (ii) Has or is testifying in the appeal on behalf of the claimant and is listed on the preliminary list of witnesses.
     (b) This subsection shall not apply once the claimant's case in chief is presented and the claimant rests the case, or if written authorization for the contact is given by the claimant or the claimant's representative or by court rule.
     (2) After notice of an appeal under RCW 51.52.060 with a preliminary list of witnesses, the claimant and the representative for the claimant, if any, shall not have ex parte contact, to discuss the facts or issues in question in the appeal, with any medical provider who examined the claimant pursuant to RCW 51.36.070, unless written authorization for the contact is given by the department or self-insured employer or by court rule.
     (3) Written requests for medical records shall not be considered ex parte contact.
     (4) This section only applies to issues set forth in a notice of appeal under RCW 51.52.060.
     (5) Nothing in this section shall be construed to limit reporting requirements under RCW 51.04.050 and 51.36.060 for issues not set forth in a notice of appeal.

Sec. 4   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)) as authorized in RCW 51.36.070.
     (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, 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 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 required under this section.
     (3) If the worker necessarily incurs traveling expenses in attending the examination pursuant to the request of the department, 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. 5   RCW 51.36.070 and 2001 c 152 s 2 are each amended to read as follows:
     (1) Subject to subsection (3) of this section, whenever the director or the self-insurer deems it necessary in order to resolve any medical issue, the department or self-insurer may, at a time and from time to time at a place reasonably convenient for the worker and as may be provided by department rules, require a worker ((shall)) to submit to examination ((by a physician or physicians selected by the director, with the rendition of a report to the person ordering the examination)) with the rendition of a report to the department or the self-insurer. 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 ordered may be required to submit to an examination at any location in the United States determined by the department or self-insurer.
     (2) The department or self-insurer shall provide the physician performing an examination with all relevant medical records from the worker's claim file.
     (3)(a) To obtain a rating for permanent partial disability as provided in RCW 51.32.080, the department or self-insurer shall first request that the worker's attending physician or treating provider conduct an examination and provide a report on the impairment, if any. The attending physician or treating provider must be qualified in an appropriate specialty to provide the rating.
     (b) If the attending physician or treating provider chooses not to conduct the requested examination, he or she may make a referral to a provider qualified in an appropriate specialty to perform the examination and provide a report on the impairment, if any.
     (4)(a) To the extent practicable, a provider conducting an examination under RCW 51.36.070 must consult with the worker's attending physician or treating provider on the outcome of the examination, including providing the attending physician or treating provider with a copy of any report related to the examination prior to submitting the report to the department or self-insurer.
     (b) If an examination is necessary to obtain a rating for permanent partial disability or to resolve any other medical or treatment issue, the department or self-insurer shall submit a copy of the report from the provider or providers conducting the examination forthwith to the attending physician or treating provider. The examination report shall be part of the claim file and shall promptly be made available to the worker or the worker's representative upon request.
     (5) 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. The cost of said examination shall include payment to the worker of reasonable expenses connected therewith.

Sec. 6   RCW 51.32.112 and 1993 c 515 s 4 are each amended to read as follows:
     (1) It is the duty of providers conducting medical examinations under RCW 51.36.070 to provide objective, professional, and complete medical examinations and reports. To obtain independent and medically appropriate information and recommendations from examinations, the department shall ((develop standards for the conduct of special)) adopt rules governing the qualifications of providers who conduct medical examinations ((to determine permanent disabilities, including, but not limited to:)) under RCW 51.36.070.
     (((a) The qualifications of persons conducting the examinations;
     (b))) (2) To conduct examinations under RCW 51.36.070, a provider must first be approved by the department. At a minimum, the provider:
     (a) Must be licensed to practice, at the time of the examination, medicine or surgery under chapter 18.71 RCW, osteopathic medicine and surgery under chapter 18.57 RCW, podiatric medicine and surgery under chapter 18.22 RCW, dentistry under chapter 18.32 RCW, chiropractic under chapter 18.25 RCW, or psychology under chapter 18.83 RCW;
     (b) Must not have had convictions of any crime, gross misdemeanor, felony, or violation of statutes or rules by any administrative agency, court, or board;
     (c) Must not have had disciplinary action concerning sexual misconduct at any time during his or her professional career; and
     (d) Must attend all continuing education programs or credits that may be required by the department.
     (3) In addition to the criteria set forth under subsection (2) of this section, the department shall also consider the following criteria when approving medical providers to conduct examinations under RCW 51.36.070:
     (a) Whether the provider has had any disciplinary action for ethical or other offenses imposed by a state board of medical licensure, as validated by the department, within the ten years prior to applying to the department for approval as an examiner; and
     (b) Whether the provider has had any disciplinary action or administrative action taken by the department at any time during his or her professional career.
     (4) The criteria for ((conducting the examinations, including guidelines for the appropriate treatment of injured workers during the examination; and
     (c) The content of examination reports)) removing providers from the list of providers approved to conduct examinations under RCW 51.36.070 includes, but is not limited to:
     (a) Disciplinary action involving sexual misconduct or ethical offense imposed by any state board of medical licensure;
     (b) Failure to maintain ethical standards in conducting examinations as determined by the department from complaints received about the provider or from reviews of the quality and timeliness of examination reports;
     (c) Convictions of any crime, gross misdemeanor, felony, or violation of statutes or rules by any administrative agency, court, or board; or
     (d) Refusal to submit to deposition, appear before, testify, or answer a material question of the department, or board of industrial insurance appeals, or produce a material document concerning his or her provision of services under this title.
     (5) Providers who fail to meet requirements set forth in this section may be immediately removed from the list of examiners approved to conduct examinations under RCW 51.36.070.
     (((2))) (6) Within the appropriate scope of practice, chiropractors licensed under chapter 18.25 RCW may conduct special medical examinations to determine permanent disabilities in consultation with physicians licensed under chapter 18.57 or 18.71 RCW. The department, in its discretion, may request that a special medical examination be conducted by a single chiropractor if the department determines that the sole issues involved in the examination are within the scope of practice under chapter 18.25 RCW. However, nothing in this section authorizes the use as evidence before the board of a chiropractor's determination of the extent of a worker's permanent disability if the determination is not requested by the department.
     (((3) The department shall investigate the amount of examination fees received by persons conducting special medical examinations to determine permanent disabilities, including total compensation received for examinations of department and self-insured claimants, and establish compensation guidelines and compensation reporting criteria.
     (4))) (7) As required in RCW 51.04.030, providers may only be paid in accordance with the maximum fees published by the department.
     (8) The department must examine the credentials of providers conducting examinations ordered under RCW 51.36.070 and must monitor the quality and objectivity of the examinations and examination reports obtained by the department and self-insured employers. The department's rules must ensure that examinations ordered under RCW 51.36.070 are performed only by qualified providers meeting department standards.
     (9) The department shall provide oversight and monitor compliance with the requirements of this section and section 7 of this act by providers who perform examinations under RCW 51.36.070 for both the state fund and self-insurers. This shall include the development of a process for obtaining and responding to complaints from state fund and self-insured workers and from providers. The department shall periodically collect information from workers, attending providers, and providers conducting examinations under RCW 51.36.070 about the quality of examinations and reports provided under RCW 51.36.070 and shall audit the level of compliance of examiners, self-insurers, and the state fund with regard to the requirements of sections 3 through 8 of this act.
     (10) The department shall investigate the level of compliance of self-insurers with the requirement of full reporting of claims information to the department, particularly with respect to medical examinations, and develop effective enforcement procedures or recommendations for legislation if needed.

NEW SECTION.  Sec. 7   A new section is added to chapter 51.36 RCW to read as follows:
     The department shall develop criteria for conducting examinations under RCW 51.36.070 including, but not limited to:
     (1) Guidelines for the appropriate treatment of injured workers during an examination. The guidelines must include requirements that the examiner:
     (a) Provide to the examinee information on who requested the examination;
     (b) Create a final report based on a review of the records, the examination, and sound medical knowledge;
     (c) Allow the worker to be accompanied as provided by rule; and
     (d) Provide a professional office suitable for the examination;
     (2) Requirements for the content and timeliness of examination reports under RCW 51.36.070. The requirements must include, but not be limited to:
     (a) A requirement that examination reports contain a signed statement certifying that the conclusions and recommendations are objective and unbiased;
     (b) A requirement that all conclusions and recommendations are based on a review of the records, the examinations of the worker, and sound medical knowledge;
     (c) A requirement that any examination report under RCW 51.36.070 be submitted to the department or self-insurer within fourteen calendar days of the examination date, or within fourteen calendar days of the receipt of the results of any special tests or studies requested as part of the examination.

NEW SECTION.  Sec. 8   A new section is added to chapter 51.36 RCW to read as follows:
     (1) Except as provided in RCW 51.36.020, the employer or representative of the employer shall not attend a medical examination or the rendering of ongoing treatment for an injured worker, nor shall the employer or a representative of the employer be present at the physical location of the examination or of the attending provider at the time of the examination or treatment.
     (2) This does not apply to instances of a self-insurer's representative aiding in the provision of treatment and benefits to a worker who has been catastrophically injured.

NEW SECTION.  Sec. 9   The department shall adopt rules or modify existing rules, as needed, to implement this act.

NEW SECTION.  Sec. 10   RCW 51.32.112 is recodified as a section in chapter 51.36 RCW.

NEW SECTION.  Sec. 11   RCW 51.32.114 (Medical examination--Department to monitor quality and objectivity) and 1988 c 114 s 3 are each repealed.

NEW SECTION.  Sec. 12   This act applies to medical examinations ordered under Title 51 RCW on or after the effective date of this act."