Effective Date of Rule: September 1, 2010.

     Purpose: This rule change will update department policy regarding injured workers traveling out of his/her immediate residential area to the nearest point of adequate treatment or other services, including vocational retraining. The effects will be to ensure a payment methodology that is reasonable, fair and cost efficient. Also the language allowing reimbursement for worker travel to treatment at department rehabilitation center will be deleted. This will have no effect because the department rehabilitation center no longer exists. Finally, the term attending doctor will be updated to attending provider to be consistent with the definition of an attending provider as stated in WAC 296-20-01002.

     Citation of Existing Rules Affected by this Order: Amending WAC 296-20-1103.

     Statutory Authority for Adoption: RCW 51.04.020, 51.04.030.

      Adopted under notice filed as WSR 10-11-106 on May 18, 2010.

     Changes Other than Editing from Proposed to Adopted Version: In response to a testimony received during the March 24, 2010, public hearing, the department removed proposed language from the revision of WAC 296-20-1103 regarding vocational services travel. Language regarding vocational retraining was also added to the adopted version.

     Number of Sections Adopted in Order to Comply with Federal Statute: New 0, Amended 0, Repealed 0; Federal Rules or Standards: New 0, Amended 0, Repealed 0; or Recently Enacted State Statutes: New 0, Amended 0, Repealed 0.

     Number of Sections Adopted at Request of a Nongovernmental Entity: New 0, Amended 0, Repealed 0.

     Number of Sections Adopted on the Agency's Own Initiative: New 0, Amended 0, Repealed 0.

     Number of Sections Adopted in Order to Clarify, Streamline, or Reform Agency Procedures: New 0, Amended 1, Repealed 0.

     Number of Sections Adopted Using Negotiated Rule Making: New 0, Amended 0, Repealed 0;      Pilot Rule Making: New 0, Amended 0, Repealed 0; or Other Alternative Rule Making: New 0, Amended 1, Repealed 0.

     Date Adopted: July 20, 2010.

Judy Schurke

Director

OTS-3010.2

AMENDATORY SECTION(Amending WSR 93-16-072, filed 8/1/93, effective 9/1/93)

WAC 296-20-1103   Travel expense.   The department or self-insurer will reimburse travel expense incurred by workers for the following reasons:

     (1) Examinations at department's or self-insurer's request;

     (2) Vocational services at department's or self-insurer's request;

     (3) ((treatment at department rehabilitation center;

     (4))) Fitting of prosthetic device; and

     (((5))) (4) Upon prior authorization for treatment or vocational retraining when worker must travel more than ((ten)) fifteen miles one-way from the worker's home to the nearest point of adequate treatment or vocational retraining. Travel expense is not payable when adequate treatment is available within ((ten)) fifteen miles of injured worker's home, yet the injured worker prefers to report to an attending ((doctor)) provider outside the worker's home area.

     Under subsections (3) and (4) of this section, when travel expense is authorized the first fifteen miles one-way are not payable. The first and last fifteen miles are not payable on an authorized round trip.

     Travel expenses will be reimbursed at the current department rate.

     Receipts are required for all expenses except parking expenses under ten dollars.

     Claims for reimbursement of travel expenses must be received by the department or self-insurer within one year after the date expenses are incurred. Refer to WAC 296-20-125 and to department policy for additional rules.

[Statutory Authority: RCW 51.04.020, 51.04.030 and 1993 c 159. 93-16-072, § 296-20-1103, filed 8/1/93, effective 9/1/93. Statutory Authority: RCW 51.04.020. 91-12-010, § 296-20-1103, filed 5/30/91, effective 7/1/91. Statutory Authority: RCW 51.04.020(4) and 51.04.030. 83-16-066 (Order 83-23), § 296-20-1103, filed 8/2/83. Statutory Authority: RCW 51.04.020(4), 51.04.030, and 51.16.120(3). 81-24-041 (Order 81-28), § 296-20-1103, filed 11/30/81, effective 1/1/82; 81-01-100 (Order 80-29), § 296-20-1103, filed 12/23/80, effective 3/1/81.]

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