WSR 19-03-161
PROPOSED RULES
DEPARTMENT OF
LABOR AND INDUSTRIES
[Filed January 22, 2019, 4:15 p.m.]
Original Notice.
Preproposal statement of inquiry was filed as WSR 18-04-102.
Title of Rule and Other Identifying Information: Medical aid rules, hearing aids and masking devices, WAC 296-20-1101.
Hearing Location(s): On February 28, 2019, at 9:00 a.m., at the Department of Labor and Industries, 7273 Linderson Way S.W., Tumwater, WA 98501.
Date of Intended Adoption: April 2, 2019.
Submit Written Comments to: Robert Mayer, Department of Labor and Industries, P.O. Box 44322, Olympia, WA 98504-4322, email robert.mayer@lni.wa.gov, fax 360-902-4249, by February 28, 2019.
Assistance for Persons with Disabilities: Contact Robert Mayer, phone 360-902-5021, fax 360-902-4249, email robert.mayer@lni.wa.gov, by February 28, 2019.
Purpose of the Proposal and Its Anticipated Effects, Including Any Changes in Existing Rules: The proposed rule change would add language allowing the replacement of hearing aids upon request five years after the issue date of the current hearing aids.
Reasons Supporting Proposal: The proposed rule language was developed through the recommendations and consensus of a department initiated and led workgroup of expert and interested parties.
Statutory Authority for Adoption: RCW 51.04.020(1) and 51.04.030.
Statute Being Implemented: RCW 51.36.080.
Rule is not necessitated by federal law, federal or state court decision.
Name of Proponent: Department of labor and industries, governmental.
Name of Agency Personnel Responsible for Drafting: Robert Mayer, Tumwater, 360-902-5021; Implementation and Enforcement: Vickie Kennedy, Tumwater, 360-902-4997.
A school district fiscal impact statement is not required under RCW 28A.305.135.
A cost-benefit analysis is required under RCW 34.05.328. A preliminary cost-benefit analysis may be obtained by contacting Robert Mayer, Department of Labor and Industries, P.O. Box 44322, Olympia, WA 98504-4322, phone 360-902-5021, fax 360-902-4249, email robert.mayer@lni.wa.gov.
The proposed rule does not impose more-than-minor costs on businesses. Following is a summary of the agency's analysis showing how costs were calculated. The costs of hearing aids are paid out of the medical aid fund. While individual changes to the medical aid fund do not change rate assumptions by themselves and cost increases are only one of many components in determining rate, costs to businesses associated with the proposed rule can be determined by calculating an increase to employers' medical aid fund premiums. Using a very conservative estimate, the proposed rule could increase annual expenditures to the medical aid fund by up to $3.3 million. $3.3 million represents 0.5 percent of all medical costs in fiscal year 2018. For 2019, the average premium rate for the medical aid fund is $0.1959 per hour. Employers pay fifty percent of the medical aid premium, and a five percent increase in costs equates to $0.0049 per hour increase in the medical premium rates per hour for an employer. Since the proposed rule impacts replacement costs of hearing aids after five years, there is no impact on individual employers' experience ratings as the costs are beyond the three year experience rating period.
In addition, employers pay premiums on a per worker-hour/unit basis for each assigned risk class so there is no potential for any disproportionate impact on small businesses.
January 22, 2019
Joel Sacks
Director
AMENDATORY SECTION(Amending WSR 08-05-093, filed 2/15/08, effective 3/22/08)
WAC 296-20-1101Hearing aids and masking devices.
The department or self-insurer is responsible for replacement or repair of hearing aids damaged or lost due to an industrial accident only to the extent of restoring the damaged item to its condition at time of the accident. If the hearing aid is repairable and the worker determines he prefers replacement, the department or self-insurer is responsible only to the extent of the cost to repair the original and the worker is responsible for the difference between repair and replacement costs.
When the department or self-insurer has accepted a hearing loss condition either as a result of industrial injury or occupational exposure, the department or self-insurer will furnish a hearing aid (hearing aids when bilateral loss is present) when prescribed or recommended by a physician.
The department or self-insurer will bear the cost of ((repairs or replacement due to normal wear and the cost of)):
(1) Repairs due to normal wear;
(2) Replacement due to normal wear;
(3) Replacement upon request five years after the issue date of the current hearing aid; and
(4) Battery replacement for the life of the hearing aid.
If the worker has been issued a linear analog hearing aid and it becomes inoperable or if the worker is unable to hear, the department or self-insurer will replace the linear analog hearing aid with a nonlinear digital or nonlinear analog hearing aid in accordance with existing medical aid rules and fee schedules and at no cost to the worker even if the linear analog hearing aid is repairable.
In cases of accepted tinnitus, the department or self-insurer may provide masking devices under the same provisions as outlined for hearing aids due to hearing loss.
Provision of masking devices and hearing aids require prior authorization.