Department Updates

Self-Insurance Webpage at WSIA Request

About a year ago, WSIA requested that the Department update their webpage for self-insurance.  Woefully inadequate, the site was in need of much renovation to make it more user-friendly.  Due to the efforts of Self-Insurance Program Manager Jean Vanek, the staff at the Department received support in the form of Connie Stewart to help make the changes.  After input from the self-insured community along the way, the Department recently unveiled their webpage update.  Go to http://www.lni.wa.gov/ClaimsIns/Insurance/SelfInsure/default.asp for your self-insurance information, and be sure to bookmark that page!  We want to thank the Department for listening to our community’s concerns, and making the changes to provide better customer service through this important project.  The rest of the Department’s website has also been upgraded.  Take a look at what’s new!

Get Department Self-Insurance Updates Automatically;

Sign up for Their ListServ

Want to get the latest updates on any variety of topics affecting self-insurance?  Sign up for the Department of Labor & Industries’ ListServ.  Step 1:  Go to http://www.lni.wa.gov/ClaimsIns/Insurance/SelfInsure/.  Step 2:  Click on “Join this e-mail list” (green box in upper right hand corner).  Step 3:  Complete the information requested (name and email address).  The sign up page automatically defaults to selecting “general information about Self Insurance” under topics.  If you would like to sign up for continuing education topics, please be sure to check the box before submitting your request.  Step 4:  Click “Join the list.”  You can opt-out by going to the same location.  Once you join, you can also view the prior ListServ emails by clicking on “Join E-mail List” and then “View the Archives.”

In Case You Hadn’t Heard …

AnnaLisa Gellerman Named Self-Insurance Program Manager

Just in case you hadn’t heard … a number of months ago AnnaLisa Gellerman was named to replace Jean Vanek as Self-Insurance Program Manager at the Department of Labor & Industries.  AnnaLisa is an attorney with a rich background in Washington workers’ compensation.  Previously, she managed the Department’s Legal Services program, responsible for a staff of 60 and a budget of $7.9 million. Over the past 10 years, AnnaLisa has represented the Department at all levels of the Board of Industrial Insurance Appeals and in the courts. She is very familiar with the Self-Insurance Program, having advised on complex policy issues and legislation related to self-insurance.  In our first six months of dealing with AnnaLisa, we have found her direct, open, and thoughtful.  We look forward to working with her over the next several years as we move forward to improve self-insurance in Washington state.

WSIA Proposed Rule Change

Regarding CEC’s Accepted by Department

At the request of the Washington Self-Insurers Association, a proposed rule change regarding Continuing Education Credits has been accepted by the Department of Labor & Industries.  The rule change, if enacted, would eliminate the various topical categories.  Watch your email and this website for more information as it becomes available.

Initial SIEDRS Reports Are Released

About five years ago, the Washington Self-Insurers Association pushed for legislation requiring the Department of Labor & Industries to collect at least some claims data from self-insured employers.  That initial data has been collected, and the initial reports are now available.  We strongly encourage you to take a look at these reports!  Click HERE for SIEDRS information, and click on SIEDRS Reports to view the actual reports.  Soon, probably in March 2010, the reports will include data for a complete year.  At our Spring Conference, WSIA President-Elect Katrina Zitnik will speak to the importance of the reports for purposes of benchmarking, and, equally important, demonstrating the use of data for purposes of audit and in pushing for legislative changes expanding self-insurer claims authority.

Department Issues

“Pay During Appeal” Matrix

To assist you in tracking when to pay benefits, the Department issued a matrix that helps outline when benefits are payable.  Click HERE to access the matrix.

Department Issues

Ex Parte Contact Matrix

As you know, the legislature amended 51.52 last year to place restriction on communication with providers once a claim is under appeal (also known as ex parte communication).  In an effort to educate providers, the department recently provided them with a matrix.  Click HERE to access the matrix.

Relief for Employees Who Volunteered for

Rescue/Cleanup in New York After 9/11/2001 Attacks

For employers who had Washington-based employees go to New York City after the 9/11/2001 attacks, and who have subsequently become ill due to the exposures of the fumes and dust from the debris, you can receive some relief by helping those workers file claims in New York.  The following link outlines the information, process and requirements to apply for workers’ compensation benefits.  http://www.nycosh.org/911info/factsheet_english.html

Department List of

“Fast Track” Medical Providers

The Department has identified a listing of providers who have passed utilization review criteria and are not turned down when submitting for services.  This listing represents doctors who are on the fast track for approval of medical procedures.  We are providing this list for your information.  Click HERE to see the list.

Department Announces Dates for

WCAC and WISHA Advisory Meetings for 2010

The Department has announced the dates for the Workers’ Compensation Advisory Committee and WISHA Advisory Committee meetings for 2010.  The WCAC will be held from 9:00am to 12:00pm on the following dates and locations:  April 30, June 23, August 25, and September 24 in the L&I Auditorium, at the Department’s Headquarters in Tumwater, WA, and December 9, 2010 at the Department’s Tukwila Service location.  The WISHA Advisory Committee will meet from 9:00am to 12:00pm at the Department’s Headquarters in Tumwater, WA on the following dates:  June 9, September 8, and November 10, 2010.  The meetings will be held in one of the ground floor rooms (S117 or S118).  Please add these dates to your calendar.

HCA’s HTCC Selects

2010 Health Technology Topics

The HCA Administrator, in consultation with participating state agencies, has selected the fourth group of health technologies that will undergo the scientific review process and then be presented to the Health Technology Clinical Committee (HTCC) for coverage determinations.  The HCA Administrator reviewed the recommended technologies and public comments submitted to the HTA program and selected the following health technologies for an evidence based review beginning in 2010: Vertebroplasty / Kyphoplasty / Sacroplastly; Spinal Cord Stimulation (again!); Breast MRI; Hyaluronic Acid; MRI or CT for the Abdomen / Pelvis; Routine Ultrasound for Pregnancy; ABA Therapy for Autism; Spinal Injections; and Knee Surgery – Replacement.  Additional information can be found on the HTA website at:  http://www.hta.hca.wa.gov/press_release/2010-hca-administrator-selects-health-technologies.html.  Not all of these would apply to workers’ compensation (the HTCC looks at all of these topics for multiple agencies), but it’s important to note that the HCA’s recommendations do carry weight with the agencies that will likely adopt these treatment technologies and modalities.

Department has Developed a Q&A

for Release of Medical Records in Workers’ Comp Claims

The Department has developed a Question & Answer sheet to help answer questions regarding the release of medical records to assist in the management of workers’ compensation claims.  Click HERE to see the Q&A.  If you have questions, please contact the Department’s Carole Winegar, Occupational Nurse Consultant, at 360.902.6708.

Requesting Self-Insured and

State Fund Claims Files

In response to changes in public disclosure law, the Department of Labor & Industries has changed the way they process and respond to requests for prior industrial insurance claims files.  You will need to submit TWO requests: for self-insured claim information fax Norm Voiles at 360-902-6900, and for State Fund claims histories fax Paula Clayton at 360-902-6970. If you have questions on the status of State Fund claims information requests, you can call 360-902-5656.  Most State Fund requests will be handled within 10 business days.

Domestic Partnership Referendum

Adopted by the Voters; Took Effect December 3, 2009

Senate Bill 5688 was signed into law earlier this year.  This law provides expanded rights and responsibilities for registered domestic partners.  Effective December 3, 2009, registered domestic partners are to receive the same benefits as married couples in Washington workers’ compensation claims.  The Department plans to update the self insurer accident report (SIF2), provider's initial report (PIR) and other publications to reflect these changes after the close of the 2010 legislative session.  This will allow them to incorporate any other changes that may be necessary as a result of the legislative session.  Because the SIF-2 and PIR are not being changed immediately, the Department is providing stickers that can be affixed to the top of the forms as an interim solution for documenting registered domestic partnership status.  Please contact Cheri Schoelkopf at (360) 902-6898 to request a supply of stickers.

Domestic Partnership “Lookup” at the

Washington Secretary of State’s Webpage

If you collect documentation regarding your employees’ legal marital status, birth certificates, and the like to prove eligibility for the level of workers’ compensation benefits your worker is entitled to, then this information will be helpful to you.  Under Referendum 71, which was passed by the voters last November 2009 and which took effect in December 2009, registered same sex domestic partnerships (and opposite sex partnerships where at least one of the partners is over age 62) are entitled to workers’ compensation benefits equivalent to a marital status.  You can find the look-up information at http://www.sos.wa.gov/corps/domesticpartnerships/Default.aspx.  Under the law, only REGISTERED domestic partnerships are subject to the benefits.

It is important that you remember that you cannot discriminate in how you treat your employees.  If you do not ask for (or look up) such information for married injured workers, you should not ask or look up such information for those in a domestic partnership.  Ask your attorneys for advice, but they will/should confirm this.  Save yourself legal problems and treat all of your workers the same when it comes to this issue.

Department Issues New Provider Bulletins

Rules, and Policies on Medical Issues

The Department has issued a number of Provider Bulletins, rules and policies over the past several months concerning various treatment modalities and whether they would be covered or not.  Provider Bulletins are temporary communications to announce changes to rules, law, policies and coverage decisions.  Here’s the list of those they’ve issued, with links to the Bulletins/policies:

Provider Bulletin 09-04 – Coverage of Spinal Cord Stimulators, not covered. 

Provider Bulletin 09-05 – Acute Cauda Equina Syndrome (CES), limited. 

Provider Bulletin 09-06 – Proximal Median Nerve Entrapment (PMNE), limited. 

Provider Bulletin 09-07 – Comprehensive Treatment for Chronic Non-Cancer Pain, limited. 

Provider Bulletin 09-08 – Influenza Claims, limited.

Provider Bulletin 09-09 – Work-Related Ulnar Neuropathy at the Elbow (UNE) Diagnosis and Treatment, limited. 

Provider Bulletin 09-10 – Quantitative Sensory Testing (QST,) not covered.

Provider Bulletin 09-11 – Bone Growth Stimulators, limited.

Provider Bulletin 10-01 – Transcutaneous Electrical Nerve Stimulation (TENS), interferential current therapy (IFC) and percutaneous neuromodulation therapy (PNT) devices for use outside of medically supervised facility settings, not covered.

Surgical Guideline for Lumbar Fusion – Effective November 1, 2009

Various Coverage Decisions – Medical Devices & Treatments

Structured Intensive Multidisciplinary Program (SIMP), Chronic Non-cancer Pain, lumbar fusion, artificial disc replacement.  This rule will implement two HTCC coverage determinations. The determinations state that certain lumbar fusion and artificial intervertebral disc replacement surgeries are covered for the treatment of chronic pain due to uncomplicated degenerative disc disease. The principal condition of coverage is that a non-invasive, structured intensive multidisciplinary program for chronic, noncancer pain (SIMP) must be completed prior to the department or self-insurer authorizing a lumbar fusion or lumbar artificial disc replacement. Also, the department will delete language in WAC 296-20-03002 that says the Charite artificial disc is non-covered. Although the SIMP program is being established for lumbar surgery candidates, as defined in WAC 296-20-12065, the SIMP program is available for other workers with chronic, noncancer pain.

 

Independent Medical Examinations.  This rulemaking improves the quality of the IME examination, the IME report, and the worker’s satisfaction with the IME process.  The adopted rules will ensure the medical providers who become independent medical examiners know and meet the department’s requirements.  These rules demonstrate the department’s willingness to address stakeholder concerns regarding the IME process and make the necessary changes.  These rules also demonstrate and support the department’s continuing efforts to improve quality in the process and the final product, the examination and the report which ultimately affects the resolution of workers’ compensation claims.

Clarification on Which Providers Can Perform Impairment Rating Exams.  This update clarifies who may perform impairment ratings and when the attending provider’s ratings require prior authorization.

Department Requires Use

of CARF Certified Pain Clinics

Labor & Industries has a new policy and WAC regarding the delivery and purchase of Structured Intensive Multidisciplinary Programs (SIMPs) for chronic pain management and rehab that are effective November 1, 2009.  Please click HERE for the list of those CARF accredited providers located in Washington and the Portland, Oregon area who currently treat injured workers. To search for other CARF accredited providers who are not on this list, please visit http://www.carf.org/consumer.aspx?content=ConsumerSearch. If you have questions regarding this message, please contact Carole Winegar, Occupational Nurse Consultant, at (360) 902-6708.

Activity Prescription Form (APF) Changes,

Vocational Providers Authorized to Request

There are changes to the APF that took effect last fall.  To find the new APF, click HERE.  In addition to the form itself, Effective September 14, 2009, Vocational Rehabilitation Counselors (VRC) can request an APF directly from the health care provider.  This change is being made to reduce delays in obtaining medical information necessary for timely return to work assistance or determining eligibility for vocational retraining.  This impacts State Fund claims more than self-insured, but makes clear that vocational providers can request the APF’s for both.

Department Issues “Your Independent Medical Exam”

Booklet for Workers of Self-Insured Employers

A new brochure providing workers information about independent medical examinations is now available.  The brochure titled, "Your Independent Medical Exam: For Employees of Self- Insured Businesses", includes the IME Travel and Wage Reimbursement Request form.  English and Spanish versions of the brochure may be printed by accessing the publication on the L&I website at http://www.lni.wa.gov/FormPub/Detail.asp?DocID=2393.  If you require multiple copies, please fax your request to (360)902-4525.  Be sure to include: Your name, mailing address and telephone number; Title or document number of the brochure you are requesting; Your Independent Medical Exam: For Employees of Self-Insured Businesses" OR document number F207-202-000 for English or F207-202-999 for Spanish; Quantity requested.  Any additional questions can be directed to the Carole Winegar at (360) 902-6708.

Workers’ Compensation Manual (“George Book”)

Being Updated and Made Available Online

The Department’s Workers’ Compensation Manual – A Guide to Claims Administration in Washington State, otherwise known as the “George Book” with its large logo of George Washington on the cover, is being updated for the first time in eleven years.  Given all of the court decisions, law and rule changes during that time, the Manual will have a substantial number of changes in it.  In addition to being able to purchase printed copies, the Manual will be posted at the Department’s website on the new Self-Insurance page.  Four chapters have been completed, and the rest will be completed over the next several months.  To order a copy of the Workers’ Compensation Manual – A Guide to Claims Administration in Washington State, contact Sharon McCahan at 360.902.6838 beginning in mid-July.  The price of the current Manual is $43.12.

Department Releases Updated

Third Party Contact Phone List

At the request of self-insured employers, the Department has provided an updated list of contacts within the Third Party Recovery Unit.  Click HERE to see the updated Phone List for the Third Party Claims Unit.

Updated Self-Insurance

Phone Contact Listing

Need an updated list of Self-Insurance section phone numbers?  Periodically they update the list, and here it is!  http://www.lni.wa.gov/ClaimsIns/Files/SelfIns/SelfInsPhoneList.pdf, updated January 11, 2010.  Note that the list still includes which adjudicator and which consultant work on which Claims Team.  Check back at this link periodically for updated information.  Just in case the link isn't updated at the Department's website, you can access the same document HERE.

Department Publishes

Helpful Leave Guide

With the adoption of yet more leave laws by the Legislature, the Department of Labor & Industries has developed a table listing all of the leave laws, and what the requirements are.  You can find the leave listing table at http://www.lni.wa.gov/WorkplaceRights/files/FamilyLeaveLawsTable.pdf.  For more detailed information on each type of leave, go HERE.  Coordination of leave benefits with workers' compensation benefits will become an even bigger issue in the future, so watch the WSIA website for more information.

Connect with the Department

on Twitter and YouTube

The Department of Labor & Industries has launched a Twitter site as its’ newest “social networking” feature. It also has consolidated its YouTube videos into one easy-to-use listing.  Links to both L&I’s Twitter and YouTube sites are available on the agency’s Web site, www.Lni.wa.gov.  L&I’s Twitter is a Web-based micro-blogging site with a range of information about such things as workers’ compensation, workplace safety and health, H1N1 flu and more. Some “tweets” on the site link to informative articles published in magazines and newspapers. Go to www.Lni.wa.gov/main/contactinfo/twitter/ for more information.  YouTube videos related to workplace safety and health are now listed at www.youtube.com/user/LaborandIndustries1. Topics cover such issues as heat stress, ergonomics, workplace-safety procedures, chainsaw safety and more. Also available on YouTube are winning student-made videos about workplace safety, and L&I’s “Work Safe. Home Safe” public service campaign.  L&I also shares information through 27 listservs that provide information important to specific groups of people. These listservs can be viewed at www.Lni.wa.gov/Main/Listservs/.

as of 11 February 2010