Draft Self-Insurance Rule Changes Completed

The stakeholder committee reviewing the draft rule changes for self-insurance, originally submitted back in July 2002, completed its work on August 31st, 2004.  The rules cover everything from qualifications for self-insurance, elimination of the 90 EAR for vocational rehabilitation, and claim adjudicator certification requirements.  On the last topic, we will continue working with the Department’s Self-Insurance Section on a more comprehensive educational setup, with the goal of moving to a continuing education program (rather than re-certification.)  Thank you to Lisa Vivian of Eberle Vivian, Rebecca Forrestor of Group Health Cooperative, and Deborah Lazaldi of the Law Offices of Deborah Lazaldi for their hard work and dedication in helping to shape the draft rules.  The formal rule making process will occur in October and November, with a hoped for implementation of January 1st, 2005.  Watch your email and newsletters for hearings and time to submit additional comments!

Don’t Leave Yourself Exposed! Request Wage Orders!

Based on conversations with the Self-Insurance Section at the Department, only about 25% of claims closure requests include a request for a Wage Orders.  Remember, all it takes is another bad court decision to leave your old claims exposed to the same problems we encountered with the Cockle decision.  We strongly encourage you to request wage orders on your claims.

Provider Bulletins A-Plenty

It has been a very busy summer for the Department of Labor & Industries in the issuance of Provider Bulletins.  Topics covering vocational rehabilitation supervision, ARNP’s and PA’s role in filing claims, guidelines for cervical surgery, new hearing aid services and devices reimbursement policies & rates, and a number of coverage decisions are included.  If you haven’t already received the Bulletins by mail, you can find them online at http://www.lni.wa.gov/ClaimsInsurance/Providers/ProviderBulletins/default.asp.  We encourage you to check them out!

California Workers’ Compensation Reforms Already Reducing Rates

Recent landmark workers’ compensation reforms in California have resulted in an average 14 percent decrease in rates this year, according to a survey by the American Insurance Association. According to current rate filings with the California Department of Insurance (CDI), insurance carriers have reduced rates from 2 percent to 22 percent since January 1. California insurance commissioner John Garamendi had previously recommended that insurers reduce their pure premium workers’ compensation rates by 20.9%.

Washington State Labor Council and the Building Industry Association of Washington file Ballot Initiatives

The Washington State Labor Council (WSLC) and the Building and Industry Association of Washington (BIAW) have filed separate workers’ compensation initiatives to the Legislature that they hope to qualify for the November 2005 ballot. The initiatives were filed with the Secretary of State, and are summarized as follows:

BIAW’s Initiative (I-333) would: exclude fringe benefits from the wage base on which workers' compensation benefits are calculated; eliminate employee and marital status as factors in the calculation of payments to workers; use four-quarter averaging instead of wages at the time of injury to calculate payments; tie cost-of- living adjustments to inflation; require an annual audit of the State Fund; and would limits fees for attorneys representing workers or beneficiaries to 20%.

WSLC’s Initiative (I-334) would: establish whistle-blower protections for workers reporting system abuses; protect workers' choice of medical provider; require employers to continue health benefits to injured workers on time loss; change the retrospective rating program so that rebate checks go directly to employers (The retrospective ratings program is administered by the Department of Labor and Industries, and allows companies to review and compare their claims record to what they paid in premiums. Program participants can receive refunds if their claims are less than the amount of premiums they paid. About 48 trade groups offer retrospective rating programs for members, but often retain a portion of the rebates to which their members are entitled. Labor wants to end the ability of groups like the BIAW to use these monies to fund their political lobbying efforts;) eliminate the workers' share of workers' compensation State Fund premiums; allow workers to receive vocational rehabilitation benefits for up to two years, and limit fees on attorneys representing both injured workers and employers.

WSIA has come out in support of Initiative 333, and in opposition to Initiative 334.

Meeting of the Minds Conference October 6th-7th, 2004

The Annual “Meeting of the Minds” Conference, sponsored jointly by business and labor and administered by Project Help Director Vicky Smith, will be held October 6-7 at the Shoreline Center in Shoreline, WA.  You can find out more about the conference by checking online at http://www.wslc.rog/upcoming.htm.

New Fee Schedules for Pain Clinics, Transitional Care Facilities

The Department is eliminating a number of contractual relationships, and moving to a fee schedule for a number of different services.  Most notable are schedules for chronic pain management programs, and residential facilities & transitional care facilities.  While we have solicited your comments back on these services, few comments were received.  WSIA expressed to the Department a desire for self-insured employers not to be subject to any pre-approval processes, but to allow employers to consider payment based on the appropriate fee schedules.  Watch your email and mailbox as these fee schedules become adopted.

New Rules for ARNP’s/PA’s, Preferred Worker Program

Hearings on new rules governing ARNP’s and PA’s in the filing of claims and treatment of workers have been held.  The rules were in response to legislation that passed during the 2004 Legislative session.  New rules are also being considered for the preferred worker program.  You can find all proposed rule changes at http://www.lni.wa.gov/ClaimsInsurance/Rules/WhatsNew/Proposed/.  A hearing will be held on Monday, November 1st, 2004 from 2:00-4:00pm at Department Headquarters in Tumwater.  Written comments are due at the Department by close of business Monday, November 8th, 2004.  If you have written comments and don’t wish to make them directly to the Department, email or fax them to WSIA by Wednesday, November 3rd, 2004.  That will give us time to respond.  If you are submitting comments directly, send them to Audrey Pitchford, DLI, fax #360-902-4960 or via email to pita235@lni.wa.gov.  Be sure to copy WSIA on your email (dave.Kaplan@wsiassn.org) so that we are aware of any concerns you might have.