Most Department Offices Closed

on Friday, August 6, 2010

The Department of Labor & Industries’ offices will be closed Friday, August 6, due to a temporary layoff ordered by the state Legislature. To report work-related fatalities and hospitalizations within 8 hours, or very hazardous workplace dangers that require immediate attention, call 1-800-423-7233.

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!

Workers’ Compensation Manual (“George Book”)

Has Been 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, has been 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.  You will no longer be able to purchase the printed version, but can print out the Manual online at http://www.lni.wa.gov/ClaimsIns/Insurance/SelfInsure/Claims/Guidelines/Default.asp.

Department and Other Agencies

Crack Down on Opioid Misuse, Over-Prescription

The New York Times of July 28, 2010 has an article talking about Washington State’s efforts at trying to stop the growing number of deaths due to misuse and over-prescribing of opioid medications for chronic pain.  The Department of Labor & Industries’ Medical Director Gary Franklin is a key player in this effort. http://www.nytimes.com/2010/07/29/business/29pain.html?_r=2&ref=health.

SIEDRS Reports

Available For Initial Year

The first year’s worth (four quarters) of SIEDRS (Self Insured Data Reporting System) reports is at http://www.lni.wa.gov/ClaimsIns/Insurance/SelfInsure/Siedrs/Reports/ViewRpts/Default.asp.  The most notable trends concern the percentage of claims closed by employers versus the Department (only about 63% of the claims we can close are being closed by employers), and the prompt payment of benefits within 14 days.  Please use these reports to review your programs, to see how you stack up, and

DLI Pharmaceutical

New Fee Schedule Announced

Effective July 1, 2010 the Department will use a new fee schedule to pay participating pharmacies for generic drugs.  The rate will be 50% of the Average Wholesale Price (AWP), plus a $4.50 dispensing fee.  DLI indicated it was making the change to be “more in line with drug payments of other state agencies.”  Self-insurers should utilize the fee schedule to the extent you have access to the AWP list.  WSIA is working with the Department in an effort to secure access to the AWP list, if possible.  Watch here for future updates.

Interpreter Fee Schedule

Change Effective July 1, 2010

Effective July 1, 2010, the Department of Labor and Industries fee for group and individual interpreter services will be $0.79 per minute. The Department believes that their fees are still competitive with other payers, including other state programs.  You can find the fees at the Department’s website at www.lni.wa.gov.

Benefit Increases

Effective July 1, 2010

As you likely already know, benefits were adjusted to reflect the COLA effective July 1, 2010.  You can now find all of those benefit schedules, as well as those for prior years, at the Department’s website at http://www.lni.wa.gov/ClaimsIns/Insurance/SelfInsure/Claims/Calculations/Default.asp.

Department Announces Vocational Benefit

Increase Effective July 1, 2010

Effective July 1, 2010, the vocational benefit for retraining programs will be increased to $14,029.29.  In addition, any injured worker who has selected option 2 and is still receiving payment of a vocational benefit award as of July 1, 2010, will need to have their vocational benefit award adjusted according to the cost-of-living adjustment.  If you have any questions please contact the Self-Insurance Vocational Services Specialists: Jerry Myron (360) 902-6913 or Bill Walkowski (360) 902-6915.

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.”

Provider Inactivated

Pending MQAC Review

Effective July 3, 2010, the provider account numbers for Nick W. Uraga, MD, were inactivated.  The Department of Health Medical Quality Assurance Commission suspended his license to practice as a physician and surgeon pending further action.  Dr. Uraga’s Occupational Medicine Clinic is located in Tacoma, WA.

IME Approved

Examiner List Changing Daily

New independent medical examination (IME) WACs became effective March 1, 2010.  The new changes are available on the IME website at www.IMES.Lni.wa.gov under "What's New for IMEs".

Some changes include: All examiners must be board certified; All examiners are required to complete the Medical Examiner's Handbook (MEH) test every 3 years; all examiners must either provide 384 hours of patient related services or complete 12 hours of continuing education every year; and all examiners and firms must reapply every 3 years. 

In an effort to keep the approved examiner list current, the reapplication process began in March 2010.  Examiners are notified by letter when it is time to reapply.  The list on the above website under "Find a Medical Examiner" is changing daily.  To date over half of the examiners and firms contacted have reapplied.  Check to be sure the examiner scheduled for an IME remains approved by the department.  For additional information, please call Carole Winegar, Self-Insured Program Occupational Nurse consultant, at (360) 902-6708.

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.

Department Issues

Pay During Appeal Benefits 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.

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 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.

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 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.

Provider Bulletin 10-02 – Work-Related Radial Nerve Entrapment (RNE) Treatment, with limitations

Provider Bulletin 10-03 – Advanced Imaging Utilization Review, preapproval required

Provider Bulletin 10-04 – Medical and Surgical Supply Coverage and Payment, changes

Surgical Guideline for Lumbar Fusion – Effective November 1, 2009

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. 

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 April 16, 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.

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 3 August 2010