reglab/statecodes huggingface dataset:
Washington Administrative Code › Title 296 - Labor and Industries, Department of › Chapter 296-20 - Medical aid rules › BILLING › Section 296-20-17002 - Billing

Current through Register Vol. 24-14, July 15, 2024
In addition to the billing procedures described in WAC
				  296-20-125 and in department
				  policy the current national drug code number for each prescribed drug, followed
				  by the average wholesale price to the pharmacy must be entered on each
				  prescription. The department's statement for pharmacy services must be used
				  when billing the department for NDC medications and supplies. The department's
				  statement for miscellaneous services must be used when billing the department
				  for non-NDC medications and supplies. In addition, the claimant's name, claim
				  number, date of injury, prescribing doctor's name and department of labor and
				  industries provider number; and the assigned department provider number for the
				  pharmacy must be on the bill. Bills for medication not containing this
				  information will be returned to the pharmacy. Billing must be made within one
				  year of the date of service. It is requested bills be presented on a monthly
				  basis.
When billing the department for compound prescriptions,
				  providers must use the "Statement for Compound
				  Prescriptions."
Statutory Authority:
					 RCW
					 51.04.020,
					 51.04.030 and 1993 c 159.
					 93-16-072, § 296-20-17002, filed 8/1/93, effective 9/1/93. Statutory
					 Authority:
					 RCW
					  51.04.020(4) and
					 51.04.030. 86-06-032 (Order
					 86-19), § 296-20-17002, filed 2/28/86, effective 4/1/86; 83-24-016 (Order
					 83-35), § 296-20-17002, filed 11/30/83, effective 1/1/84. Statutory
					 Authority:
					 RCW
					  51.04.020(4),
					 51.04.030, and
					 51.16.120(3).
					 80-18-033 (Order 80-24), § 296-20-17002, filed 12/1/80, effective 1/1/81;
					 Order 76-34, § 296-20-17002, filed 11/24/76, effective
					 1/1/77.
Washington Administrative Code › Title 296 - Labor and Industries, Department of › Chapter 296-20 - Medical aid rules › BILLING › Section 296-20-17004 - Billing and payment for initial prescription drugs

Current through Register Vol. 24-14, July 15, 2024
(1) Pharmacies may bill the department for
				initial prescription drugs prior to claim acceptance upon the presentation to
				the pharmacy of a state fund identification card or a copy of the
Report of Industrial Injury or Occupational Disease
with a
				valid claim number.
(2) The
				department will pay pharmacies or reimburse the worker for initial prescription
				drugs prescribed during the initial visit except when the prescription is:
(a) A second or subsequent filling of the
				initial prescription drugs prescribed for the same industrial injury or
				occupational disease prior to claim acceptance; or
(b) Associated with a self-insurer
				claim.
Washington Administrative Code › Title 296 - Labor and Industries, Department of › Chapter 296-20 - Medical aid rules › IMPAIRMENT RATING › Section 296-20-19000 - What is a permanent partial disability award?

Current through Register Vol. 24-14, July 15, 2024
Permanent partial disability is any anatomic or functional
				  abnormality or loss after maximum medical improvement (MMI) has been achieved.
				  At MMI, the worker's condition is determined to be stable or nonprogressive at
				  the time the evaluation is made. A permanent partial disability award is a
				  monetary award designed to compensate the worker for the amputation or loss of
				  function of a body part or organ system. Impairment is evaluated without
				  reference to the nature of the injury or the treatment given. To ensure
				  uniformity, consistency and fairness in rating permanent partial disability, it
				  is essential that injured workers with comparable anatomic abnormalities and
				  functional loss receive comparable disability awards. As such, the amount of
				  the permanent partial disability award is not dependent upon or influenced by
				  the economic impact of the occupational injury or disease on an individual
				  worker. Rather, Washington's Industrial Insurance Act requires that permanent
				  partial disability be established primarily by objective physical or clinical
				  findings establishing a loss of function. Mental health impairments are
				  evaluated under WAC
				  296-20-330 and
				  296-20-340.
Statutory Authority:
					 RCW
					 51.04.010,
					 51.04.020,
					 51.04.030,
					 51.32.080,
					 51.32.110,
					 51.32.112,
					 51.36.060. 02-21-105, §
					 296-20-19000, filed 10/22/02, effective
					 12/1/02.
Washington Administrative Code › Title 296 - Labor and Industries, Department of › Chapter 296-20 - Medical aid rules › IMPAIRMENT RATING › Section 296-20-19010 - Are there different types of permanent partial disabilities?

Current through Register Vol. 24-14, July 15, 2024
Under
				  Title
				  51 RCW, there are two types of
				  permanent partial disabilities.
(1)
				Specified disabilities are listed in
				RCW
				 51.32.080(1)(a). They are
				limited to amputation or loss of function of extremities, loss of hearing or
				loss of vision.
(2) Unspecified
				disabilities include, but are not limited to, internal injuries, back injuries,
				mental health conditions, respiratory disorders, and other disorders affecting
				the internal organs.
Statutory Authority:
					 RCW
					 51.04.010,
					 51.04.020,
					 51.04.030,
					 51.32.080,
					 51.32.110,
					 51.32.112,
					 51.36.060. 02-21-105, §
					 296-20-19010, filed 10/22/02, effective
					 12/1/02.
Washington Administrative Code › Title 296 - Labor and Industries, Department of › Chapter 296-20 - Medical aid rules › IMPAIRMENT RATING › Section 296-20-19020 - How is it determined which impairment rating system is to be used to rate specified and unspecified disabilities?

Current through Register Vol. 24-14, July 15, 2024
(1) Specified disabilities are rated in one
				of two ways:
(a) Impairment due to
				amputation, total loss of hearing, and total loss of vision are rated according
				to RCW
				 51.32.080;
(b) Impairment for the loss of function of
				extremities, as well as partial loss of hearing or vision, is rated using a
				nationally recognized impairment rating guide unless otherwise precluded by
				department rule.
Washington Administrative Code › Title 296 - Labor and Industries, Department of › Chapter 296-20 - Medical aid rules › IMPAIRMENT RATING › Section 296-20-19030 - To what extent is pain considered in an award for permanent partial disability?

Current through Register Vol. 24-14, July 15, 2024
The categories used to rate unspecified disabilities
				  incorporate the worker's subjective complaints. Similarly, the organ and body
				  system ratings in the AMA
Guides to the Evaluation of Permanent
				  Impairment
incorporate the worker's subjective complaints. A worker's
				  subjective complaints or symptoms, such as a report of pain, cannot be
				  objectively validated or measured. There is no valid, reliable or consistent
				  means to segregate the worker's subjective complaints of pain from the pain
				  already rated and compensated for in the conventional rating methods. When
				  rating a worker's permanent partial disability, reliance is primarily placed on
				  objective physical or clinical findings that are independent of voluntary
				  action by the worker and can be seen, felt or consistently measured by
				  examiners. No additional permanent partial disability award will be made beyond
				  what is already allowed in the categories and in the organ and body system
				  ratings in the AMA guides.
For example:
Chapter 18 of the 5th Edition of the AMA
Guides to
				  the Evaluation of Permanent Impairment
attempts to rate impairment
				  caused by a patient's pain complaints. The impairment caused by the worker's
				  pain complaints is already taken into consideration in the categories and in
				  the organ and body system ratings in the AMA guides. There is no reliable means
				  to segregate the pain already rated and compensated from the pain impairment
				  that Chapter 18 purports to rate. Chapter 18 of the 5th Edition of AMA
Guides to the Evaluation of Permanent Impairment
cannot be
				  used to calculate awards for permanent partial disability under Washington's
				  Industrial Insurance Act.
Statutory Authority:
					 RCW
					 51.04.010,
					 51.04.020,
					 51.04.030,
					 51.32.080,
					 51.32.110,
					 51.32.112,
					 51.36.060. 02-21-105, §
					 296-20-19030, filed 10/22/02, effective
					 12/1/02.
Washington Administrative Code › Title 296 - Labor and Industries, Department of › Chapter 296-20 - Medical aid rules › IMPAIRMENT RATING › Section 296-20-2010 - General rules for impairment rating examinations by attending doctors and consultants

Current through Register Vol. 24-14, July 15, 2024
These general rules must be followed by doctors who perform
				  examinations or evaluations of permanent bodily impairment.
(1) Impairment rating examinations shall be
				performed only by doctors currently licensed in medicine and surgery (including
				osteopathic and podiatric) or dentistry, and department-approved chiropractors
				subject to
				RCW
				 51.32.112. The department or self-insurer may
				request the worker's attending doctor conduct the impairment rating when
				appropriate. If the attending doctor is unable or unwilling to perform the
				impairment rating examination, a consultant, at the attending doctor's request,
				may conduct a consultation examination and provide an impairment rating based
				on the findings. The department or self-insurer can also request an impairment
				rating examination from an independent medical examination (IME) provider. A
				chiropractic impairment rating examination may be performed only when the
				worker has been clinically managed by a chiropractor.
(2) Whenever an impairment rating examination
				is made, the attending doctor or consultant must complete a rating report that
				includes, at a minimum, the following:
(a)
				Statement that the patient has reached maximum medical improvement (MMI) and
				that no further curative treatment is recommended;
(b) Pertinent details of the physical
				examination performed (both positive and negative findings);
(c) Results of any pertinent diagnostic tests
				performed (both positive and negative findings). Include copies of any
				pertinent tests or studies ordered as part of the exam;
(d) An impairment rating consistent with the
				findings and a statement of the system on which the rating was based (for
				example, the AMA
Guides to the Evaluation of Permanent
				Impairment
and edition used, or the Washington state category rating
				system - refer to WAC
				296-20-19000 through
				296-20-19030 and WAC
				296-20-200 through
				296-20-690); and
(e) The rationale for the rating, supported
				by specific references to the clinical findings, especially objective findings
				and supporting documentation including the specific rating system, tables,
				figures and page numbers on which the rating was based.
Washington Administrative Code › Title 296 - Labor and Industries, Department of › Chapter 296-20 - Medical aid rules › IMPAIRMENT RATING › Section 296-20-2015 - What rating systems are used for determining an impairment rating conducted by the attending doctor or a consultant?

Current through Register Vol. 24-14, July 15, 2024
The following table provides guidance regarding the rating
				  systems generally used. These rating systems or others adopted through
				  department policies should be used to conduct an impairment rating.
Overview of Systems for Rating Impairment
Rating System
Used for These Conditions
Form of the Rating
RCW  51.32.080
Specified disabilities: Loss by amputation, total
								loss of vision or hearing
Supply the level of amputation
AMA
Guides to the Evaluation of Permanent
								Impairment
Loss of function of extremities, partial loss of
								vision or hearing
Determine the percentage of loss of function, as
								compared to amputation value listed in
								RCW
								 51.32.080
Category Rating System
Spine, neurologic system, mental health,
								respiratory, taste and smell, speech, skin, or disorders affecting other
								internal organs
Select the category that most accurately indicates
								overall impairment
Total Bodily Impairment (TBI)
Impairments not addressed by any of the rating
								systems above, and claims prior to 1971
Supply the percentage of TBI
Statutory Authority:
					 RCW
					 51.32.055,
					 51.32.112,
					 51.32.114,
					 51.36.060, and
					 51.36.070. 04-04-029, §
					 296-20-2015, filed 1/27/04, effective
					 3/1/04.
Washington Administrative Code › Title 296 - Labor and Industries, Department of › Chapter 296-20 - Medical aid rules › IMPAIRMENT RATING › Section 296-20-2025 - May a worker bring someone with them to an impairment rating examination conducted by the attending doctor or a consultant?

Current through Register Vol. 24-14, July 15, 2024
(1) Workers can bring an adult friend or
				family member to the impairment ratingexamination to provide comfort and
				reassurance. The accompanying person may attend the physical examination but
				may not attend a psychiatric examination.
(2) The accompanying person cannot be
				compensated for attending the examination by anyone in any manner.
(3) The worker may not bring an interpreter
				to the examination. If interpretive services are needed, the department or
				self-insurer will provide an interpreter.
(4) The purpose of the impairment rating
				examination is to provide information to assist in the determination of the
				level of any permanent impairment, not to conduct an adversarial procedure.
				Therefore, the accompanying person cannot be:
(a) The worker's attorney, paralegal, any
				other legal representative, or any other personnel employed by the worker's
				attorney or legal representative; or
(b) The worker's attending doctor, any other
				provider involved in the worker's care, or any other personnel employed by the
				attending doctor or other provider involved in the worker's care.
The department may designate other conditions under which the
				  accompanying person is allowed to be present during the impairment rating
				  examination.
Washington Administrative Code › Title 296 - Labor and Industries, Department of › Chapter 296-20 - Medical aid rules › IMPAIRMENT RATING › Section 296-20-2030 - May the worker videotape or audiotape the impairment rating examination conducted by the attending doctor or a consultant?

Current through Register Vol. 24-14, July 15, 2024
The use of recording equipment of any kind by the worker or
				  accompanying person is not allowed.
Statutory Authority:
					 RCW
					 51.32.055,
					 51.32.112,
					 51.32.114,
					 51.36.060, and
					 51.36.070. 04-04-029, §
					 296-20-2030, filed 1/27/04, effective
					 3/1/04.
Washington Administrative Code › Title 296 - Labor and Industries, Department of › Chapter 296-20 - Medical aid rules › IMPAIRMENT RATING › Section 296-20-230 - Cervical and cervico-dorsal impairments

Current through Register Vol. 24-14, July 15, 2024
(1) Rules for evaluation of cervical and
				cervico-dorsal impairments are as follows:
(a) Muscle spasm or involuntary guarding,
				bony or fibrous fusion, any arthritic condition, internal fixation devices or
				other physical finding shall be considered, in selecting the appropriate
				category, only insofar as productive of cervical or cervico-dorsal
				impairment.
(b) Gradations of
				clinical findings of cervico-dorsal impairments in terms of "mild," "moderate"
				or "marked" shall be based on objective medical tests.
(c) Categories 2, 3, 4 and 5 include the
				presence of complaints of whatever degree in the neck or extremities.
(d) Bladder and/or bowel sphincter
				impairments deriving from cervical and cervico-dorsal impairment shall be
				evaluated separately.
(e) Neck as
				used in these rules and categories shall include the cervical and adjacent
				areas.
Washington Administrative Code › Title 296 - Labor and Industries, Department of › Chapter 296-20 - Medical aid rules › IMPAIRMENT RATING › Section 296-20-240 - Categories of permanent cervical and cervico-dorsal impairments

Current through Register Vol. 24-14, July 15, 2024
(1) No objective
				clinical findings are present. Subjective complaints may be present or
				absent.
(2) Mild cervico-dorsal
				impairment, with objective clinical findings of such impairment with neck
				rigidity substantiated by X-ray findings of loss of anterior curve, without
				significant objective neurological findings.
This and subsequent categories include the presence or
				  absence of pain locally and/or radiating into an extremity or extremities. This
				  and subsequent categories also include the presence or absence of reflex and/or
				  sensory losses. This and subsequent categories also include objectively
				  demonstrable herniation of a cervical intervertebral disc with or without
				  discectomy and/or fusion, if present.
(3) Mild cervico-dorsal impairment, with
				objective clinical findings of such impairment, with neck rigidity
				substantiated by X-ray findings of loss of anterior curve, narrowed
				intervertebral disc spaces and/or osteoarthritic lipping of vertebral margins,
				with significant objective findings of mild nerve root involvement.
This and subsequent categories include the presence or
				  absence of any other neurological deficits not otherwise specified in these
				  categories with the exception of bladder and/or bowel sphincter
				  impairments.
(4) Moderate
				cervico-dorsal impairment, with objective clinical findings of such impairment,
				with neck rigidity substantiated by X-ray findings of loss of anterior curve,
				narrowed intervertebral disc spaces and/or osteoarthritic lipping of vertebral
				margins, with objective findings of moderate nerve root involvement with
				weakness and numbness in one or both upper extremities.
(5) Marked cervico-dorsal impairment, with
				marked objective clinical findings of such impairment, with neck rigidity
				substantiated by X-ray findings of loss of anterior curve, narrowed
				intervertebral disc spaces and/or osteoarthritic lipping of vertebral margins,
				with objective findings of marked nerve root involvement with weakness and
				numbness in one or both upper extremities.
Order 74-32, § 296-20-240, filed 6/21/74, effective
					 10/1/74.
Washington Administrative Code › Title 296 - Labor and Industries, Department of › Chapter 296-20 - Medical aid rules › IMPAIRMENT RATING › Section 296-20-250 - Impairments of the dorsal area

Current through Register Vol. 24-14, July 15, 2024
(1)
				Rules for evaluation of permanent dorsal area impairments are as follows:
(a) Muscle spasm or involuntary guarding,
				bony or fibrous fusion, any arthritic condition, internal fixation devices or
				other physical finding shall be considered, in selection of the appropriate
				category, only insofar as productive of dorsal area impairment.
(b) Gradations of clinical findings of dorsal
				impairments in terms of "mild," "moderate" or "marked" shall be based on
				objective medical tests.
(c)
				Categories 2 and 3 include the presence of complaints of whatever
				degree.
(d) Bladder and/or bowel
				sphincter impairments deriving from impairments of the dorsal area shall be
				evaluated separately.
(e)
				Impairments which also involve the cervical or lumbar areas shall be evaluated
				only under the cervical and cervico-dorsal or dorsolumbar and lumbosacral
				categories.
Washington Administrative Code › Title 296 - Labor and Industries, Department of › Chapter 296-20 - Medical aid rules › IMPAIRMENT RATING › Section 296-20-260 - Categories of permanent dorsal area impairments

Current through Register Vol. 24-14, July 15, 2024
(1) No objective clinical findings are
				present. Subjective complaints may be present or absent.
(2) Mild or moderate dorsal impairment, with
				objective clinical findings of such impairment, without significant objective
				neurological findings, with or without X-ray changes of narrowed intervertebral
				disc spaces and/or osteoarthritic lipping of intervertebral margins. Includes
				the presence or absence of reflex and/or sensory losses.
This and the subsequent category include the presence or
				  absence of pain, locally or radiating from the dorsal area.
(3) Marked dorsal impairment, with marked
				objective clinical findings, with marked X-ray findings of narrowed
				intervertebral disc spaces and/or osteoarthritic lipping of vertebral margins,
				with significant objective neurological deficits, complaints and/or findings,
				deriving from dorsal impairment.
Order 74-32, § 296-20-260, filed 6/21/74, effective
					 10/1/74.
Washington Administrative Code › Title 296 - Labor and Industries, Department of › Chapter 296-20 - Medical aid rules › IMPAIRMENT RATING › Section 296-20-270 - Dorso-lumbar and lumbosacral impairments

Current through Register Vol. 24-14, July 15, 2024
(1) Rules for evaluation of permanent
				dorso-lumbar and lumbosacral impairments are as follows:
(a) Muscle spasm or involuntary guarding,
				bony or fibrous fusion, any arthritic condition, internal fixation devices or
				other physical finding shall be considered, in selecting the appropriate
				category, only insofar as productive of low back impairment.
(b) Gradations of clinical findings of low
				back impairments in terms of "mild," "moderate" or "marked" shall be based on
				objective medical tests.
(c) All of
				the low back categories include the presence of complaints of whatever
				degree.
(d) Any and all
				neurological deficits, complaints, and/or findings in other bodily areas or
				systems which are the result of dorso-lumbar and lumbosacral impairments,
				except for objectively demonstrated bladder and/or bowel sphincter impairments,
				shall be evaluated by the descriptions contained in the categories of
				dorso-lumbar and lumbosacral impairments.
(e) Bladder and/or bowel sphincter
				impairments deriving from dorso-lumbar and lumbosacral impairments shall be
				evaluated separately.
(f) Low back
				as used in these rules and categories includes the lumbar and adjacent
				areas.
Washington Administrative Code › Title 296 - Labor and Industries, Department of › Chapter 296-20 - Medical aid rules › IMPAIRMENT RATING › Section 296-20-280 - Categories of permanent dorso-lumbar and lumbosacral impairments

Current through Register Vol. 24-14, July 15, 2024
(1) No objective
				clinical findings. Subjective complaints and/or sensory losses may be present
				or absent.
(2) Mild low back
				impairment, with mild intermittent objective clinical findings of such
				impairment but no significant X-ray findings and no significant objective motor
				loss. Subjective complaints and/or sensory losses may be present.
(3) Mild low back impairment, with mild
				continuous or moderate intermittent objective clinical findings of such
				impairment but without significant X-ray findings or significant objective
				motor loss.
This and subsequent categories include: The presence or
				  absence of reflex and/or sensory losses; the presence or absence of pain
				  locally and/or radiating into an extremity or extremities; the presence or
				  absence of a laminectomy or discectomy with normally expected residuals.
(4) Mild low back impairment, with
				mild continuous or moderate intermittent objective clinical findings of such
				impairment, with mild but significant X-ray findings and with mild but
				significant motor loss objectively demonstrated by atrophy and weakness of a
				specific muscle or muscle group.
This and subsequent categories include the presence or
				  absence of a surgical fusion with normally expected residuals.
(5) Moderate low back impairment,
				with moderate continuous or marked intermittent objective clinical findings of
				such impairment, with moderate X-ray findings and with mild but significant
				motor loss objectively demonstrated by atrophy and weakness of a specific
				muscle or muscle group.
(6) Marked
				low back impairment, with marked intermittent objective clinical findings of
				such impairment, with moderate or marked X-ray findings and with moderate motor
				loss objectively demonstrated by atrophy and weakness of a specific muscle or
				muscle group.
(7) Marked low back
				impairment, with marked continuous objective clinical findings of such
				impairment, with marked X-ray findings and with marked motor loss objectively
				demonstrated by marked atrophy and weakness of a specific muscle or muscle
				group.
(8) Essentially total loss
				of low back functions, with marked X-ray findings and with marked motor loss
				objectively demonstrated by marked atrophy and weakness of a muscle group or
				groups.
Statutory Authority:
					 RCW
					 51.04.020(4) and
					 51.04.030. 83-16-066 (Order
					 83-23), § 296-20-280, filed 8/2/83; Order 74-32, § 296-20-280, filed
					 6/21/74, effective 10/1/74.
Washington Administrative Code › Title 296 - Labor and Industries, Department of › Chapter 296-20 - Medical aid rules › IMPAIRMENT RATING › Section 296-20-290 - Impairments of the pelvis

Current through Register Vol. 24-14, July 15, 2024
(1) Rules for
				impairment of the pelvis:
(a) All of these
				categories include the presence of complaints of whatever degree.
(b) Categories 2, 5, 6 and 7 describe
				separate entities and more than one may be selected when appropriate. Category
				9 includes the findings described in Category 3, and Category 8 includes the
				findings described in Category 4.
Washington Administrative Code › Title 296 - Labor and Industries, Department of › Chapter 296-20 - Medical aid rules › IMPAIRMENT RATING › Section 296-20-300 - Categories of permanent impairments of the pelvis

Current through Register Vol. 24-14, July 15, 2024
(1) Healed pelvic fractures without
				displacement, without residuals; healed fractures with displacement without
				residuals, of: Single ramus, bilateral rami, ilium, innominate or coccyx; or
				healed fracture of single rami with displacement with deformity and
				residuals.
(2) Healed fractures
				with displacement with deformity and residuals of ilium.
(3) Healed fractures of symphysis pubis,
				without separation with displacement without residuals.
(4) Healed fractures of sacrum with
				displacement without residuals.
(5)
				Healed fracture of bilateral rami with displacement with deformity and
				residuals.
(6) Excision or nonunion
				of fractures of coccyx.
(7) Healed
				fractures of innominate, displaced one inch or more, with deformity and
				residuals.
(8) Healed fractures of
				sacrum extending into sacroiliac joint with deformity and residuals.
(9) Healed fractures of symphysis, displaced
				or separated, with deformity and residuals.
Order 74-32, § 296-20-300, filed 6/21/74, effective
					 10/1/74.
Washington Administrative Code › Title 296 - Labor and Industries, Department of › Chapter 296-20 - Medical aid rules › IMPAIRMENT RATING › Section 296-20-310 - Convulsive neurological impairments

Current through Register Vol. 24-14, July 15, 2024
(1)
				Rules for evaluation of convulsive neurological impairments:
(a) The description of Categories 2, 3 and 4
				include the presence of complaints of whatever degree.
Washington Administrative Code › Title 296 - Labor and Industries, Department of › Chapter 296-20 - Medical aid rules › IMPAIRMENT RATING › Section 296-20-320 - Categories of permanent convulsive neurological impairments

Current through Register Vol. 24-14, July 15, 2024
(1) No
				electroencephalogram findings of convulsive neurological disorder. Subjective
				complaints may be present or absent.
(2) Electroencephalogram findings of
				convulsive neurological disorder, but on appropriate medication there are no
				seizures.
(3) Electroencephalogram
				findings of convulsive neurological disorder, and on appropriate medication
				there are each year either one through four major seizures or one through
				twelve minor seizures.
(4)
				Electroencephalogram findings of convulsive neurological disorder, and on
				appropriate medication there are each year either more than four major seizures
				or more than twelve minor seizures.
Order 74-32, § 296-20-320, filed 6/21/74, effective
					 10/1/74.
Washington Administrative Code › Title 296 - Labor and Industries, Department of › Chapter 296-20 - Medical aid rules › IMPAIRMENT RATING › Section 296-20-330 - Impairments of mental health

Current through Register Vol. 24-14, July 15, 2024
Rules for evaluation of permanent impairment of mental
				  health:
(1) Mental illness means
				malfunction of the psychic apparatus that significantly interferes with
				ordinary living.
(2) Each person
				has a pattern of adjustment to life. The pattern of adjustment before the
				industrial injury or occupational disease serves as a base line for all
				assessments of whether there has been a permanent impairment due to the
				industrial injury or occupational disease.
(3) To determine the preinjury pattern of
				adjustment, all evaluations of mental health shall contain a complete preinjury
				history including, but not necessarily limited to: Family background and the
				relationships with parents or other nurturing figures; extent of education and
				reaction to it; military experience, if any; problems with civil authorities;
				any history of prolonged illness, and difficulty with recovery; any history of
				drug abuse or alcoholism; employment history, the extent of and reaction to
				responsibility, and relationships with others at work; capacity to make and
				retain friends; relationships with spouses and children; nature of daily
				activities, including recreation and hobbies; and lastly, some summary
				statement about the sources of the patient's self-esteem and sense of identity.
				Both strengths and vulnerabilities of the person shall be included.
(4) Differences in adjustment patterns before
				and after the industrial injury or occupational disease shall be described, and
				the report shall contain the examining physician's opinion as to whether any
				differences:
(a) Are the result of the
				industrial injury or occupational disease and its sequelae, in the sense they
				would not have occurred had there not been the industrial injury or
				occupational disease;
(b) Are
				permanent or temporary;
(c) Are
				more than the normal, self-correcting and expectable response to the stress of
				the industrial injury or occupational disease;
(d) Constitute an impairment psychosocially
				or physiologically; and
(e) Are
				susceptible to treatment, and, if so, what kind. The presence of any unrelated
				or coincidental mental impairment shall always be mentioned.
Washington Administrative Code › Title 296 - Labor and Industries, Department of › Chapter 296-20 - Medical aid rules › IMPAIRMENT RATING › Section 296-20-350 - Cardiac impairments

Current through Register Vol. 24-14, July 15, 2024
(1) Rule for
				evaluation of permanent cardiac impairments:
(a) Classification of impairment using the
				following categories shall be based upon a carefully obtained history, thorough
				physical examination and the use of appropriate laboratory aids.
Washington Administrative Code › Title 296 - Labor and Industries, Department of › Chapter 296-20 - Medical aid rules › IMPAIRMENT RATING › Section 296-20-360 - Categories of permanent cardiac impairments

Current through Register Vol. 24-14, July 15, 2024
(1) No objective findings are present.
				Subjective complaints may be present or absent.
(2) Objective findings of mild organic heart
				disease but no signs of congestive heart failure. No medically appropriate
				symptoms produced by prolonged exertion or intensive effort or marked emotional
				stress.
(3) Objective findings of
				mild organic heart disease but no signs of congestive heart failure. Medically
				appropriate symptoms produced by prolonged exertion or intensive effort, or
				marked emotional stress but not by usual daily activities.
(4) Objective findings of moderate organic
				heart disease but no signs of congestive heart failure. Medically appropriate
				symptoms produced by prolonged exertion or intensive effort or marked emotional
				stress but not by usual daily activities.
(5) Objective findings of marked organic
				heart disease with minimal signs of congestive heart failure with therapy.
				Medically appropriate symptoms produced by usual daily activities.
(6) Objective findings of marked organic
				heart disease with mild to moderate signs of congestive heart failure despite
				therapy. Medically appropriate symptoms produced by usual daily
				activities.
Order 74-32, § 296-20-360, filed 6/21/74, effective
					 10/1/74.
Washington Administrative Code › Title 296 - Labor and Industries, Department of › Chapter 296-20 - Medical aid rules › IMPAIRMENT RATING › Section 296-20-380 - Categories of permanent respiratory impairments

Current through Register Vol. 24-14, July 15, 2024
(1) The FVC and FEV1 are greater than or
				equal to eighty percent of predicted normal for the person's age, gender, and
				height. The FEV1/FVC ratio is greater than or equal to .70. Subjective
				complaints may be present or absent. If exercise testing is done, the maximum
				oxygen consumption is greater than 25cc/kilo/min.
(2) The FVC or FEV1 is from seventy to
				seventy-nine percent of predicted, and if obstruction is present, the FEV1/FVC
				ratio is .60 - .69. If exercise testing is done, the maximum oxygen consumption
				is 22.5-25cc/kilo/min.
(3) The FVC
				or FEV1 is from sixty to sixty-nine percent of predicted, and if obstruction is
				present, the FEV1/FVC ratio is .60 - .69. If exercise testing is done, the
				maximum oxygen consumption is 20-22.4cc/kilo/min.
(4) The FVC or FEV1 is from fifty-one to
				fifty-nine percent of predicted. The FEV1/FVC ratio is .51 - .59. If exercise
				testing is done, the maximum oxygen consumption is
				17.5-19.9cc/kilo/min.
(5) FVC from
				fifty-one to fifty-nine percent of predicted, or the FEV1 from forty-one to
				fifty percent of predicted, and if obstruction is present, the FEV1/FVC ratio
				is .41 - .50. If exercise testing is done, the maximum oxygen consumption is
				15-17.4cc/kilo/min.
(6) The FVC is
				equal to or less than fifty percent of predicted or the FEV1 is equal to or
				less than forty percent of predicted. The FEV1/FVC ratio is equal to or less
				than .40. If exercise testing is done, the maximum oxygen consumption is less
				than 15cc/kilo/min.
Statutory Authority:
					 RCW
					 51.04.020(4),
					 51.04.030 and
					 51.32.080(2).
					 94-03-073, § 296-20-380, filed 1/17/94, effective 3/1/94. Statutory
					 Authority:
					 RCW
					  51.04.020(4) and
					 51.04.030. 82-24-050 (Order
					 82-39), § 296-20-380, filed 11/29/82, effective 1/1/83; Order 74-32,
					 § 296-20-380, filed 6/21/74, effective
					 10/1/74.
Washington Administrative Code › Title 296 - Labor and Industries, Department of › Chapter 296-20 - Medical aid rules › IMPAIRMENT RATING › Section 296-20-385 - Categories of persisting variable respiratory impairment with normal baseline spirometry

Current through Register Vol. 24-14, July 15, 2024
(1) "Normal"
				bronchial reactivity is demonstrated by an insignificant (less than twenty
				percent) fall from baseline FEV1 at test doses of histamine or methacholine, up
				to 16 mg/ml (continuous inhalation method) or up to 160 breath units
				(cumulative, repeated deep breath technique).
(2) "Mild" bronchial hyperactivity (BHR) is a
				significant (equal to or greater than twenty percent) fall in the FEV1 at test
				doses of 2.1-16 mg/ml, or 21-160 breath units.
(3) "Moderate" BHR is a significant (equal to
				or greater than twenty percent) fall in the FEV1 at test doses of 0.26-2 mg/ml,
				or 2.6-20 breath units.
(4)
				"Marked" BHR is a significant (equal to or greater than twenty percent) fall in
				the FEV1 at test doses equal to or less than .25 mg/ml, or 2.5 breath
				units.
Statutory Authority:
					 RCW
					 51.04.020(4),
					 51.04.030 and
					 51.32.080(2).
					 94-03-073, § 296-20-385, filed 1/17/94, effective
					 3/1/94.
Washington Administrative Code › Title 296 - Labor and Industries, Department of › Chapter 296-20 - Medical aid rules › IMPAIRMENT RATING › Section 296-20-390 - Air passage impairments

Current through Register Vol. 24-14, July 15, 2024
(1) Rule for
				evaluation of permanent air passage impairments:
(a) Categories 2, 3, 4 and 5 include the
				presence of complaints of whatever degree.
Washington Administrative Code › Title 296 - Labor and Industries, Department of › Chapter 296-20 - Medical aid rules › IMPAIRMENT RATING › Section 296-20-400 - Categories of permanent air passage impairments

Current through Register Vol. 24-14, July 15, 2024
(1) No objective findings are present.
				Subjective complaints may be present or absent.
(2) Objective findings of one or more of the
				following air passage defects: Partial obstruction of oropharynx,
				laryngopharynx, larynx, trachea, bronchi, complete obstruction of nasopharynx
				or of nasal passages bilaterally. No dyspnea caused by the air passage defect
				even on activity requiring prolonged exertion or intensive effort.
(3) Objective findings of one or more of the
				following air passage defects: Partial obstruction of oropharynx,
				laryngopharynx, larynx, trachea, bronchi, complete obstruction of nasopharynx
				or of nasal passages bilaterally, dyspnea caused by the air passage defect
				produced only by prolonged exertion or intensive effort.
(4) Objective findings of one or more of the
				following air passage defects: Partial obstruction of oropharynx,
				laryngopharynx, larynx, trachea, bronchi, complete obstruction of nasopharynx
				or of nasal passages bilaterally, with permanent tracheostomy or stoma, dyspnea
				caused by the air passage defect produced only by prolonged exertion or
				intensive effort.
(5) Objective
				findings of one or more of the following air passage defects: Partial
				obstruction of oropharynx, laryngopharynx, larynx, trachea, bronchi, with or
				without permanent tracheostomy or stoma if dyspnea is produced by moderate
				exertion.
(6) Objective findings of
				one or more of the following air passage defects: Partial obstruction of
				oropharynx, laryngopharynx, larynx, trachea, bronchi, with or without permanent
				tracheostomy or stoma if dyspnea is produced by mild exertion.
Statutory Authority:
					 RCW
					 51.04.020(4) and
					 51.04.030. 83-16-066 (Order
					 83-23), § 296-20-400, filed 8/2/83; Order 74-32, § 296-20-400, filed
					 6/21/74, effective 10/1/74.
Washington Administrative Code › Title 296 - Labor and Industries, Department of › Chapter 296-20 - Medical aid rules › IMPAIRMENT RATING › Section 296-20-410 - Nasal septum impairments

Current through Register Vol. 24-14, July 15, 2024
(1)
				Rules for evaluation of permanent air passage impairments due to nasal septum
				perforation.
(a) These categories, if
				appropriate, are to be used in addition to the categories of permanent air
				passage impairment.
(b) Categories
				1 and 2 include complaints of whatever degree.
Washington Administrative Code › Title 296 - Labor and Industries, Department of › Chapter 296-20 - Medical aid rules › IMPAIRMENT RATING › Section 296-20-420 - Categories of permanent air passage impairment due to nasal septum perforations

Current through Register Vol. 24-14, July 15, 2024
(1) Perforation
				or perforations posterior to the cartilaginous septum.
(2) Perforation or perforations through or
				anterior to the cartilaginous septum.
Order 74-32, § 296-20-420, filed 6/21/74, effective
					 10/1/74.
Washington Administrative Code › Title 296 - Labor and Industries, Department of › Chapter 296-20 - Medical aid rules › IMPAIRMENT RATING › Section 296-20-430 - Loss of taste and smell

Current through Register Vol. 24-14, July 15, 2024
(1) Rule
				for evaluation of permanent loss of taste and smell.
(a) If the person being examined can detect
				any odor or taste, even though it cannot be named, no category shall be
				assigned.
Washington Administrative Code › Title 296 - Labor and Industries, Department of › Chapter 296-20 - Medical aid rules › IMPAIRMENT RATING › Section 296-20-440 - Categories of permanent loss of taste and smell

Current through Register Vol. 24-14, July 15, 2024
(1) Loss of sense of taste.
(2) Loss of sense of smell.
Order 74-32, § 296-20-440, filed 6/21/74, effective
					 10/1/74.
Washington Administrative Code › Title 296 - Labor and Industries, Department of › Chapter 296-20 - Medical aid rules › IMPAIRMENT RATING › Section 296-20-450 - Speech impairments

Current through Register Vol. 24-14, July 15, 2024
(1) Rules for
				evaluation of permanent speech impairments.
(a) The physician making an examination for
				evaluation of permanent speech impairment should have normal hearing and the
				examination should be conducted in a reasonably quiet office which approximates
				the noise level conditions of everyday living.
(b) Selection of the appropriate category of
				permanent speech impairment shall be based on direct observation of the speech
				of the person being examined, including, but not limited to: Response to
				interview, oral reading, and counting aloud. The observation shall be made with
				the physician about eight feet from the person being examined both when he
				faces the physician and with his back to the physician.
Washington Administrative Code › Title 296 - Labor and Industries, Department of › Chapter 296-20 - Medical aid rules › IMPAIRMENT RATING › Section 296-20-460 - Categories of permanent speech impairments

Current through Register Vol. 24-14, July 15, 2024
(1) No objective findings of significant
				speech impairment are present. Subjective complaints may be present or
				absent.
(2) Can produce speech of
				sufficient audibility, intelligibility and functional efficiency for most
				everyday needs, although this may require effort and occasionally exceed
				capacity; listeners may occasionally ask for repetition and it may be difficult
				to produce some elements of speech, and there may be slow speaking and
				hesitation.
(3) Can produce speech
				of sufficient audibility, intelligibility and functional efficiency for many
				everyday needs, is usually heard under average conditions but may have
				difficulty in automobiles, busses, trains, or enclosed areas; can give name,
				address, and be understood by a stranger, but may have numerous inaccuracies
				and have difficulty articulating; speech may be interrupted, hesitant or
				slow.
(4) Can produce speech of
				sufficient audibility, intelligibility and functional efficiency for some
				everyday needs such as close conversation, conversation with family and
				friends, but has considerable difficulty in noisy places; voice tires rapidly
				and tends to become inaudible in a few seconds, strangers may find patient
				difficult to understand; patient may be asked to repeat often, and often can
				only sustain consecutive speech for brief periods.
(5) Can produce speech of sufficient
				audibility, intelligibility and functional efficiency for few everyday needs;
				can barely be heard by a close listener or over the telephone; may be able to
				whisper audibly but has no voice; can produce some speech elements; may have
				approximation of a few words such as names of family members which are,
				however, unintelligible out of context; cannot maintain uninterrupted speech
				flow, speech is labored, and its rate is impractically slow.
(6) Is unable to produce speech of sufficient
				audibility, intelligibility and functional efficiency for any everyday
				needs.
Order 74-32, § 296-20-460, filed 6/21/74, effective
					 10/1/74.
Washington Administrative Code › Title 296 - Labor and Industries, Department of › Chapter 296-20 - Medical aid rules › IMPAIRMENT RATING › Section 296-20-470 - Skin impairments

Current through Register Vol. 24-14, July 15, 2024
(1) Rules for
				evaluation of permanent skin impairments.
(a)
				Evaluation of permanent impairment of the skin shall be based upon actual loss
				of function and cosmetic factors shall not be considered.
(b) Categories 2, 3, 4, 5 and 6 include the
				presence of complaints of whatever degree.
Washington Administrative Code › Title 296 - Labor and Industries, Department of › Chapter 296-20 - Medical aid rules › IMPAIRMENT RATING › Section 296-20-480 - Categories of permanent skin impairments

Current through Register Vol. 24-14, July 15, 2024
(1) Objective findings of skin disorder may
				be present or absent but there is no or minimal limitation in daily activities.
				Subjective complaints may be present or absent.
(2) Objective findings of skin disorder are
				present and there is discomfort and minimal limitation in the performance of
				daily activities.
(3) Objective
				findings of skin disorder are present and there is limitation in some daily
				activities, including avoidance of and protective measures against certain
				chemical or physical agents. Intermittent symptomatic treatment is
				required.
(4) Objective findings of
				skin disorder are present and there is limitation in many daily activities,
				including avoidance of and protective measures against certain chemical or
				physical agents. Continuous symptomatic treatment is required.
(5) Objective findings of skin disorder are
				present and there is limitation in most daily activities, including avoidance
				of and protective measures against certain chemical or physical agents.
				Continuous symptomatic treatment is required.
(6) Objective findings of skin disorder are
				present and there is limitation in all daily activities, including avoidance of
				and protective measures against certain chemical or physical agents. Continuous
				symptomatic treatment is required.
Order 74-32, § 296-20-480, filed 6/21/74, effective
					 10/1/74.
Washington Administrative Code › Title 296 - Labor and Industries, Department of › Chapter 296-20 - Medical aid rules › IMPAIRMENT RATING › Section 296-20-490 - Impairment of the upper digestive tract, stomach, esophagus or pancreas

Current through Register Vol. 24-14, July 15, 2024
(1) Rule for
				evaluation of permanent impairments of the upper digestive tract, stomach,
				esophagus or pancreas.
(a) Categories 2, 3, 4
				and 5 include complaints of whatever degree.
Washington Administrative Code › Title 296 - Labor and Industries, Department of › Chapter 296-20 - Medical aid rules › IMPAIRMENT RATING › Section 296-20-500 - Categories of permanent impairments of the upper digestive tract, stomach, esophagus or pancreas

Current through Register Vol. 24-14, July 15, 2024
(1) No objective
				findings are present. Subjective complaints may be present or absent.
(2) There are objective findings of digestive
				tract impairment but no anatomic loss or alteration, continuous treatment is
				not required and weight can be maintained at the medically appropriate
				level.
(3) There are objective
				findings of digestive tract impairment, or there is anatomic loss or
				alteration. Dietary restrictions and drugs control symptoms, signs and/or
				nutritional state, and weight can be maintained at at least 90 percent of
				medically appropriate level.
(4)
				There are objective findings of digestive tract impairment, or there is
				anatomic loss or alteration. Dietary restrictions and drugs do not completely
				control symptoms, signs and/or nutritional state. Weight can be maintained at
				80-90 percent of medically appropriate level.
(5) There are objective findings of digestive
				tract impairment, or there is anatomic loss or alteration. Dietary restrictions
				and drugs do not control symptoms, signs and/or nutritional state. Weight
				cannot be maintained as high as 80 percent of medically appropriate
				level.
Order 74-32, § 296-20-500, filed 6/21/74, effective
					 10/1/74.