Washington Administrative Code › Title 296 - Labor and Industries, Department of › Chapter 296-20 - Medical aid rules › IMPAIRMENT RATING › Section 296-20-200 - General information for impairment rating examinations by attending doctors, consultants or independent medical examination (IME) providers

Current through Register Vol. 24-14, July 15, 2024
(1) The department
				of labor and industries has promulgated the following rules and categories to
				provide a comprehensive system of classifying unspecified permanent partial
				disabilities in the proportion they reasonably bear to total bodily impairment.
				The department's objectives are to reduce litigation and establish more
				certainty and uniformity in the rating of unspecified permanent partial
				disabilities pursuant to
				RCW
				 51.32.080(2).
(2) The following system of rules and
				categories directs the provider's attention to the actual conditions found and
				establishes a uniform system for conducting rating examinations and reporting
				findings and conclusions in accord with broadly accepted medical principles.
The evaluation of bodily impairment must be made by experts
				  authorized to perform rating examinations. After conducting the examination,
				  the provider will choose the appropriate category for each bodily area or
				  system involved in the particular claim and include this information in the
				  report. The provider will, therefore, in addition to describing the worker's
				  condition in the report, submit the conclusions as to the relative severity of
				  the impairment by giving it in terms of a defined condition rather than a
				  personal opinion as to a percentage figure. In the final section of this system
				  of categories and rules are some rules for determining disabilities and the
				  classification of disabilities in bodily impairment is listed for each
				  category. These last provisions are for the department's administrative use in
				  acting upon the expert opinions which have been submitted to it.
(3) In preparing this system, the
				department has complied with its duty to enact rules classifying unspecified
				disabilities in light of statutory references to nationally recognized
				standards or guides for determining various bodily impairments. Accordingly,
				the department has obtained and acted upon sound established medical opinion in
				thus classifying unspecified disabilities in the reasonable proportion they
				bear to total bodily impairment. In framing descriptive language of the
				categories and in assigning a percentage of disability, careful consideration
				has been given to nationally recognized medical standards and guides. Both are
				matters calling for the use of expert medical knowledge. For this reason, the
				meaning given the words used in this set of categories and accompanying rules,
				unless the text or context clearly indicates the contrary, is the meaning
				attached to the words in normal medical usage.
(4) The categories describe levels of
				physical and mental impairment. Impairment is anatomic or functional
				abnormality or loss of function after maximum medical improvement has been
				achieved. This is the meaning of "impairment" as the word is used in the guides
				mentioned above. This standard applies to all persons equally, regardless of
				factors other than loss of physical or mental function. Impairment is evaluated
				without reference to the nature of injury or the treatment therefore, but is
				based on the functional loss due to the injury or occupational disease. The
				categories have been framed to include conditions in other bodily areas which
				derive from the primary impairment. The categories also include the presence of
				pain, tenderness and other complaints. Workers with comparable loss of function
				thus receive comparable awards.
(5)
				These rules and categories (WAC
				296-20-200 through
				296-20-690)  shall only be
				applicable to compensable injuries occurring on or after the effective date of
				these rules and categories.
(6)
				These rules and categories (WAC
				296-20-200 through
				296-20-690)  shall be applicable
				only to cases of permanent partial disability. They have no applicability to
				determinations of permanent total disability.
Statutory Authority:
					 RCW
					 51.32.055,
					 51.32.112,
					 51.32.114,
					 51.36.060, and
					 51.36.070. 04-04-029, §
					 296-20-200, filed 1/27/04, effective 3/1/04. Statutory Authority:
					 RCW
					  51.04.020,
					 51.04.030,
					 51.32.112,
					 51.32.114 and
					 51.36.015. 97-09-036, §
					 296-20-200, filed 4/14/97 effective 5/15/97. Statutory Authority:
					 RCW
					  51.04.020(4) and
					 51.04.030. 91-07-008, §
					 296-20-200, filed 3/8/91, effective 5/1/91; Order 74-32, § 296-20-200,
					 filed 6/21/74, effective 10/1/74.