Washington Administrative Code

(1) Under RCW 18.27.250 a contractor may appeal a notice of infraction by:(a) Filing the notice of appeal with the department within thirty calendar days of service of the infraction on-site or within thirty calendar days of the postmark date of the infraction served through the …

If a contractor fails to appeal a notice of infraction and assessment within the required time frame, the notice of infraction and assessment becomes final and binding and payment is due. If the department does not receive payment, collections action will be taken, which may incl…

An administrative law judge from the office of administrative hearings will preside over the hearing and give a decision. The hearing shall be conducted in the county where the infraction occurred. However, both the contractor and the department have a right to ask the administra…

(1) Contractors may be represented by themselves or be represented by an attorney at law qualified to practice in the state of Washington.(2) The department shall be represented by the office of the attorney general.[Statutory Authority: Chapter 18.27 RCW and 2007 c 436. WSR 08-1…

The hearing process shall be conducted according to chapter 34.05 RCW, Administrative Procedure Act and chapter 10-08 WAC. All appeals of the administrative law judge's decision shall be to the superior court according to chapter 34.05 RCW.[Statutory Authority: RCW 18.27.040, 18.…

The admission of evidence is subject to chapter 34.05 RCW, Administrative Procedure Act.[Statutory Authority: RCW 18.27.040, 18.27.070, 18.27.075, 18.27.125, 2001 c 159, and chapter 18.27 RCW. WSR 03-20-097, § 296-200A-380, filed 9/30/03, effective 11/17/03. Statutory Authority: …

(1) Appeal notices that are received timely are first reviewed by the department for purposes of reconsideration.(2) Appeal notices that are not received timely will be returned to the appellant with appeal rights stated, and return of the required two hundred dollar appeal bond …

(1) Each day that a violation occurs will be a separate offense.(2) Once a violation of chapter 18.27 RCW or this chapter becomes a final judgment, any additional violation within three years becomes a "second" or "additional" offense subject to an increased penalty as set forth …

(1) If a contractor named in a notice of infraction does not choose to appeal the notice, then the contractor must pay the department the amount of the penalty prescribed for the infraction.(2) After an administrative law judge decides that an infraction has been committed, a con…

(Effective until July 1, 2026)The department charges the following fees:(1) $141.10 for each issuance, renewal or reregistration of a certificate of registration for contractors. This registration is valid for two years from date of issuance, renewal or reregistration or until it…

(Effective July 1, 2026)(1) "Claimant" means the owner of an owner-occupied residential property in the state.(2) "Residential property" means a single-family dwelling, or a multifamily dwelling consisting of four or fewer units, but does not include a condominium.[Statutory Auth…

(Effective July 1, 2026)A claimant may file a claim with the department. To qualify, the claimant must:(1) Own and occupy the residential property at the time the work was performed;(2) Have obtained a final judgment from superior court for a claim filed against the bond as ident…

(Effective July 1, 2026)(1) Claimants must submit:(a) A completed claim on the department provided form;(b) A certified copy of the final judgment;(c) Proof of residency such as a deed, mortgage statement, or utility bill from the last 60 days showing the name and address of the …

(Effective July 1, 2026)After a claim is submitted, the department will:(1) Review the documentation for completeness and eligibility.(2) Make a decision to approve or deny the claim and notify the claimant in writing of the decision.(a) If a claim is denied, the department will …

(Effective July 1, 2026)The department will pay the amount of the unpaid judgment up to $25,000 per contractor per parcel.[Statutory Authority: 2023 c 213, 2019 c 155, and chapter 18.27 RCW. WSR 26-09-115 (Order 25-07), s 296-200A-9120, filed 4/21/26, effective 7/1/26.]

(Effective July 1, 2026)The department may deny a claim if:(1) The claim is incomplete or contains false information;(2) The judgment does not meet eligibility requirements;(3) The judgment has been satisfied; or(4) The application was not made within 90 days of the final judgmen…

(Effective July 1, 2026)(1) Claims will be reviewed in the order received.(2) If there are not enough funds available for payment, claimants will be placed on a waitlist until funds become available.(3) Claimants on the waitlist will be paid in the order of placement on the list.…

(Effective July 1, 2026)(1) Prior to payment, the claimant will assign their final judgment which includes their right, title, and interest to the department.(2) Upon payment from the homeowner recovery account, the department will notify the contractor the existing final judgmen…

(1) The following rule supplements information contained in the fee schedules regarding coverage and reimbursement for mental health services.(2) Treatment of mental conditions to workers is to be goal directed, time limited, intensive, targeted on specific symptoms and functiona…

Procedures listed in the fee schedules are for use by medical doctors, osteopathic physicians, licensed psychologists and other qualified providers as determined by department policy. All providers of biofeedback are bound by the medical aid rules and fee schedule for biofeedback…

(1) Whom does the department authorize and pay for physical medicine or physical therapy services? The department or self-insurer may authorize and pay for physical medicine services from the following providers:• A medical or osteopathic physician who is "board certified or boar…

(1) Rules and billing procedures pertaining to all practitioners rendering services to workers are presented in the general instruction section beginning with WAC 296-20-010.(2) Billing codes, reimbursement levels, and supporting policies are listed in the fee schedules.(3) Refer…

(1) Radiographs should not be sent to the department or self-insurer unless they are requested for comparison and interpretation in determining a permanent disability, administrative or legal decisions, and for cases in litigation. X-rays must be retained for a period of 10 years…

Every attempt should be made to minimize the number of X-rays taken for workers. The attending provider or any other person or institution having possession of X-rays which pertain to the injury and are deemed to be needed for diagnostic or treatment purposes should make these X-…

(1) Rules and billing procedures pertaining to all practitioners rendering service to workers are presented in general information section beginning with WAC 296-20-010.(2) Refer to WAC 296-20-132 and 296-20-135 for information regarding use of the conversion factors.(3) Refer to…

(1) The department or self-insurer is responsible only for repair or replacement of teeth injured or prosthodontics broken as a result of an industrial injury.(2) Information pertaining to industrial claims is explained in WAC 296-20-010.(3) Information pertaining to reports of a…

(1) The department or self-insurer will reimburse for certain proper and necessary miscellaneous services and items needed as a result of an industrial accident. Nursing care, attendant services, transportation, hearing aids, eyeglasses, orthotics and prosthetics, braces, medical…

Requires prior approval from the assistant director for industrial insurance.[Statutory Authority: RCW 51.04.020(4) and 51.04.030. WSR 96-10-086, § 296-23-180, filed 5/1/96, effective 7/1/96. Statutory Authority: RCW 51.04.020, 51.04.030 and 1993 c 159. WSR 93-16-072, § 296-23-18…

See WAC 296-20-035, 296-20-045, and 296-20-051 for rules pertaining to consultation.Chiropractic consultation requires prior notification to the department or self-insurer. Consultants must be from an approved list of chiropractic consultants.The codes and reimbursement levels fo…

General instructions for naturopathic physicians:(1) Refer to WAC 296-20-010 through 296-20-125 for general rules and billing procedures including, but not limited to:(a) WAC 296-20-06101 for reporting requirements.(b) WAC 296-20-01002 for the definition of "proper and necessary"…

(Effective until July 1, 2026)Practitioners should refer to WAC 296-20-010 through 296-20-125 for general information and rules pertaining to the care of workers.Refer to WAC 296-20-132 and 296-20-135 regarding the use of conversion factors.All supplies and materials must be bill…

(Effective until July 1, 2026)Practitioners should refer to WAC 296-20-010 through 296-20-125 for general information and rules pertaining to the care of workers.Refer to WAC 296-20-132 and 296-20-135 for information regarding the conversion factors.All supplies and materials mus…

The department will publish billing instructions, reimbursement limits, quality assurance standards, utilization review guidelines, admission criteria, outcome criteria, measures of effectiveness, minimum staffing levels, certification requirements, special reporting requirements…

(1) The department or self-insurer may pay for acupuncture treatment when ordered by the worker's attending provider or physician assistant and only for specific conditions related to the accepted condition on a claim and per department policy.(2) For the purposes of this section…

(1) Registered nurses and licensed practical nurses may perform private duty nursing care in industrial injury cases when the attending provider deems this care necessary. Registered nurses may be reimbursed for services as outlined by department policy. (See chapter 296-20 WAC f…

(1) Advanced registered nurse practitioners (ARNPs) may independently perform the functions of an attending provider under the Industrial Insurance Act and applicable rules in Title 296 WAC, with the exception of rating permanent impairment. These functions include, but are not l…

(1) Registered nurses may be required to obtain provider account numbers from the department as outlined by department policy.(2) Advanced registered nurse practitioners must obtain provider account numbers from the department.(3) Refer to WAC 296-20-132 and 296-20-135 for inform…

(1) What are attendant services? Attendant services are proper and necessary personal care services provided to maintain the injured worker in their residence.(2) Who may receive attendant services? Workers who are temporarily or permanently totally disabled and rendered physical…

Practitioners should refer to WAC 296-20-010 through 296-20-125 for general information and rules pertaining to the care of workers. See WAC 296-20-125 for billing instructions.Refer to WAC 296-20-132 and 296-20-135 for information regarding use of the conversion factors.Massage …

Approved independent medical examination (IME) provider - A licensed provider or firm whose credentials are approved to conduct an independent medical examination, rating evaluation, or provide IME associated services including, but not limited to, file preparation, scheduling of…

(1) Unless a case progress examination is requested by the attending provider, no case progress examination may be scheduled until 120 days have passed since the later of:(a) The department or self-insurer's receipt of the claim; or(b) The department or self-insurer's receipt of …

Unless explicitly required by statute, the total number of examinations per claim is limited as follows:(1) One complete examination including report prior to an order under RCW 51.52.050 or 51.52.060 allowing or denying a new claim unless an additional examination is authorized …

No. Only doctors who possess an active IME provider number can provide independent medical examinations for the department or self-insurer. Providers must submit an IME provider application and be approved by the department to receive this number.[Statutory Authority: RCW 51.32.0…

To ensure that independent medical examinations are of the highest quality and propriety, examiners and firms (partnerships, corporations, or other legal entities) that derive income from independent medical exams must apply and meet the following requirements for department appr…

The department accepts certifications from boards recognized by the following as meeting the board certification requirements in WAC 296-23-317:(1) American Board of Medical Specialties;(2) American Osteopathic Association (AOA) Bureau of Osteopathic Specialties;(3) American Podi…

The department's medical director considers other factors in approving or disapproving an IME application, including, but not limited to, the following:(1) Complaints about the provider;(2) Quality of reports;(3) Timeliness of reports;(4) Charges regarding any crime, gross misdem…

Providers must immediately notify the department of any change in status that might affect their qualifications for an independent medical examination (IME)provider number. The notification must be in writing. Providers must include a copy of any charges or final orders if applic…

To ensure high quality independent medical examinations (IMEs), the department's medical director or designee may, in the situations described below, terminate, suspend, or inactivate approval of examiners or firms (partnerships, corporations, or other legal entities) that derive…

No. The department or self-insured employer refers industrially injured or ill workers for independent medical examination (IME) services at their sole discretion. No provider is entitled to referrals from the referral source.[Statutory Authority: RCW 51.32.055, 51.32.112, 51.32.…

(1) The IME provider's responsibilities prior to the examination are to:(a) Be familiar with the contents of the medical examiner's handbook;(b) Review all claim documents provided by the department or self-insurer;(c) Contact the worker prior to the examination to confirm the ap…