The department or self-insurer will not allow nor pay for following treatment:
- (1) Use of diapulse, thermatic (standard model only), spectrowave and superpulse machines on workers entitled to benefits under the Industrial Insurance Act.
- (2) Iontophoresis; prolotherapy; injections of colchicine; injections of fibrosing or sclerosing agents; and injections of substances other than anesthetic or contrast into the subarachnoid space (intra-thecal injections).
- (3) Treatment to improve or maintain general health (i.e., prescriptions and/or injection of vitamins or referrals to special programs such as health spas, swim programs, exercise programs, athletic-fitness clubs, diet programs, social counseling).
- (4) Continued treatment beyond stabilization of the industrial condition(s), i.e., maintenance care, except where necessary to monitor prescription of medication necessary to maintain stabilization i.e., anti-convulsive, anti-spasmodic, etc.
- (5) After consultation and advice to the department or self-insurer, any treatment measure deemed to be dangerous or inappropriate for the injured worker in question.
- (6) Treatment measures of an unusual, controversial, obsolete, or experimental nature (see WAC 296-20-045). Under certain conditions, treatment in this category may be approved by the department or self-insurer. Approval must be obtained prior to treatment. Requests must contain a description of the treatment, reason for the request with benefits and results expected.
- (7) Therapeutic medial branch block injections, therapeutic intradiscal injections, and therapeutic facet injections of the spine.
- (8) Transcutaneous, interferential, and percutaneous nerve stimulators used in the home setting, and all associated supplies and equipment.
[Statutory Authority: RCW 51.04.020 and 51.04.030. WSR 19-10-063, § 296-20-03002, filed 4/30/19, effective 6/1/19. Statutory Authority: RCW 70.14.110, 51.04.020, and 51.04.030. WSR 12-12-059, § 296-20-03002, filed 6/5/12, effective 7/6/12. Statutory Authority: RCW 70.14.120, 51.04.020, 51.04.030. WSR 09-20-040, § 296-20-03002, filed 9/30/09, effective 11/1/09. Statutory Authority: RCW 51.04.020, 51.04.030. WSR 06-15-110, § 296-20-03002, filed 7/18/06, effective 8/18/06. Statutory Authority: RCW 51.04.020(4) and 51.04.030. WSR 86-06-032 (Order 86-19), § 296-20-03002, filed 2/28/86, effective 4/1/86; WSR 83-16-066 (Order 83-23), § 296-20-03002, filed 8/2/83. Statutory Authority: RCW 51.04.020(4), 51.04.030, and 51.16.120(3). WSR 81-24-041 (Order 81-28), § 296-20-03002, filed 11/30/81, effective 1/1/82; WSR 81-01-100 (Order 80-29), § 296-20-03002, filed 12/23/80, effective 3/1/81; Order 76-34, § 296-20-03002, filed 11/24/76, effective 1/1/77.]