(1) No payment will be made for treatment or medication on rejected claims except:
- (a) Services which were carried out at the specific request of the department or the self-insurer; or
- (b) Examination or diagnostic services which served as a basis for the adjudication decision; or
- (c) Initial prescription drugs prescribed during the initial visit for state fund claims.
- (2) No payment will be made for services rendered after the date of claim closure. Following the date of the order and notice of claim closure, the department or self-insurer will be responsible only for those services specifically requested or those examinations, and diagnostic services necessary to complete and file a reopening application.
- (3) Periodic medical surveillance examinations will be covered by the department or self-insurer for workers with closed claims for asbestos-related disease, to include chest X-ray abnormalities, without the necessity of filing a reopening application when such examinations are recommended by accepted medical protocol.
- (4) Replacement of prosthetics, orthotics, and special equipment can be provided on closed claims after prior authorization. See WAC 296-20-1102 for further information.
[Statutory Authority: RCW 51.04.020, 51.04.030 and 2007 c 134. WSR 08-02-021, § 296-20-124, filed 12/21/07, effective 1/21/08. Statutory Authority: Chapters 34.04 [34.05], 51.04, 51.32 and 51.36 RCW. WSR 90-04-007, § 296-20-124, filed 1/26/90, effective 2/26/90. Statutory Authority: RCW 51.04.020(4), 51.04.030, and 51.16.120(3). WSR 81-01-100 (Order 80-29), § 296-20-124, filed 12/23/80, effective 3/1/81; Order 76-34, § 296-20-124, filed 11/24/76, effective 1/1/77.]