Wash. Admin. Code § 296-31-074 - What if the claimant has an unrelated condition?

(1) You must immediately notify us when you are treating an unrelated condition concurrently with an accepted condition and provide us with the following information:

(a) Diagnosis and/or nature of unrelated condition;

(b) Treatment being provided; and

(c) The effect, if any, on the accepted condition.

(2) Temporary treatment of an unrelated condition may be allowed and payment for service authorized if:

(a) We approve your request for authorization prior to treatment;

(b) You give us a thorough explanation of how the unrelated condition is affecting the accepted condition;

(c) The unrelated condition is retarding recovery of the accepted condition; and

(d) We receive monthly reports from you, outlining treatment and its effect on both the unrelated and accepted conditions.

(3) We will not approve or pay for treatment of:

(a) An unrelated condition that has no influence or no longer influences the existing condition.

(b) A preexisting unrelated condition that was treated prior to acceptance of the crime victim's claim, unless it is retarding recovery of the accepted condition.

Notes

Wash. Admin. Code § 296-31-074

Statutory Authority: Chapter 7.68 RCW. 12-23-085, § 296-31-074, filed 11/20/12, effective 1/1/13. Statutory Authority: RCW 7.68.030. 00-03-056, § 296-31-074, filed 1/14/00, effective 2/14/00.