(1) The department or self-insurer will pay for medications or supplies dispensed for the treatment of conditions resulting from an industrial injury and/or conditions which are retarding the recovery from the industrial injury, for which the department or self-insurer has accepted temporary responsibility.
(2) Approved generic are to be substituted for brand name pharmaceuticals in all cases unless the worker's condition will not tolerate a generic preparation and the prescribing physician indicates no substitution is permitted. A list of approved generics and their base cost will be published periodically by the department.
(3) Items not normally paid include: Syringes, injectables, heating pads, vibrators, personal appliances, oral nutritional supplements, anorexiants, and medications normally prescribed for systemic conditions. These items may be authorized to certain individuals in unusual circumstances; prior approval from the department or self-insurer is mandatory.
(4) Rental or purchase of medical equipment must be prior authorized by the department or self-insurer.
(5) No payment will be made for medication dispensed after the date of the order and notice of claim closure or rejection or for conditions unrelated to the industrial injury or occupational disease except for initial prescription drugs prescribed during the initial visit for state fund claims.
[Statutory Authority: RCW 51.04.020, 51.04.030 and 2007 c 134. 08-02-021, § 296-20-17001, filed 12/21/07, effective 1/21/08. Statutory Authority: RCW 51.04.020(4) and51.04.030 . 86-06-032 (Order 86-19), § 296-20-17001, filed 2/28/86, effective 4/1/86; 83-24-016 (Order 83-35), § 296-20-17001, filed 11/30/83, effective 1/1/84. Statutory Authority: RCW 51.04.020(4), 51.04.030, and 51.16.120(3). 80-18-033 (Order 80-24), § 296-20-17001, filed 12/1/80, effective 1/1/81; Order 76-34, § 296-20-17001, filed 11/24/76, effective 1/1/77.]