(1) Legislative findings and intent. The legislature finds that posttraumatic stress disorder is a serious and growing concern for workers in high risk occupations, and that emerging research supports the link between trauma exposure and the development of posttraumatic stress disorder. The legislature intends to support trauma-informed strategies to reduce the severity of work-related posttraumatic stress disorder, with the goal of improving recovery outcomes that enable sustained work. To that end, the department is authorized and directed to develop and implement a pilot program focused on these objectives.
(2) Pilot program design and implementation.
(a) In consultation with subject matter experts from the department and advisory committees including, but not limited to, the advisory committee established under RCW 51.04.110, the department shall design and implement a pilot program to expand access to evidence-based, high quality care for workers exposed to trauma seeking coverage of posttraumatic stress disorder as an occupational disease. Self-insurers may choose to participate in the pilot program.
(i) As part of the pilot program, when a worker files an occupational disease claim for posttraumatic stress disorder pursuant to RCW 51.08.142 (2) or (3), the department or participating self-insurer shall provide the worker the opportunity to participate in the pilot program. If the worker opts for their claim to be part of the pilot program, the department or participating self-insurer shall authorize access to treatment for posttraumatic stress disorder prior to claim adjudication, without regard to whether the worker's claim for benefits is allowed. Workers may receive the preclaim adjudication treatment from a mental health provider qualified to provide mental health treatment under this title if the provider agrees to be paid in accordance with the department's medical aid rules and fee schedules and signs a nonnetwork provider agreement. The department will survey or contact these providers to better understand barriers to entering the medical provider network. Costs for treatment prior to claim adjudication on state fund claims that are ultimately rejected shall be spread across all risk classes for which there is a presumption of coverage of posttraumatic stress disorder as an occupational disease. Costs for treatment prior to claim adjudication on self-insured claims that are ultimately rejected shall be paid by the self-insurer. Payment for this treatment or any other benefits under this title, prior to the entry of an order by the department in accordance with RCW 51.52.050 as now or hereafter amended, shall not be considered a binding determination of the obligations of the department or self-insurer under this title. Treatment for posttraumatic stress disorder prior to claim adjudication shall be limited to a clinical diagnostic interview or mental health evaluation in which a mental health provider diagnoses posttraumatic stress disorder and 11 treatment sessions to occur within 90 days of filing the claim. If the claim has not been adjudicated for allowance within 90 days, the supervisor of industrial insurance may authorize continued treatment of up to 12 treatment sessions. Once the claim is allowed, the worker must seek treatment for posttraumatic stress disorder from a provider in the medical provider network.
(ii) As part of the pilot program, to improve access to trauma-informed care, the department may enter into agreements with health care organizations or providers experienced in the diagnosis, assessment, and treatment of posttraumatic stress disorder and probable posttraumatic stress disorder. To enter into an agreement with the department, a health care organization or provider must meet qualifications and requirements established by the department. The department may identify and implement financial and other incentives for participating providers, develop criteria for workers to receive services under these agreements, and develop criteria for evaluating the success of these agreements. These agreements may not be used to limit workers' choice of providers or organizations for mental health treatment.
(iii) As part of the pilot program, the department and participating self-insurers shall authorize up to six additional treatment sessions for posttraumatic stress disorder within one year of claim closure, when such treatment is deemed necessary to maintain the worker's level of functioning at the time of claim closure.
(iv) As part of the pilot program, the department may reduce administrative requirements as necessary to simplify and address barriers for both workers and treating providers participating in the pilot program. "Administrative requirements" for the purpose of chapter 220, Laws of 2026 may include, but are not limited to, forms, documentation, timelines, reporting obligations, prior authorizations, or other programmatic processes imposed on workers or treating providers solely for treatment under the pilot program.
(b) Self-insurers who participate in the pilot program shall upon request produce a report of all workers' compensation claims that were subject to provisions of the pilot program in a format required by the department.
(c) To the extent any provision of the pilot program conflicts with an existing statute, the pilot program supersedes the conflicting statute for the duration of the pilot program only.
(3) Reporting and recommendations. By July 1, 2030, the director shall provide recommendations to the appropriate committees of the legislature on:
(a) Whether the pilot program or behavioral health programs should be extended or expanded;
(b) Any statutory or policy changes needed to support broader implementation; and
(c) Potential incentives or programmatic changes that provide measurable benefits to workers and employers.
(4) This section expires December 31, 2030.
[ 2026 c 220 s 5.]
Notes:
Rules—Effective date—2026 c 220: See notes following RCW 49.17.243.