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PDFWAC 296-14-970

Worker's review of claim file.

(1) Pursuant to RCW 51.28.070, workers may be allowed to review their claim file(s) upon written request to the department or self-insurer. The written request should contain the worker's name, claim number, signature, and the information requested. If the request is approved, the department or self-insurer shall provide a copy of the claim file to the worker.
(2) Reasons for denying release of a claim file, to a worker shall include, but not be limited to the following:
(a) Presence of psychological, mental health, or physical treatment records, investigative reports or other records, release of which may not be in the interest of the worker.
(b) Medical opinion or other documented information indicates the worker is a danger to himself or herself or others.
(3) If, pursuant to the criteria established under subsection (2) of this section, the self-insured employer determines that release of the claim file, in whole or in part, may not be in the worker's interest, the employer must submit a request for denial with explanations along with a copy of that portion of the claim file not previously submitted to the self-insurance section within 20 days after receipt of the request from the worker.
(4) If the request for the claim file is denied, in whole or in part, a written order of denial will be issued by the department and mailed to the worker. The worker may appeal the order to the board of industrial insurance appeals.
(5) The provisions of this rule will apply to all claims regardless of the date of injury.
[Statutory Authority: RCW 51.28.070. WSR 90-18-002, ยง 296-14-970, filed 8/23/90, effective 9/23/90.]
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