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PDFWAC 296-19A-193

What documentation must be submitted to the department for prejob accommodations?

(1) A vocational provider assisting the injured worker in applying for prejob accommodation assistance must submit to the department a prejob accommodation assistance application. Prejob accommodations assistance applications shall be submitted on a form prescribed by the department.
(2) The prejob accommodation assistance application shall include, but is not limited to:
(a) A document supporting the need for prejob accommodation;
(b) A description of the prejob accommodation;
(c) An itemized account of each expense to be incurred in the prejob accommodation;
(d) An ownership agreement;
(e) Physician's certification of medical necessity.
[Statutory Authority: RCW 51.04.020, 51.04.030, 51.32.095, 51.36.100, 51.36.110. WSR 03-11-009, ยง 296-19A-193, filed 5/12/03, effective 2/1/04.]
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