When can a Washington self-insured employer issue a closing order?
Generally, when a Washington workers’ compensation claim is ready for closure, a self-insured employer will submit a request for claim closure to the Department and await issuance of a closing order. However, self-insured employers have the authority to close certain claims through a Self-Insured Employer’s Closure Order and Notice pursuant to WAC 296-15-450.
A self-insured employer may close a medical only claim filed on or after July 1, 1990 and before August 1, 1997 with no additional requirements.
A self-insured employer may close a time loss claim (without PPD) that was filed on or after July 1, 1986 and before August 1, 1997 if:
- The Department has not issued an order resolving a dispute (such as an order denying time loss or segregating a condition); and
- The worker returned to work with the employer of record at the same job or at a job with comparable wages and benefits.
A self-insured employer may close any claim (medical only, time loss, or PPD) filed on or after August 1, 1997 if:
- The Department has not issued an order resolving a dispute;
- The worker returned to work with the employer of record at the same job or at a job with comparable wages and benefits; and
- The closing medical report was sent to the attending or treating provider and the provider either concurs or fails to respond within 14 days.
- If the doctor disagrees with the closing medical opinion on medical fixity or PPD, the employer must either obtain a supplemental medical opinion from a Department approved examiner or forward the claim to Department and request closure (the Department may require additional medical examinations).
If you have any questions about the circumstances under which a self-insured employer may close a claim, please contact me at 503-595-6114 or .
Posted by Elizabeth Aaberg.
