WAC 296-20-12065   SIMP definitions.  The definitions in this section refer to terms used in WAC 296-20-12055 through296-20-12095 .

     (1) SIMP means a chronic pain management program with the following four components:

     Structured means care is delivered through regular scheduled modules of assessment, education, treatment, and follow up evaluation where workers interact directly with licensed health care practitioners. Workers follow a treatment plan designed specifically to meet their needs.

     Intensive means the treatment phase is delivered on a daily basis, six to eight hours per day, five days per week, for up to four consecutive weeks. Slight variations can be allowed if necessary to meet the worker's needs.

     Multidisciplinary (interdisciplinary) means that structured care is delivered and directed by licensed health care professionals with expertise in pain management in at least the areas of medicine, psychology, and physical therapy or occupational therapy. The SIMP may add vocational, nursing, and additional health services depending on the workers' needs and covered benefits.

     Program means an interdisciplinary pain rehabilitation program that provides outcome-focused, coordinated, goal-oriented team services. Care coordination is included within and across each service area. The program benefits workers who have impairments associated with pain that impact their participation in daily activities and their ability to work. This program measures and improves the functioning of persons with pain and encourages their appropriate use of healthcare systems and services.

     (2) Uncomplicated degenerative disc disease (UDDD) means chronic low back pain of discogenic origin without objective clinical evidence of any of the following conditions:

     • Radiculopathy;

     • Functional neurologic deficits;

     • Spondylolisthesis (> grade 1);

     • Isthmic spondylolysis;

     • Primary neurogenic claudication associated with stenosis;

     • Fracture, tumor, infection, inflammatory disease; or

     • Degenerative disease associated with significant deformity.

     (3) Lumbar surgery candidate means an injured worker who is considering having a lumbar fusion or lumbar intervertebral artificial disc replacement due to uncomplicated degenerative disc disease.

     (4) Important associated conditions means medical or psychological conditions (often referred to as comorbid conditions) that hinder functional recovery from chronic pain.

     (5) Treatment plan means an individualized plan of action and care developed by licensed health care professionals that addresses the worker's identified needs and goals. It describes the intensity, duration, frequency, setting, and timeline for treatment and addresses the elements described in the treatment phase. It is established during the evaluation phase and may be revised during the treatment phase.

     (6) Valid tests and instruments mean those that have been shown to be scientifically accurate and reliable for tracking functional progress over time.



[Statutory Authority: RCW 70.14.120, 51.04.020, 51.04.030. 09-20-040, § 296-20-12065, filed 9/30/09, effective 11/1/09.]