• This section applies each time a medical examination or
consultation is performed to determine whether medical removal
or restriction is required.
You must:
• Promptly notify employees that they may seek a second
medical opinion from an LHCP of their choice, each time a
medical examination or consultation is conducted by an LHCP
selected by the employer to evaluate medical removal.
– At a minimum, this notification must include the
details of your multiple physician review process.
Note:
Notification may be provided in writing or by verbal communication.
You must:
• Complete requirements in the multiple LHCP review
process once you have been informed of an employee's decision
to seek a second medical opinion.
• Pay for and complete the multiple LHCP review process
for employees who:
– Inform you in writing or by verbal communication that
they will seek a second medical opinion.
– Initiate steps to make an appointment with the LHCP
they select. This LHCP will be referred to as the second
LHCP.
– Fulfill the previous actions to inform you, and
initiate steps for an appointment, within fifteen days from
receiving either your notification or the initial LHCP's
written opinion, whichever is received later.
Note:
This process allows for selection of a second LHCP and, when disagreements between LHCPs persist, for selection of a
third LHCP.
Multiple LHCP review process:
Step 1: Make sure the information required by Step 4 of
the medical evaluation process is received by the second LHCP.
This process is located in the section, Medical and emergency
evaluations, WAC 296-856-30020.
– This requirement also applies when a third LHCP is
selected.
Step 2: Allow the second LHCP to:
– Review findings, determinations, or recommendations
from the original LHCP you selected;
AND
– Conduct medical examinations, consultations, and
laboratory tests as necessary to complete their review.
Step 3: Obtain a written opinion from the second LHCP
and make sure the employee receives a copy within five
business days from the date you receive it. If findings,
determinations, and recommendations in the written opinion
are:
– Consistent with the written opinion from the initial
LHCP, you can end the multiple physician review process. Make
sure you follow the LHCP's recommendations.
– Inconsistent with the written opinion from the initial
LHCP, then you and the employee must make sure efforts are
made for the LHCPs to resolve any disagreements.
▪ If the LHCPs quickly resolve disagreements, you can end
the multiple physician review process. Make sure you follow
the LHCP's recommendations.
▪ If disagreements are not resolved within thirty
business days, continue to Step 4.
Step 4: You and the employee must work through your
respective LHCPs to agree on the selection of a third LHCP, or
work together to designate a third LHCP to:
– Review findings, determinations, or recommendations
from the initial and second LHCP;
AND
– Conduct medical examinations, consultations, and
laboratory tests as necessary to resolve disagreements between
the initial and second LHCP.
Step 5: Obtain a written opinion from the third LHCP and
make sure the employee receives a copy within five business
days from the day you receive it.
– Follow the third LHCP's recommendations, unless you and
the employee agree to follow recommendations consistent with
at least one of the three LHCPs.