Bill would broaden workers' ability to seek out‑of‑network and medically appropriate care under state workers' comp

The committee heard an engrossed second substitute to Senate Bill 58 47, which would change several rules governing medical treatment under Washington's workers' compensation system.

Staff (Allison Ryan) said the bill allows providers to deviate from Department of Labor and Industries (L&I) coverage decisions when medically appropriate, prohibits employers from requiring or coercing injured workers to seek treatment from a specific provider, and requires L&I to investigate allegations of coercion. The bill also adjusts out‑of‑network access rules: if no in‑network provider is willing to treat an injured worker within 15 miles in counties with population 500,000 or more (or within 30 miles in counties under 500,000), the worker may seek treatment from a non‑network provider. The draft also allows continued treatment authorization in some closed permanent partial disability claims and requires medical monitoring of cancer patients at frequencies recommended by oncologists.

Prime sponsor Sen. Saldanha emphasized the bill's aim “to make sure that injured workers get care from providers that they trust,” and noted concerns about employers offering on‑site clinics or lists of doctors in ways that might be perceived as coercive. Proponents including David Lauman, an attorney for injured workers, said the bill would help return the ability for injured workers to choose treating doctors and reduce litigation delays; Lauman referenced the Supreme Court's Murray decision as relevant precedent.

Union testimony from Nicole Gomez (Washington Federation of State Employees) highlighted overloaded L&I caseloads, noting that a 2015 JLARC benchmark recommended about 141 claims per case manager while staff averaged about 225 at the end of last year — a level she said delays care and drives up costs. Opponents — including the Building Industry Association and the Washington Retail Association — said the bill may weaken provider networks, asked for an updated fiscal note, and warned it could increase claim durations.

Tammy Felon of L&I said the agency supports the bill with a technical amendment to clarify attending vs. treating provider language, confirmed implementation costs, and requested time to update the fiscal note; she said adding claims managers would reduce benefit impacts. The committee did not take a final vote during the hearing.