Self-insurers/claims

AN ACT Relating to allowing self-insurers to accept certain 1
industrial insurance claims; and amending RCW 51.14.130 and 2
51.32.190. 3
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF WASHINGTON:4
Sec. 1. RCW 51.14.130 and 1993 c 122 s 3 are each amended to 5
read as follows: 6
((The)) (1) If the self-insurer allows a claim for compensation, 7
the self-insurer shall ((request)) issue an allowance ((or denial of 8
a claim )) order within ((sixty)) 30 days from the ((date that the 9
claim is filed. )) notice of the claim. The allowance order may not 10
include any claim decisions other than an allowance.11
(2) If the self-insurer fails to act within ((sixty)) 60 days, 12
((the)) no later than 65 days from the date that the claim is filed, 13
the self-insurer must forward the matter to the department informing 14
the worker and director that the claim is in provisional status and 15
the self-insurer is paying provisional time loss if the worker is 16
eligible. The department shall promptly determine whether the claim 17
is allowed or denied.18
(3) If the self-insurer denies a claim for compensation, the 19
self-insurer must request denial of a claim within 60 days from 20
S-3632.1
SENATE BILL 5997
State of Washington 69th Legislature 2026 Regular Session
By Senator MacEwen
Prefiled 01/05/26.
p. 1 SB 5997
notice of claim. If the self-insurer fails to act within 60 days, the 1
department shall promptly intervene and adjudicate the claim.2
Sec. 2. RCW 51.32.190 and 1996 c 58 s 2 are each amended to read 3
as follows: 4
(1) If the self-insurer denies a claim for compensation, written 5
notice of such denial, clearly informing the claimant of the reasons 6
therefor and that the director will rule on the matter shall be 7
mailed or given to the claimant and the director within ((thirty)) 60 8
days after the self-insurer has notice of the claim.9
(2) Until such time as the department has entered an order in a 10
disputed case acceptance of compensation by the claimant shall not be 11
considered a binding determination of his or her rights under this 12
title. Likewise the payment of compensation shall not be considered a 13
binding determination of the obligations of the self-insurer as to 14
future compensation payments. 15
(3) Upon making the first payment of income benefits, the self-16
insurer shall immediately notify the director in accordance with a 17
form to be prescribed by the director. Upon request of the department 18
on a form prescribed by the department, the self-insurer shall submit 19
a record of the payment of income benefits including initial, 20
termination or terminations, and change or changes to the benefits. 21
Where temporary disability compensation is payable, the first payment 22
thereof shall be made within ((fourteen)) 14 days after notice of 23
claim and shall continue at regular semimonthly or biweekly 24
intervals. 25
(4) If, after the payment of compensation without an award, the 26
self-insurer elects to controvert the right to compensation, the 27
payment of compensation shall not be considered a binding 28
determination of the obligations of the self-insurer as to future 29
compensation payments. The acceptance of compensation by the worker 30
or his or her beneficiaries shall not be considered a binding 31
determination of their rights under this title. 32
(5) The director: (a) May, upon his or her own initiative at any 33
time in a case in which payments are being made without an award; and 34
(b) shall, upon receipt of information from any person claiming to be 35
entitled to compensation, from the self-insurer, or otherwise that 36
the right to compensation is controverted, or that payment of 37
compensation has been opposed, stopped or changed, whether or not 38
claim has been filed, promptly make such inquiry as circumstances 39
p. 2 SB 5997
require, cause such medical examinations to be made, hold such 1
hearings, require the submission of further information, make such 2
orders, decisions or awards, and take such further action as he or 3
she considers will properly determine the matter and protect the 4
rights of all parties. 5
(6) The director, upon his or her own initiative, may make such 6
inquiry as circumstances require or is necessary to protect the 7
rights of all the parties and he or she may enact rules and 8
regulations providing for procedures to ensure fair and prompt 9
handling by self-insurers of the claims of workers and beneficiaries.10
--- END ---
p. 3 SB 5997