HB 2243
In CommitteeHouse
Workers' comp./PTs & OTs
Including physical and occupational therapists as attending providers for workers' compensation.
This status may be delayed. See Action History below for the latest updates.
How does a bill become law?
- Introduced: The bill is filed and assigned a number.
- Committee: A subject-matter committee holds hearings, takes public testimony, and decides whether to advance the bill.
- Floor Vote: The full chamber (House or Senate) debates and votes on the bill.
- Opposite Chamber: The bill repeats the committee and floor vote process in the other chamber.
- Governor: The Governor reviews the bill and decides whether to sign or veto it.
- Signed: The bill has been signed into law.
AI Analysis
This bill adds physical therapists and occupational therapists to the list of licensed providers who can serve as 'attending providers' for Washington workers' compensation claims, allowing them to treat injured workers, certify claims, and assist with applications. It also updates reporting and anti-suppression rules to reflect this expansion and strengthens oversight of the provider network.
- Physical and occupational therapists are now included in the legal definition of 'attending provider'—meaning they can treat injured workers, certify claims, and assist with compensation applications.
- Employers must report injuries to L&I when a worker receives treatment from a physical or occupational therapist (in addition to other licensed providers), especially if the injury results in hospitalization, disability, or death.
- The bill strengthens prohibitions against 'claim suppression'—such as pressuring workers not to report injuries or misclassifying work injuries as off-the-job—and clarifies that workplace safety programs and first aid are not considered suppression.
- The Department of Labor & Industries (L&I) must update its provider network standards to include physical and occupational therapists, and ensure quality oversight, credentialing, and access to care for these providers.
- Injured workers may now choose a physical or occupational therapist as their attending provider (if conveniently located), and providers must inform workers of their rights under workers' compensation—including access to in-network care.
Who is affected
- Injured workers — Workers who suffer job-related injuries or illnesses gain the right to receive medical care from physical therapists and occupational therapists as part of their workers' compensation treatment plan, including choosing these providers as their attending provider.
- Physical and occupational therapists — Physical therapists and occupational therapists licensed in Washington can now serve as 'attending providers' for workers' compensation claims, meaning they can treat injured workers, certify claims, and assist with compensation applications—within their scope of practice.
- Employers — Employers must report injuries when workers receive treatment from physical or occupational therapists (in addition to other providers), and are prohibited from discouraging or suppressing claims—even when therapy is involved.
- Washington State Department of Labor & Industries (L&I) — The Department of Labor & Industries (L&I) must update its provider network standards, reporting, and oversight to include physical and occupational therapists, and ensure quality and access for these providers.
Pro/Con Analysis
Stronger case for benefits
Potential Benefits (5)
Injured workers gain the explicit legal right to choose physical or occupational therapists as their attending provider—including certifying claims and assisting with applications—expanding access to timely, evidence-based rehabilitation and potentially reducing long-term disability.
HealthcarePeopleRef: Sec. 1; RCW 51.08.200The bill strengthens protections against claim suppression by explicitly defining prohibited employer conduct (e.g., pressuring workers not to report injuries), shifting the burden of proof to L&I, and clarifying that workplace safety programs are not suppression—reducing employer coercion and improving claim reporting fidelity.
Rights & LibertiesPeopleRef: Sec. 2, 3; RCW 51.28.010(3)-(5)The requirement that employers report injuries when workers receive therapy-based treatment—especially if resulting in hospitalization, disability, or death—ensures more complete data collection and helps prevent underreporting of work-related injuries, improving system integrity.
HealthcarePeopleRef: Sec. 2, 3; RCW 51.28.010(2)The bill mandates that physical and occupational therapists inform injured workers of their rights under workers’ compensation and assist without charge in filing claims—empowering workers to navigate the system and reducing barriers to timely benefits.
HealthcarePeopleRef: Sec. 4, 5; RCW 51.28.020(1)(b)The bill requires L&I to establish quality oversight and credentialing standards for physical and occupational therapists in the provider network—including incentives for second-tier providers who demonstrate occupational health best practices—promoting higher-quality, more consistent care.
HealthcarePeopleRef: Sec. 6, 7; RCW 51.36.010(2)(a), (f), (5)
Potential Concerns (5)
The bill may increase administrative and compliance burdens for employers, especially small businesses, by requiring reporting of injuries even when treatment is provided by physical or occupational therapists—potentially expanding the scope of reportable events and increasing paperwork.
Business & EmploymentRef: Sec. 1, 2, 4, 5; RCW 51.08.200, 51.28.010, 51.28.020The bill’s clarification that workplace safety programs and first aid are *not* claim suppression may reduce employer liability exposure, but the burden of proving non-suppression rests with the department and the standard is preponderance of evidence—creating modest legal uncertainty for employers.
Business & EmploymentRef: Sec. 2, 3; RCW 51.28.010(6)The bill expands the provider network to include physical and occupational therapists, but does not mandate increased reimbursement rates or address potential provider capacity constraints—risking access delays if therapist supply does not grow in line with demand.
HealthcareRef: Sec. 6, 7; RCW 51.36.010(2)(a), (c), (e)The bill grants L&I broad authority to remove providers from the network for “patterns” of poor outcomes, but excludes isolated incidents—this may deter risk-tolerant but competent providers (e.g., those treating complex or chronic cases) from joining the network, especially in rural areas.
HealthcareRef: Sec. 6, 7; RCW 51.36.010(6), (7), (8)The sunset provision (June 30, 2027) for Sections 2, 4, and 6 creates a potential cliff for implementation of reporting and rights-notification requirements, risking inconsistent enforcement and confusion for employers and providers during the transition.
Local GovernmentRef: Sec. 8, 9; Effective dates
Who Is Most Affected
Injured workers—especially those with musculoskeletal injuries—gain direct access to evidence-based rehabilitation services earlier in the claims process, potentially reducing chronic disability and improving functional outcomes. This is especially beneficial for low-wage workers who may have previously faced barriers to therapy access.
Physical and occupational therapists gain formal recognition as attending providers, expanding their scope of authority and potentially increasing demand for their services. However, they must comply with new network credentialing, billing, and reporting requirements, and face increased liability exposure if they fail to meet quality benchmarks.
Employers face increased reporting obligations and heightened legal risk if they engage in—or are perceived to engage in—claim suppression. While the bill clarifies that bona fide safety programs are exempt, the burden of proving non-suppression rests with L&I, creating modest uncertainty for HR and safety managers.
L&I gains expanded authority to regulate and oversee physical and occupational therapists in the provider network, including credentialing, quality monitoring, and enforcement of anti-suppression rules. This increases administrative workload but aligns with its statutory mission to ensure fair and effective workers’ compensation.
Insurance carriers (especially self-insured employers) may see modest short-term cost increases due to expanded provider access and potential rise in therapy-related claims, but could benefit in the long run from reduced chronic disability and faster return-to-work outcomes if early intervention proves effective.