Industrial Insurance Chiropractic Advisory Committee (IICAC)

Chiropractic Consultant Program Information and Resources

Chiropractic Consultant Program overview

The Chiropractic Consultant Program is a second opinion program overseen by L&I Industrial Insurance Chiropractic Advisory Committee (IICAC) that serves as a resource to attending providers and claim staff for Washington’s State Fund and self-insured employers. Chiropractic consultants have at least 5 years of clinical practice experience and have completed additional continuing education training covering occupational health best practices, adjudication issues in workers’ compensation, conservative care options for common work injuries, functional improvement including return to work, as well as documentation and reporting best practices.

Referral for any consultation examination, including to Chiropractic Consultants, does not require prior authorization. Attending providers referring a patient for any second opinion consultation should notify the claim manager of this action. Timing can be an issue if a claim manager is already scheduling an Independent Medical Examination (IME), the claim has been closed, or if a claim re-opening is pending. 

Chiropractic Consultants are located throughout Washington State and are a resource for any attending provider who needs clinical guidance regarding:

    • Active Rehabilitation for Work-related Low Back Conditions
    • Additional insight for conservative care, return to work, and/or injury rehabilitation options
    • Advice for making a specialist referral or advanced diagnostics (including imaging)
    • Assistance with stalled progress
    • Issues leading to complications or disputes in a claim, or
    • The worker’s accepted condition presents a non-emergency diagnostic or therapeutic conundrum

For more information:

  • Locate a Chiropractic Consultant
    To find a chiropractic consultant, please use L&I’s Find a Doctor application, and select United States, then provider type "Chiropractor" and specialty "Chiropractor/Consultant".
  • Second Opinion Evaluations
  • Services offered by Chiropractic Consultants
  • Requirements and application to become a Chiropractic Consultant
  • Renewing your Chiropractic Consultation Status
  • Chiropractic Consultant Program Toolbelt
    A number of resources are available for Chiropractic Consultants and others to assist with providing best practices for conservative occupational health care.
    • Clinical Best Practices Resources
      IICAC has developed a number of evidence-based best practice resources for a variety of common work-related conditions including:
      • Conservative Care Options for Work-Related Knee Conditions
      • Active Rehabilitation for Work-Related Low Back Conditions
      • Reducing Disability: Psychosocial Determinants Influencing Recovery (PDIR)
      • Conservative Care Options for Work-Related Foot and Ankle Conditions
      • Conservative Care Options for Occupational Carpal Tunnel Syndrome
      • Conservative Care Options for Work-Related Epicondylosis
      • Conservative Care Options for Work-Related Mechanical Shoulder Conditions
      • Options for Documenting Functional Improvement in Conservative Care plus Functional Scales
    • Resources to Optimize Your Practice Workflows to care for Injured Workers
      • Occupational Health Best Practices Readiness Assessment
      • Employer Communication tools (Notice of employee injury care, Employer Contact Workflow Template)
      • Attending Provider Referral Form
      • Functional recovery oriented PT Referral Form

Communicating your role as a Chiropractic Consultant:

In addition to your active clinical practices, Chiropractic Consultants serve as second opinion evaluators for their local health care communities and the workers’ compensation system. IICAC has consistently worked with the department to oversee the development of training resources and mentorship for DCs interested in providing second opinions. The Chiropractic Consultation program is not an academic or clinical credential and should not be portrayed as such. Additionally it is not to be used as an explicit recruitment tool for new or transferring patients. However, IICAC has developed language that may be used with your practice information (websites, curriculum vitae, advertisements) regarding your role and services as a chiropractic consultant:

  • Listing on vitae, business cards, etc:
    • Chiropractic Consultant, Department of Labor & Industries
    • Dates, years of program participation
    • Links to L&I webpages for the Chiropractic Consultant Program
  • Information that can be included in promotion (advertising, website, fliers, etc):
    • Copies of information on L&Is Chiropractic Consultant webpages. Language within this overview page, listing of services provided
    • Information about contacting you for making a second opinion referral
    • Links to or copies of information on L&Is Chiropractic Consultant webpages (e.g., Attending Provider referral form)
  • Sample introductory letter to colleagues about your role and services as a chiropractic consultant:


Educational resources


Billing For Chiropractic Consultation Services

Consultations are second opinion encounters billed using CPT Evaluation and Management consultation codes. Like other E/M codes, DCs who have become approved Chiropractic Consultants may bill any of the four lower levels of consultation services for patient encounters. In addition, consultants may bill for case conference services associated 2nd opinion consultations.

Independent Medical Examiner Program

Chiropractors with at least two years experience as chiropractic consultants, who have also taken the L&I Chiropractic IME Seminar may apply to become an independent medical examiner (IME). IME doctors are called on by the department or self-insured employer to provide an independent assessment of the patient’s status, including rating for any permanent impairment.   

Requirements and IME Provider Application Form

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