Chiropractic Consultation Program

This is a second-opinion program in Washington state. Doctors can ask for assistance with diagnosis or treatment planning.

Locate chiropractic consultants

To find a chiropractic consultant, please use our Find a Doctor application, and select United States, then provider type "Chiropractor" and specialty "Chiropractor/Consultant".

Second opinions, what do I need to know?

Prior authorization is not required, but timing can be an issue. The attending doctor should notify the claim manager of this action.

When to get a second opinion ...

Required when:

Attending Provider discretion when:

May not be referred by the attending doctor if:

  • Before 120 days of conservative care have passed
  • 20 conservative care visits with an attending provider have been made
  • A complication, controversy or dispute arises over the treatment of injured worker
  • The insurer requests a consultation exam.
  • The worker's accepted condition presents a diagnostic or therapeutic problem
  • Clinical guidance on conservative care, return to work or injury rehabilitation
  • Assitance with stalled progress
  • Advice on specialist referrals or advanced diagnostics
  • An independent medical exam (IME) has already been requested by the claim manager
  • Claim reopening is pending
  • Claim is closed.

Differences between a Second Opinion and Independent Medical Examination

Service requested

Referral source

Type of exam

Select examiner from

Prior authorization required?


Attending doctor.

Second opinion.

Refer to a chiropractic consultant or medical specialist listed in Find a Doctor.


Independent medical exam

L&I claim manager.

IME exam.

Approved IME provider.

Yes. By L&I claim manager.

    Services Offered by Chiropractic Consultants

    L&Is Chiropractic Consultants may provide a variety of useful services for attending providers who need help or guidance with an injured worker. Common services are outlined below.

    Attending Providers may refer patients or set up telephone peer-to-peer consultation for:

      • Physical examination
      • Guidance with return to work and/or resolving employer issues
      • Guidance with advanced diagnostics and specialist referral or consultation
      • Closing examinations (including permanent disability ratings if the Chiropractic Consultant is also on the department’s Approved Examiner List)
      • Informal occupational health advice (some CCs in your community may be willing to volunteer to coach providers through using available best practices resources to optimize your ability to care for injured workers)

    Claim managers or Occupational Nurse Consultants may sometimes recommend that an attending provider obtain a Chiropractic Consultant evaluation to address questions regarding:

      • Physical examination
      • Work-relatedness or causation of a condition
      • Diagnostic evaluation
      • Treatment and care planning


  • Chiropractic Services
  • Becoming a Chiropractic Consultant



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