The treatment guidelines are written from a clinical perspective, to guide clinical care. Providers should consult the Medical Aid Rules and Fee Schedule (MARFS) for documentation and coding requirements.

The Treatment Guidelines (also called Medical Treatment Guidelines, Medical Practice Guidelines or Review Criteria) are evidence based and were developed by the Office of the Medical Director in collaboration with practicing physicians and advisors.

Some guidelines are intended to be educational tools for medical providers. Some guidelines and the review criteria are used by L&I in the Utilization Review program and claim management process to promote best practices and improve the health of injured workers. They are published by L&I, which is solely responsible for coverage decisions that may result from their use.

See Conditions and Treatments (Coverage Decisions) for additional information.

How to use the guidelines

Health care providers are expected to be familiar with the guidelines and follow the recommendations. Good medical judgment is important in deciding how to use and interpret this information.

Guideline history and development process

See the Guideline Process for background information and a description of how guidelines are prioritized, developed, and implemented. All current guidelines are those listed individually below.

Treatment Guidelines

Treatment Guidelines

Archived Medical Treatment Guidelines

Advanced Imaging Guidelines

Advanced Imaging Guidelines

The Washington Legislature passed a new law in 2009 (ESHB 2105/ Chapter 258, Laws of 2009) that directed the State to convene an Advanced Imaging Management Work Group. The Work Group was directed to identify evidence-based best practice guidelines for advanced imaging; State agencies were directed to implement the Work Group recommendations. Work Group recommendations include:

  • Evidence-based checklists for certain high-cost, high-use imaging studies.
  • Web-based utilization review.

For information about how to request authorization please see L&I's utilization review information pages.

Guidelines for Advanced Imaging Studies

Practice Resources for Attending Providers

Practice Resources for Attending Providers

L&I offers self-directed online learning, in-person seminars, and occasional conferences. Topics range from billing for staff to evidence based clinical topics for providers. Some allow you to meet our program requirements, some describe our processes, and some offer FREE education certificates.

L&I's OMD Training Catalog includes opportunities for earning education certificates*.  The Learning Management System (LMS) requires registration. For guidance, please review the LMS Tutorial.

Need help? Call 360-902-5999 weekdays between 8 a.m. and 5 p.m. (Pacific). Email Web Customer Support.

*After each completed activity you will be able to generate your own certificate. Print or save them as needed because L&I cannot reproduce them.

Accreditation Statement

The Washington State Department of Labor and Industries is accredited by the PacWest to provide continuing medical education for physicians.

  • The Washington State Department of Labor and Industries designates Enduring Material activities for AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
  • The Washington State Department of Labor and Industries certifies that non-physicians have participated in Enduring Material activities designated for AMA PRA Category 1 Credit(s)™.

These conservative care resources target specific occupational conditions/regions and were developed by the Industrial Insurance Chiropractic Advisory Committee in conjunction with L&I. The best evidence has been collected and organized to provide you with easy strategies to manage these conditions. Recommendations for provocation tests, diagnostic strategies, outcomes assessments and treatment interventions are included.

Optimizing your practice

These resources can decrease the administrative burden and enhance your clinic’s ability to work within the Workers’ Compensation system. They include:

  • Resources for proper documentation
  • Reference materials for attending providers
  • Services offered by L&I for injured workers
  • Templates and forms for working with employers
  • Forms for referral and collaboration
  • Checklist tool for assessing your readiness for workers' comp patients

Treating injured workers

Working with employers of injured workers

Collaborating with other providers

Educational Tool

Upcoming continuing education seminars

Information on upcoming seminars can be found here.

Additional resources and publications