Section 296-842-22005. Use this medical questionnaire for medical evaluations.

Use the medical questionnaire in Table 10 when conducting medical evaluations.

Note:	• You may use a physical exam instead of this questionnaire if the exam covers the same information as the questionnaire.
	• You may use online questionnaires if the questions are the same and the requirements in WAC 296-842-14005 of this chapter are met.
	• You may choose to send the questionnaire to the LHCP ahead of time, giving time to review it and add any necessary questions.
	• The LHCP determines what questions to add to the questionnaire, if any; however, questions in Parts 1-3 may not be deleted or substantially altered.

Table 10

[Statutory Authority: RCW 49.17.050 and 29 C.F.R. Subpart Z. WSR 09-19-119, § 296-842-22005, filed 9/22/09, effective 12/1/09. Statutory Authority: RCW 49.17.010, 49.17.040, 49.17.050, 49.17.060. WSR 07-05-072, § 296-842-22005, filed 2/20/07, effective 4/1/07; WSR 03-20-114, § 296-842-22005, filed 10/1/03, effective 1/1/04.]

RCW 49.17.050 and 29 C.F.R. Subpart Z. WSR 09-19-119, § 296-842-22005, filed 9/22/09, effective 12/1/09. Statutory Authority: RCW 49.17.010, 49.17.040, 49.17.050, 49.17.060. WSR 07-05-072, § 296-842-22005, filed 2/20/07, effective 4/1/07; WSR 03-20-114, § 296-842-22005, filed 10/1/03, effective 1/1/04.

Rules

296-842-14005,