Peer-reviewed medical literature plays a decisive role in policy development at the Washington State Department of Labor and Industries (L&I). L&I relies on multiple evidence-based mechanisms to make coverage decisions and translate medical science into public policy, including statute, rule writing, executive policy, real-time evidence assessment, pilot testing, and collaboration with researchers. Elements of L&I’s policy process structure and evidence-based culture are also observed in original literature discussing the needs and barriers of incorporating evidence into public policy.