H-0832.1 _______________________________________________
HOUSE BILL 1920
_______________________________________________
State of Washington 52nd Legislature 1991 Regular Session
By Representatives Heavey and Cole.
Read first time February 14, 1991. Referred to Committee on Commerce & Labor.
AN ACT Relating to employer obligations for providing industrial insurance; amending RCW 51.04.110, 51.04.120, 51.16.060, 51.16.105, 51.16.120, 51.16.140, 51.24.030, 51.24.050, 51.24.060, 51.24.070, 51.24.080, 51.24.090, 51.28.030, 51.28.055, 51.32.055, 51.32.073, 51.32.075, 51.32.095, 51.32.110, 51.32.112, 51.32.114, 51.32.160, 51.32.220, 51.32.240, 51.36.010, 51.36.020, 51.36.050, 51.36.060, 51.36.070, 51.44.040, 51.44.070, 51.48.050, 51.52.050, 51.52.110, 51.52.120, and 51.52.130; adding a new section to chapter 51.28 RCW; adding a new section to chapter 51.98 RCW; repealing RCW 51.14.010, 51.14.020, 51.14.030, 51.14.040, 51.14.050, 51.14.060, 51.14.070, 51.14.073, 51.14.077, 51.14.080, 51.14.090, 51.14.095, 51.14.100, 51.14.110, 51.14.150, 51.14.160, 51.32.190, 51.32.195, 51.32.200, 51.36.085, 51.44.140, 51.44.150, 51.48.017, and 51.48.110; prescribing penalties; and providing an effective date.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF WASHINGTON:
Sec. 1. RCW 51.04.110 and 1982 c 109 s 2 are each amended to read as follows:
The
director shall appoint a workers' compensation advisory committee composed of
ten members: ((Three)) Four representing subject workers, ((three))
four representing subject employers, ((one representing
self-insurers, one representing workers of self-insurers,)) and two ex
officio members, without a vote, one of whom shall be the chairman of the board
of industrial appeals and the other the representative of the department. The
member representing the department shall be chairman. This committee shall
conduct a continuing study of any aspects of workers' compensation as the
committee shall determine require their consideration. The committee shall
report its findings to the department or the board of industrial insurance
appeals for such action as deemed appropriate. The members of the committee
shall be appointed for a term of three years commencing on July 1, 1971 and the
terms of the members representing the workers and employers shall be staggered
so that the director shall designate one member from each such group initially
appointed whose term shall expire on June 30, 1972 and one member from each
such group whose term shall expire on June 30, 1973. The members shall serve
without compensation, but shall be entitled to travel expenses as provided in
RCW 43.03.050 and 43.03.060 as now existing or hereafter amended. The
committee may hire such experts, if any, as it shall require to discharge its
duties, and may utilize such personnel and facilities of the department and
board of industrial insurance appeals as it shall need without charge. All
expenses of this committee shall be paid by the department.
Sec. 2. RCW 51.04.120 and 1986 c 9 s 1 are each amended to read as follows:
Every
employer under this title shall secure the payment of compensation under this
title by insuring and keeping insured the payment of benefits with the state
fund. Any employer ((other than a self-insurer)) subject to this
title shall, under such rules as the department shall prescribe, apply for and
obtain from the department a certificate of coverage. The certificate shall be
personal and nontransferable and shall be valid as long as the employer
continues in business and pays the taxes due the state. In case the employer
maintains more than one place of business, a separate certificate of coverage
for each place at which business is transacted shall be required. Each
certificate shall be numbered and shall show the name, residence, and place and
character of business of the employer and such other information as the
department deems necessary and shall be posted conspicuously at the place of
business for which it is issued. Where a place of business of the employer is
changed, the employer must notify the department within thirty days of the new
address and a new certificate shall be issued for the new place of business. No
employer may engage in any business for which taxes are due under this title
without having a certificate of coverage in compliance with this section,
except that the department, by general rule, may provide for the issuance of a
certificate of coverage to employers with temporary places of business.
Sec. 3. RCW 51.16.060 and 1985 c 315 s 1 are each amended to read as follows:
Every
employer ((not qualifying as a self-insurer,)) shall insure with the
state and shall, on or before the last day of January, April, July and October
of each year thereafter, furnish the department with a true and accurate
payroll for the period in which workers were employed by it during the
preceding calendar quarter, the total amount paid to such workers during such
preceding calendar quarter, and a segregation of employment in the different
classes established pursuant to this title, and shall pay its premium thereon
to the appropriate fund. Premiums for a calendar quarter, whether reported or
not, shall become due and delinquent on the day immediately following the last
day of the month following the calendar quarter. The sufficiency of such
statement shall be subject to the approval of the director: PROVIDED, That the
director may in his or her discretion and for the effective administration of
this title require an employer in individual instances to furnish a
supplementary report containing the name of each individual worker, his or her
hours worked, his or her rate of pay and the class or classes in which such
work was performed: PROVIDED FURTHER, That in the event an employer shall
furnish the department with four consecutive quarterly reports wherein each
such quarterly report indicates that no premium is due the department may close
the account: PROVIDED FURTHER, That the department may promulgate rules and
regulations in accordance with chapter 34.05 RCW to establish other reporting
periods and payment due dates in lieu of reports and payments following each
calendar quarter, and may also establish terms and conditions for payment of
premiums and assessments based on estimated payrolls, with such payments being
subject to approval as to sufficiency of the estimated payroll by the
department, and also subject to appropriate periodic adjustments made by the
department based on actual payroll: AND PROVIDED FURTHER, That a temporary
help company which provides workers on a temporary basis to its customers shall
be considered the employer for purposes of reporting and paying premiums and
assessments under this title according to the appropriate rate classifications
as determined by the department: PROVIDED, That the employer shall be liable
for paying premiums and assessments, should the temporary help company fail to
pay the premiums and assessments under this title.
Sec. 4. RCW 51.16.105 and 1977 ex.s. c 350 s 27 are each amended to read as follows:
All
expenses of the industrial safety and health division of the department
pertaining to workers' compensation shall be paid by the department and
financed by premiums ((and by assessments collected from a self-insurer as
provided in this title)).
Sec. 5. RCW 51.16.120 and 1984 c 63 s 1 are each amended to read as follows:
(1)
Whenever a worker has a previous bodily disability from any previous injury or
disease, whether known or unknown to the employer, and shall suffer a further
disability from injury or occupational disease in employment covered by this
title and become totally and permanently disabled from the combined effects
thereof or die when death was substantially accelerated by the combined effects
thereof, then the experience record of an employer insured with the state fund
at the time of said further injury or disease shall be charged and ((a
self-insured)) an employer who was formerly self-insured under
this title shall pay directly into the reserve fund only the accident cost
which would have resulted solely from said further injury or disease, had there
been no preexisting disability, and which accident cost shall be based upon an
evaluation of the disability by medical experts. The difference between the
charge thus assessed to such employer at the time of said further injury or
disease and the total cost of the pension reserve shall be assessed against the
second injury fund. The department shall pass upon the application of this
section in all cases where benefits are paid for total permanent disability or
death and issue an order thereon appealable by the employer. Pending outcome
of such appeal the transfer or payment shall be made as required by such order.
(2) The department shall, in cases of claims of workers sustaining injuries or occupational diseases in the employ of state fund employers, recompute the experience record of such employers when the claims of workers injured in their employ have been found to qualify for payments from the second injury fund after the regular time for computation of such experience records and the department may make appropriate adjustments in such cases including cash refunds or credits to such employers.
(3) To encourage employment of injured workers who are not reemployed by the employer at the time of injury, the department may adopt rules providing for the reduction or elimination of premiums or assessments from subsequent employers of such workers and may also adopt rules for the reduction or elimination of charges against such employers in the event of further injury to such workers in their employ.
Sec. 6. RCW 51.16.140 and 1989 c 385 s 3 are each amended to read as follows:
(((1)
Every employer who is not a self-insurer shall deduct from the pay of each of
his or her workers one-half of the amount he or she is required to pay, for
medical benefits within each risk classification. Such amount shall be
periodically determined by the director and reported by him or her to all
employers under this title: PROVIDED, That the state governmental unit shall
pay the entire amount into the medical aid fund for volunteers, as defined in
RCW 51.12.035, and the state apprenticeship council shall pay the entire amount
into the medical aid fund for registered apprentices or trainees, for the
purposes of RCW 51.12.130. The deduction under this section is not authorized
for premiums assessed under RCW 51.16.210.
(2))) It shall
be unlawful for the employer, unless specifically authorized by this title, to
deduct or obtain any part of the premium or other costs required to be by him
or her paid from the wages or earnings of any of his or her workers, and the
making of or attempt to make any such deduction shall be a gross misdemeanor.
Sec. 7. RCW 51.24.030 and 1987 c 212 s 1701 are each amended to read as follows:
(1) If a third person, not in a worker's same employ, is or may become liable to pay damages on account of a worker's injury for which benefits and compensation are provided under this title, the injured worker or beneficiary may elect to seek damages from the third person.
(2) In
every action brought under this section, the plaintiff shall give notice to the
department ((or self-insurer)) when the action is filed. The department
((or self-insurer)) may file a notice of statutory interest in
recovery. When such notice has been filed by the department ((or
self-insurer)), the parties shall thereafter serve copies of all notices,
motions, pleadings, and other process on the department ((or self-insurer)).
The department ((or self-insurer)) may then intervene as a party in the
action to protect its statutory interest in recovery.
(3) For the purposes of this chapter, "injury" shall include any physical or mental condition, disease, ailment or loss, including death, for which compensation and benefits are paid or payable under this title.
(4) Damages recoverable by a worker or beneficiary pursuant to the underinsured motorist coverage of an insurance policy shall be subject to this chapter only if the owner of the policy is the employer of the injured worker.
Sec. 8. RCW 51.24.050 and 1984 c 218 s 4 are each amended to read as follows:
(1) An
election not to proceed against the third person operates as an assignment of
the cause of action to the department ((or self-insurer)), which may
prosecute or compromise the action in its discretion in the name of the injured
worker, beneficiary or legal representative.
(2) If
an injury to a worker results in the worker's death, the department ((or
self-insurer)) to which the cause of action has been assigned may petition
a court for the appointment of a special personal representative for the
limited purpose of maintaining an action under this chapter and chapter 4.20
RCW.
(3) If a beneficiary is a minor child, an election not to proceed against a third person on such beneficiary's cause of action may be exercised by the beneficiary's legal custodian or guardian.
(4)
Any recovery made by the department ((or self-insurer)) shall be
distributed as follows:
(a)
The department ((or self-insurer)) shall be paid the expenses incurred
in making the recovery including reasonable costs of legal services;
(b) The injured worker or beneficiary shall be paid twenty-five percent of the balance of the recovery made, which shall not be subject to subsection (5) of this section: PROVIDED, That in the event of a compromise and settlement by the parties, the injured worker or beneficiary may agree to a sum less than twenty-five percent;
(c)
The department ((and/or self-insurer)) shall be paid the compensation
and benefits paid to or on behalf of the injured worker or beneficiary by the
department ((and/or self-insurer)); and
(d) The injured worker or beneficiary shall be paid any remaining balance.
(5)
Thereafter no payment shall be made to or on behalf of a worker or beneficiary
by the department ((and/or self-insurer)) for such injury until the
amount of any further compensation and benefits shall equal any such remaining
balance. Thereafter, such benefits shall be paid by the department ((and/or
self-insurer)) to or on behalf of the worker or beneficiary as though no
recovery had been made from a third person.
(6) ((In
the case of an employer not qualifying as a self-insurer,)) The
department shall make a retroactive adjustment to ((such)) the
employer's experience rating in which the third party claim has been included
to reflect that portion of the award or settlement which is reimbursed for
compensation and benefits paid and, if the claim is open at the time of
recovery, applied against further compensation or benefits to which the injured
worker or beneficiary may be entitled.
(7)
When the cause of action has been assigned to ((the)) a former
self-insurer and compensation and benefits have been paid and/or are payable
from state funds for the same injury:
(a) The prosecution of such cause of action shall also be for the benefit of the department to the extent of compensation and benefits paid and payable from state funds;
(b) Any compromise or settlement of such cause of action which results in less than the entitlement under this title is void unless made with the written approval of the department;
(c) The department shall be reimbursed for compensation and benefits paid from state funds;
(d) The department shall bear its proportionate share of the costs and reasonable attorneys' fees incurred by the former self-insurer in obtaining the award or settlement; and
(e) Any remaining balance under subsection (4)(d) of this section shall be applied, under subsection (5) of this section, to reduce the obligations of the department and self-insurer to pay further compensation and benefits in proportion to which the obligations of each bear to the remaining entitlement of the worker or beneficiary.
Sec. 9. RCW 51.24.060 and 1987 c 442 s 1118 are each amended to read as follows:
(1) If the injured worker or beneficiary elects to seek damages from the third person, any recovery made shall be distributed as follows:
(a)
The costs and reasonable attorneys' fees shall be paid proportionately by the
injured worker or beneficiary and the department ((and/or self-insurer));
(b) The injured worker or beneficiary shall be paid twenty-five percent of the balance of the award: PROVIDED, That in the event of a compromise and settlement by the parties, the injured worker or beneficiary may agree to a sum less than twenty-five percent;
(c)
The department ((and/or self-insurer)) shall be paid the balance of the
recovery made, but only to the extent necessary to reimburse the department ((and/or
self-insurer)) for compensation and benefits paid;
(i)
The department ((and/or self-insurer)) shall bear its proportionate
share of the costs and reasonable attorneys' fees incurred by the worker or
beneficiary to the extent of the benefits paid or payable under this title:
PROVIDED, That the department ((or self-insurer)) may require court
approval of costs and attorneys' fees or may petition a court for determination
of the reasonableness of costs and attorneys' fees.
(ii)
The sum representing the department's ((and/or self-insurer's))
proportionate share shall not be subject to subsection (1) (d) and (e) of this
section.
(d) Any remaining balance shall be paid to the injured worker or beneficiary;
(e)
Thereafter no payment shall be made to or on behalf of a worker or beneficiary
by the department ((and/or self-insurer)) for such injury until the
amount of any further compensation and benefits shall equal any such remaining
balance. Thereafter, such benefits shall be paid by the department ((and/or
self-insurer)) to or on behalf of the worker or beneficiary as though no
recovery had been made from a third person;
(f) If
the employer or a co-employee are determined under RCW 4.22.070 to be at fault,
(c) and (e) of this subsection do not apply and benefits shall be paid by the
department ((and/or self-insurer)) to or on behalf of the worker or
beneficiary as though no recovery had been made from a third person.
(2)
The recovery made shall be subject to a lien by the department ((and/or
self-insurer)) for its share under this section.
(3)
The department ((or self-insurer)) has sole discretion to compromise the
amount of its lien. In deciding whether or to what extent to compromise its lien,
the department ((or self-insurer)) shall consider at least the
following:
(a) The likelihood of collection of the award or settlement as may be affected by insurance coverage, solvency, or other factors relating to the third person;
(b) Factual and legal issues of liability as between the injured worker or beneficiary and the third person. Such issues include but are not limited to possible contributory negligence and novel theories of liability; and
(c) Problems of proof faced in obtaining the award or settlement.
(4) ((In
the case of an employer not qualifying as a self-insurer,)) The
department shall make a retroactive adjustment to such employer's experience
rating in which the third party claim has been included to reflect that portion
of the award or settlement which is reimbursed for compensation and benefits
paid and, if the claim is open at the time of recovery, applied against further
compensation and benefits to which the injured worker or beneficiary may be
entitled.
(5) In an action under this section involving a claim formerly self-insured under this title, the former self-insurer may act on behalf and for the benefit of the department to the extent of any compensation and benefits paid or payable from state funds.
(6) It shall be the duty of the person to whom any recovery is paid before distribution under this section to advise the department or former self-insurer of the fact and amount of such recovery, the costs and reasonable attorneys' fees associated with the recovery, and to distribute the recovery in compliance with this section.
(7) The distribution of any recovery made by award or settlement of the third party action shall be confirmed by department order, served by registered or certified mail, and shall be subject to chapter 51.52 RCW. In the event the order of distribution becomes final under chapter 51.52 RCW, the director or the director's designee may file with the clerk of any county within the state a warrant in the amount of the sum representing the unpaid lien plus interest accruing from the date the order became final. The clerk of the county in which the warrant is filed shall immediately designate a superior court cause number for such warrant and the clerk shall cause to be entered in the judgment docket under the superior court cause number assigned to the warrant, the name of such worker or beneficiary mentioned in the warrant, the amount of the unpaid lien plus interest accrued and the date when the warrant was filed. The amount of such warrant as docketed shall become a lien upon the title to and interest in all real and personal property of the injured worker or beneficiary against whom the warrant is issued, the same as a judgment in a civil case docketed in the office of such clerk. The sheriff shall then proceed in the same manner and with like effect as prescribed by law with respect to execution or other process issued against rights or property upon judgment in the superior court. Such warrant so docketed shall be sufficient to support the issuance of writs of garnishment in favor of the department in the manner provided by law in the case of judgment, wholly or partially unsatisfied. The clerk of the court shall be entitled to a filing fee of five dollars, which shall be added to the amount of the warrant. A copy of such warrant shall be mailed to the injured worker or beneficiary within three days of filing with the clerk.
(8) The director, or the director's designee, may issue to any person, firm, corporation, municipal corporation, political subdivision of the state, public corporation, or agency of the state, a notice and order to withhold and deliver property of any kind if he or she has reason to believe that there is in the possession of such person, firm, corporation, municipal corporation, political subdivision of the state, public corporation, or agency of the state, property which is due, owing, or belonging to any worker or beneficiary upon whom a warrant has been served by the department for payments due to the state fund. The notice and order to withhold and deliver shall be served by the sheriff of the county or by the sheriff's deputy, or by any authorized representatives of the director. Any person, firm, corporation, municipal corporation, political subdivision of the state, public corporation, or agency of the state upon whom service has been made shall answer the notice within twenty days exclusive of the day of service, under oath and in writing, and shall make true answers to the matters inquired of in the notice and order to withhold and deliver. In the event there is in the possession of the party named and served with such notice and order, any property which may be subject to the claim of the department, such property shall be delivered forthwith to the director or the director's authorized representative upon demand. If the party served and named in the notice and order fails to answer the notice and order within the time prescribed in this section, the court may, after the time to answer such order has expired, render judgment by default against the party named in the notice for the full amount claimed by the director in the notice together with costs. In the event that a notice to withhold and deliver is served upon an employer and the property found to be subject thereto is wages, the employer may assert in the answer to all exemptions provided for by chapter 6.27 RCW to which the wage earner may be entitled.
Sec. 10. RCW 51.24.070 and 1984 c 218 s 6 are each amended to read as follows:
(1) The department, or former self-insurer if the claim was formerly self-insured under this title, may require the injured worker or beneficiary to exercise the right of election under this chapter by serving a written demand by registered mail, certified mail, or personal service on the worker or beneficiary.
(2) Unless an election is made within sixty days of the receipt of the demand, and unless an action is instituted or settled within the time granted by the department or former self-insurer, the injured worker or beneficiary is deemed to have assigned the action to the department or former self-insurer. The department or former self-insurer shall allow the worker or beneficiary at least ninety days from the election to institute or settle the action. When a beneficiary is a minor child the demand shall be served upon the legal custodian or guardian of such beneficiary.
(3) If an action which has been filed is not diligently prosecuted, the department or former self-insurer may petition the court in which the action is pending for an order assigning the cause of action to the department or former self-insurer. Upon a sufficient showing of a lack of diligent prosecution the court in its discretion may issue the order.
(4) If the department or former self-insurer has taken an assignment of the third party cause of action under subsection (2) of this section, the injured worker or beneficiary may, at the discretion of the department or former self-insurer, exercise a right of reelection and assume the cause of action subject to reimbursement of litigation expenses incurred by the department or former self-insurer.
Sec. 11. RCW 51.24.080 and 1977 ex.s. c 85 s 6 are each amended to read as follows:
(1) If the injured worker or beneficiary elects to seek damages from the third person, notice of the election must be given to the department or former self-insurer if the claim was formerly self-insured under this title. The notice shall be by registered mail, certified mail, or personal service. If an action is filed by the injured worker or beneficiary, a copy of the complaint must be sent by registered mail to the department or former self-insurer.
(2) A return showing service of the notice on the department or former self-insurer shall be filed with the court but shall not be part of the record except as necessary to give notice to the defendant of the lien imposed by RCW 51.24.060(2).
Sec. 12. RCW 51.24.090 and 1984 c 218 s 7 are each amended to read as follows:
(1) Any compromise or settlement of the third party cause of action by the injured worker or beneficiary which results in less than the entitlement under this title is void unless made with the written approval of the department or former self-insurer if the claim was formerly self-insured under this title: PROVIDED, That for the purposes of this chapter, "entitlement" means benefits and compensation paid and payable.
(2) If a compromise or settlement is void because of subsection (1) of this section, the department or former self-insurer may petition the court in which the action was filed for an order assigning the cause of action to the department or former self-insurer. If an action has not been filed, the department or former self-insurer may proceed as provided in chapter 7.24 RCW.
Sec. 13. RCW 51.28.030 and 1972 ex.s. c 43 s 17 are each amended to read as follows:
Where
death results from injury the parties entitled to compensation under this
title, or someone in their behalf, shall make application for the same to the
department ((or self-insurer as the case may be)), which application
must be accompanied with proof of death and proof of relationship showing the
parties to be entitled to compensation under this title, certificates of
attending physician, if any, and such proof as required by the rules of the
department.
Upon receipt of notice of accident under RCW 51.28.010, the director shall immediately forward to the party or parties required to make application for compensation under this section, notification, in nontechnical language, of their rights under this title.
Sec. 14. RCW 51.28.055 and 1984 c 159 s 2 are each amended to read as follows:
Claims
for occupational disease or infection to be valid and compensable must be filed
within two years following the date the worker had written notice from a
physician: (1) Of the existence of his or her occupational disease, and (2)
that a claim for disability benefits may be filed. The notice shall also
contain a statement that the worker has two years from the date of the notice
to file a claim. The physician shall file the notice with the department. The
department shall send a copy to the worker ((and to the self-insurer if the
worker's employer is self-insured)). However, a claim is valid if it is
filed within two years from the date of death of the worker suffering from an
occupational disease.
Sec. 15. RCW 51.32.055 and 1988 c 161 s 13 are each amended to read as follows:
(1) One purpose of this title is to restore the injured worker as near as possible to the condition of self-support as an able-bodied worker. Benefits for permanent disability shall be determined under the director's supervision only after the injured worker's condition becomes fixed.
(2)
All determinations of permanent disabilities shall be made by the department.
Either the worker((,)) or employer((, or self-insurer))
may make a request or such inquiry may be initiated by the director on his or
her own motion. Such determinations shall be required in every instance where
permanent disability is likely to be present. All medical reports and other
pertinent information in the possession of or under the control of the employer
((or self-insurer)) shall be forwarded to the director with such
requests.
(3) A request for determination of permanent disability shall be examined by the department and an order shall issue in accordance with RCW 51.52.050.
(4)
The department may require that the worker present himself or herself for a
special medical examination by a physician, or physicians, selected by the
department, and the department may require that the worker present himself or
herself for a personal interview. In such event the costs of such examination
or interview, including payment of any reasonable travel expenses, shall be
paid by the department ((or self-insurer as the case may be)).
(5)
The director may establish a medical bureau within the department to perform
medical examinations under this section. Physicians hired or retained for this
purpose shall be grounded in industrial medicine and in the assessment of
industrial physical impairment. ((Self-insurers shall bear a proportionate
share of the cost of such medical bureau in a manner to be determined by the
department.))
(6)
Where dispute arises from the handling of any claims prior to the condition of
the injured worker becoming fixed, the worker((,)) or employer((,
or self-insurer)) may request the department to resolve the dispute or the
director may initiate an inquiry on his or her own motion. In such cases the
department shall proceed as provided in this section and an order shall issue
in accordance with RCW 51.52.050.
(((7)(a)
In the case of claims accepted by self-insurers after June 30, 1986, and before
July 1, 1990, which involve only medical treatment and/or the payment of
temporary disability compensation under RCW 51.32.090 and which at the time
medical treatment is concluded do not involve permanent disability, if the
claim is one with respect to which the department has not intervened under
subsection (6) of this section, and the injured worker has returned to work
with the self-insured employer of record, such claims may be closed by the
self-insurer, subject to reporting of claims to the department in a manner
prescribed by department rules adopted under chapter 34.05 RCW.
(b)
All determinations of permanent disability for claims accepted by self-insurers
after June 30, 1986, and before July 1, 1990, shall be made by the self-insured
section of the department under subsections (1) through (4) of this section.
(c)
Upon closure of claims under (a) of this subsection the self-insurer shall
enter a written order, communicated to the worker and the department
self-insurance section, which contains the following statement clearly set
forth in bold face type: "This order constitutes notification that your
claim is being closed with medical benefits and temporary disability
compensation only as provided, and with the condition you have returned to work
with the self-insured employer. If for any reason you disagree with the
conditions or duration of your return to work or the medical benefits or the
temporary disability compensation that has been provided, you may protest in
writing to the department of labor and industries, self-insurance section,
within sixty days of the date you received this order." In the event the
department receives such a protest the self-insurer's closure order shall be
held in abeyance. The department shall review the claim closure action and
enter a determinative order as provided for in RCW 51.52.050.
(d)
If within two years of claim closure the department determines that the
self-insurer has made payment of benefits because of clerical error, mistake of
identity, or innocent misrepresentation, or the department discovers a
violation of the conditions of claim closure, the department may require the
self-insurer to correct the benefits paid or payable. This paragraph shall not
limit in any way the application of RCW 51.32.240.
(8)
In the case of claims accepted by self-insurers after June 30, 1990, which
involve only medical treatment and which do not involve payment of temporary
disability compensation under RCW 51.32.090 and which at the time medical
treatment is concluded do not involve permanent disability, such claims may be
closed by the self-insurers subject to reporting of claims to the department in
a manner prescribed by department rules promulgated pursuant to chapter 34.05
RCW. Upon such closure the self-insurers shall enter a written order,
communicated to the worker, which contains the following statement clearly set
forth in bold-face type: "This order constitutes notification that your
claim is being closed with medical benefits only, as provided. If for any
reason you disagree with this closure, you may protest in writing to the Department
of Labor and Industries, Olympia, within 60 days of the date you received this
order. The department will then review your claim and enter a further
determinative order." In the event the department receives such a protest
it shall review the claim and enter a further determinative order as provided
for in RCW 51.52.050.))
Sec. 16. RCW 51.32.073 and 1989 c 385 s 4 are each amended to read as follows:
(1)
Except as provided in subsection (2) of this section, each employer shall
retain from the earnings of each worker that amount as shall be fixed from time
to time by the director, the basis for measuring said amount to be determined
by the director. The money so retained shall be matched in an equal amount by
each employer, and all such moneys shall be remitted to the department in such
manner and at such intervals as the department directs and shall be placed in
the supplemental pension fund: PROVIDED, That the state apprenticeship council
shall pay the entire amount into the supplemental pension fund for registered
apprentices or trainees during their participation in supplemental and related
instruction classes. The moneys so collected shall be used exclusively for the
additional payments from the supplemental pension fund prescribed in this title
and for the amount of any increase payable under the provisions of RCW
51.32.075, as now or hereafter amended, and shall be no more than necessary to
make such payments on a current basis. ((The department may require a self-insurer
to make any additional payments which are payable from the supplemental pension
fund and thereafter such self-insurer shall be reimbursed therefrom.))
(2) None of the amount assessed for the supplemental pension fund under RCW 51.16.210 may be retained from the earnings of workers covered under RCW 51.16.210.
Sec. 17. RCW 51.32.075 and 1988 c 161 s 7 are each amended to read as follows:
The compensation or death benefits payable pursuant to the provisions of this chapter for temporary total disability, permanent total disability, or death arising out of injuries or occupational diseases shall be adjusted as follows:
(1) On July 1, 1982, there shall be an adjustment for those whose right to compensation was established on or after July 1, 1971, and before July 1, 1982. The adjustment shall be determined by multiplying the amount of compensation to which they are entitled by a fraction, the denominator of which shall be the average monthly wage in the state under RCW 51.08.018 for the fiscal year in which such person's right to compensation was established, and the numerator of which shall be the average monthly wage in the state under RCW 51.08.018 on July 1, 1982.
(2) In addition to the adjustment established by subsection (1) of this section, there shall be another adjustment on July 1, 1983, for those whose right to compensation was established on or after July 1, 1971, and before July 1983, which shall be determined by multiplying the amount of compensation to which they are entitled by a fraction, the denominator of which shall be the average monthly wage in the state under RCW 51.08.018 for the fiscal year in which such person's right to compensation was established, and the numerator of which shall be the average monthly wage in the state under RCW 51.08.018 on July 1, 1983.
(3) In
addition to the adjustments under subsections (1) and (2) of this section,
further adjustments shall be made beginning on July 1, 1984, and on each July
1st thereafter for those whose right to compensation was established on or
after July 1, 1971. The adjustment shall be determined by multiplying the
amount of compensation to which they are entitled by a fraction, the
denominator of which shall be the average monthly wage in the state under RCW
51.08.018 for the fiscal year in which such person's right to compensation was
established, and the numerator of which shall be the average monthly wage in
the state under RCW 51.08.018 on July 1st of the year in which the adjustment
is being made. The department ((or self-insurer)) shall adjust the
resulting compensation rate to the nearest whole cent, not to exceed the
average monthly wage in the state as computed under RCW 51.08.018.
Sec. 18. RCW 51.32.095 and 1988 c 161 s 9 are each amended to read as follows:
(1)
One of the primary purposes of this title is to enable the injured worker to
become employable at gainful employment. To this end, the department ((or
self-insurers)) shall utilize the services of individuals and
organizations, public or private, whose experience, training, and interests in
vocational rehabilitation and retraining qualify them to lend expert assistance
to the supervisor of industrial insurance in such programs of vocational
rehabilitation as may be reasonable to make the worker employable consistent
with his or her physical and mental status. Where, after evaluation and
recommendation by such individuals or organizations and prior to final evaluation
of the worker's permanent disability and in the sole opinion of the supervisor
or supervisor's designee, whether or not medical treatment has been concluded,
vocational rehabilitation is both necessary and likely to enable the injured
worker to become employable at gainful employment, the supervisor or
supervisor's designee may, in his or her sole discretion, pay ((or, if the
employer is a self-insurer, direct the self-insurer to pay)) the cost as
provided in subsection (3) of this section.
(2) When in the sole discretion of the supervisor or the supervisor's designee vocational rehabilitation is both necessary and likely to make the worker employable at gainful employment, then the following order of priorities shall be used:
(a) Return to the previous job with the same employer;
(b) Modification of the previous job with the same employer including transitional return to work;
(c) A new job with the same employer in keeping with any limitations or restrictions;
(d) Modification of a new job with the same employer including transitional return to work;
(e) Modification of the previous job with a new employer;
(f) A new job with a new employer or self-employment based upon transferable skills;
(g) Modification of a new job with a new employer;
(h) A new job with a new employer or self-employment involving on-the-job training;
(i) Short-term retraining and job placement.
(3) Costs for vocational rehabilitation benefits allowed by the supervisor or supervisor's designee under subsection (1) of this section may include the cost of books, tuition, fees, supplies, equipment, transportation, child or dependent care, and other necessary expenses for any such worker in an amount not to exceed three thousand dollars in any fifty-two week period, and the cost of continuing the temporary total disability compensation under RCW 51.32.090 while the worker is actively and successfully undergoing a formal program of vocational rehabilitation. Such expenses may include training fees for on-the-job training and the cost of furnishing tools and other equipment necessary for self-employment or reemployment: PROVIDED, That such compensation or payment of retraining with job placement expenses may not be authorized for a period of more than fifty-two weeks: PROVIDED FURTHER, That such period may, in the sole discretion of the supervisor after his or her review, be extended for an additional fifty-two weeks or portion thereof by written order of the supervisor.
In
cases where the worker is required to reside away from his or her customary
residence, the reasonable cost of board and lodging shall also be paid. Said
costs shall be chargeable to the employer's cost experience ((or shall be
paid by the self-insurer as the case may be)).
(4) The department shall establish criteria to monitor the quality and effectiveness of rehabilitation services provided by the individuals and organizations used under subsection (1) of this section. The state fund shall make referrals for vocational rehabilitation services based on these performance criteria.
(5) The department shall engage in, where feasible and cost-effective, a cooperative program with the state employment security department to provide job placement services under this section.
(6) ((The
benefits in this section shall be provided for the injured workers of
self-insured employers. Self-insurers shall report both benefits provided and
benefits denied under this section in the manner prescribed by the department
by rule adopted under chapter 34.05 RCW.)) The director may, in his or her
sole discretion and upon his or her own initiative or at any time that a
dispute arises under this section, promptly make such inquiries as
circumstances require and take such other action as he or she considers will
properly determine the matter and protect the rights of the parties.
(7) The benefits provided for in this section are available to any otherwise eligible worker regardless of the date of industrial injury. However, claims shall not be reopened solely for vocational rehabilitation purposes.
Sec. 19. RCW 51.32.110 and 1980 c 14 s 11 are each amended to read as follows:
Any
worker entitled to receive any benefits or claiming such under this title
shall, if requested by the department ((or self-insurer)), submit
himself or herself for medical examination, at a time and from time to time, at
a place reasonably convenient for the worker and as may be provided by the
rules of the department. If the worker refuses to submit to medical
examination, or obstructs the same, or, if any injured worker shall persist in
unsanitary or injurious practices which tend to imperil or retard his or her
recovery, or shall refuse to submit to such medical or surgical treatment as is
reasonably essential to his or her recovery or refuse or obstruct evaluation or
examination for the purpose of vocational rehabilitation or does not cooperate
in reasonable efforts at such rehabilitation, the department ((or the
self-insurer upon approval by the department)), with notice to the worker
may suspend any further action on any claim of such worker so long as such
refusal, obstruction, noncooperation, or practice continues and reduce,
suspend, or deny any compensation for such period: PROVIDED, That the
department ((or the self-insurer)) shall not suspend any further action
on any claim of a worker or reduce, suspend, or deny any compensation if a
worker has good cause for refusing to submit to or to obstruct any examination,
evaluation, treatment or practice requested by the department or required under
this section. If the worker necessarily incurs traveling expenses in attending
for examination pursuant to the request of the department, such traveling
expenses shall be repaid to him or her out of the accident fund upon proper
voucher and audit ((or shall be repaid by the self-insurer, as the case may
be)).
If the medical examination required by this section causes the worker to be absent from his or her work without pay he or she shall be paid for such time lost in accordance with the schedule of payments provided in RCW 51.32.090 as amended.
Sec. 20. RCW 51.32.112 and 1988 c 114 s 2 are each amended to read as follows:
(1) The department shall develop standards for the conduct of special medical examinations to determine permanent disabilities, including, but not limited to:
(a) The qualifications of persons conducting the examinations;
(b) The criteria for conducting the examinations, including guidelines for the appropriate treatment of injured workers during the examination; and
(c) The content of examination reports.
(2)
The department shall investigate the amount of examination fees received by
persons conducting special medical examinations to determine permanent
disabilities, including total compensation received for examinations of ((department
and self-insured)) claimants, and establish compensation guidelines and
compensation reporting criteria.
(((3)
The department shall investigate the level of compliance of self-insurers with
the requirement of full reporting of claims information to the department,
particularly with respect to medical examinations, and develop effective
enforcement procedures or recommendations for legislation if needed.))
Sec. 21. RCW 51.32.114 and 1988 c 114 s 3 are each amended to read as follows:
The
department shall examine the credentials of persons conducting special medical
examinations and shall monitor the quality and objectivity of examinations and
reports for ((the department and self-insured)) claimants. The
department shall adopt rules to ensure that examinations are performed only by
qualified persons meeting department standards.
Sec. 22. RCW 51.32.160 and 1988 c 161 s 11 are each amended to read as follows:
If
aggravation, diminution, or termination of disability takes place, the director
may, upon the application of the beneficiary, made within seven years from the
date the first closing order becomes final, or at any time upon his or her own
motion, readjust the rate of compensation in accordance with the rules in this
section provided for the same, or in a proper case terminate the payment:
PROVIDED, That the director may, upon application of the worker made at any
time, provide proper and necessary medical and surgical services as authorized
under RCW 51.36.010. "Closing order" as used in this section means
an order based on factors which include medical recommendation, advice, or
examination. Applications for benefits where the claim has been closed without
medical recommendation, advice, or examination are not subject to the seven
year limitation of this section. The preceding sentence shall not apply to any
closing order issued prior to July 1, 1981. First closing orders issued
between July 1, 1981, and July 1, 1985, shall, for the purposes of this section
only, be deemed issued on July 1, 1985. The time limitation of this section
shall be ten years in claims involving loss of vision or function of the eyes.
If an order denying an application to reopen filed on or after July 1, 1988, is
not issued within ninety days of receipt of such application by ((the self-insured
employer or)) the department, such application shall be deemed granted.
However, for good cause, the department may extend the time for making the
final determination on the application for an additional sixty days.
If a worker receiving a pension for total disability returns to gainful employment for wages, the director may suspend or terminate the rate of compensation established for the disability without producing medical evidence that shows that a diminution of the disability has occurred.
No act done or ordered to be done by the director, or the department prior to the signing and filing in the matter of a written order for such readjustment shall be grounds for such readjustment.
Sec. 23. RCW 51.32.220 and 1982 c 63 s 19 are each amended to read as follows:
(1) For persons under the age of sixty-five receiving compensation for temporary or permanent total disability pursuant to the provisions of chapter 51.32 RCW, such compensation shall be reduced by an amount equal to the benefits payable under the federal old-age, survivors and disability insurance act as now or hereafter amended not to exceed the amount of the reduction established pursuant to 42 USC 424a. However, such reduction shall not apply when the combined compensation provided pursuant to chapter 51.32 RCW and the federal old-age, survivors and disability insurance act is less than the total benefits to which the federal reduction would apply, pursuant to 42 USC 424a. Where any person described in this section refuses to authorize the release of information concerning the amount of benefits payable under said federal act the department's estimate of said amount shall be deemed to be correct unless and until the actual amount is established and no adjustment shall be made for any period of time covered by any such refusal.
(2)
Any reduction under subsection (1) of this section shall be effective the month
following the month in which the department ((or self-insurer)) is
notified by the federal social security administration that the person is
receiving disability benefits under the federal old-age, survivors and
disability insurance act: PROVIDED, That in the event of an overpayment of
benefits the department ((or self-insurer)) may not recover more than
the overpayments for the six months immediately preceding the date the
department ((or self-insurer)) notifies the worker that an overpayment
has occurred: PROVIDED FURTHER, That upon determining that there has been an
overpayment, the department ((or self-insurer)) shall immediately notify
the person who received the overpayment that he or she shall be required to
make repayment pursuant to this section and RCW 51.32.230.
(3)
Recovery of any overpayment must be taken from future temporary or permanent
total disability benefits or permanent partial disability benefits provided by
this title. In the case of temporary or permanent total disability benefits,
the recovery shall not exceed twenty-five percent of the monthly amount due
from the department ((or self-insurer)) or one-sixth of the total
overpayment, whichever is the lesser.
(4) No reduction may be made unless the worker receives notice of the reduction prior to the month in which the reduction is made.
(5) In no event shall the reduction reduce total benefits to less than the greater amount the worker may be entitled to under this title or the federal old-age, survivors and disability insurance act.
(6) The director, pursuant to rules adopted in accordance with the procedures provided in the administrative procedure act, chapter 34.05 RCW, may exercise his discretion to waive, in whole or in part, the amount of any overpayment where the recovery would be against equity and good conscience.
(7) The amendment in subsection (1) of this section by chapter 63, Laws of 1982 raising the age limit during which the reduction shall be made from age sixty-two to age sixty-five shall apply with respect to workers whose effective entitlement to total disability compensation begins after January 1, 1983.
Sec. 24. RCW 51.32.240 and 1986 c 54 s 1 are each amended to read as follows:
(1)
Whenever any payment of benefits under this title is made because of clerical
error, mistake of identity, innocent misrepresentation by or on behalf of the
recipient thereof mistakenly acted upon, or any other circumstance of a similar
nature, all not induced by fraud, the recipient thereof shall repay it and
recoupment may be made from any future payments due to the recipient on any
claim with the state fund ((or self-insurer, as the case may be)). The
department ((or self-insurer, as the case may be,)) must make claim for
such repayment or recoupment within one year of the making of any such payment
or it will be deemed any claim therefor has been waived. The director,
pursuant to rules adopted in accordance with the procedures provided in the
administrative procedure act, chapter 34.05 RCW, may exercise his discretion to
waive, in whole or in part, the amount of any such timely claim where the
recovery would be against equity and good conscience.
(2)
Whenever the department issues an order rejecting a claim for benefits paid
pursuant to RCW ((51.32.190 or)) 51.32.210, after payment for temporary
disability benefits has been paid ((by a self-insurer pursuant to RCW
51.32.190(3) or)) by the department pursuant to RCW 51.32.210, the
recipient thereof shall repay such benefits and recoupment may be made from any
future payments due to the recipient on any claim with the state fund ((or
self-insurer, as the case may be)). The director, under rules adopted in
accordance with the procedures provided in the administrative procedure act,
chapter 34.05 RCW, may exercise discretion to waive, in whole or in part, the
amount of any such payments where the recovery would be against equity and good
conscience.
(3)
Whenever any payment of benefits under this title has been made pursuant to an
adjudication by the department or by order of the board or any court and timely
appeal therefrom has been made where the final decision is that any such
payment was made pursuant to an erroneous adjudication, the recipient thereof
shall repay it and recoupment may be made from any future payments due to the
recipient on any claim with the state fund ((or self-insurer, as the case
may be)). The director, pursuant to rules adopted in accordance with the
procedures provided in the administrative procedure act, chapter 34.05 RCW, may
exercise his discretion to waive, in whole or in part, the amount of any such
payments where the recovery would be against equity and good conscience.
(4)
Whenever any payment of benefits under this title has been induced by fraud the
recipient thereof shall repay any such payment together with a penalty of fifty
percent of the total of any such payments and the amount of such total sum may
be recouped from any future payments due to the recipient on any claim with the
state fund ((or self-insurer against whom the fraud was committed, as the
case may be)), and the amount of such penalty shall be placed in the
supplemental pension fund. Such repayment or recoupment must be demanded or
ordered within one year of the discovery of the fraud.
Sec. 25. RCW 51.36.010 and 1986 c 58 s 6 are each amended to read as follows:
Upon the occurrence of any injury to a worker entitled to compensation under the provisions of this title, he or she shall receive proper and necessary medical and surgical services at the hands of a physician of his or her own choice, if conveniently located, and proper and necessary hospital care and services during the period of his or her disability from such injury, but the same shall be limited in point of duration as follows:
In the case of permanent partial disability, not to extend beyond the date when compensation shall be awarded him or her, except when the worker returned to work before permanent partial disability award is made, in such case not to extend beyond the time when monthly allowances to him or her shall cease; in case of temporary disability not to extend beyond the time when monthly allowances to him or her shall cease: PROVIDED, That after any injured worker has returned to his or her work his or her medical and surgical treatment may be continued if, and so long as, such continuation is deemed necessary by the supervisor of industrial insurance to be necessary to his or her more complete recovery; in case of a permanent total disability not to extend beyond the date on which a lump sum settlement is made with him or her or he or she is placed upon the permanent pension roll: PROVIDED, HOWEVER, That the supervisor of industrial insurance, solely in his or her discretion, may authorize continued medical and surgical treatment for conditions previously accepted by the department when such medical and surgical treatment is deemed necessary by the supervisor of industrial insurance to protect such worker's life or provide for the administration of medical and therapeutic measures including payment of prescription medications, but not including those controlled substances currently scheduled by the state board of pharmacy as Schedule I, II, III, or IV substances under chapter 69.50 RCW, which are necessary to alleviate continuing pain which results from the industrial injury. In order to authorize such continued treatment the written order of the supervisor of industrial insurance issued in advance of the continuation shall be necessary.
The
supervisor of industrial insurance((,)) or the supervisor's
designee, ((or a self-insurer,)) in his or her sole discretion, may
authorize inoculation or other immunological treatment in cases in which a
work-related activity has resulted in probable exposure of the worker to a
potential infectious occupational disease. Authorization of such treatment
does not bind the department ((or self-insurer)) in any adjudication of
a claim by the same worker or the worker's beneficiary for an occupational
disease.
Sec. 26. RCW 51.36.020 and 1982 c 63 s 12 are each amended to read as follows:
(1)
When the injury to any worker is so serious as to require his or her being
taken from the place of injury to a place of treatment, his or her employer
shall, at the expense of the medical aid fund, ((or self-insurer, as the
case may be,)) furnish transportation to the nearest place of proper
treatment.
(2) Every worker whose injury results in the loss of one or more limbs or eyes shall be provided with proper artificial substitutes and every worker, who suffers an injury to an eye producing an error of refraction, shall be once provided proper and properly equipped lenses to correct such error of refraction and his or her disability rating shall be based upon the loss of sight before correction.
(3) Every worker whose accident results in damage to or destruction of an artificial limb, eye, or tooth, shall have same repaired or replaced.
(4)
Every worker whose hearing aid or eyeglasses or lenses are damaged, destroyed,
or lost as a result of an industrial accident shall have the same restored or
replaced. The department ((or self-insurer)) shall be liable only for
the cost of restoring damaged hearing aids or eyeglasses to their condition at
the time of the accident.
(5) All mechanical appliances necessary in the treatment of an injured worker, such as braces, belts, casts, and crutches, shall be provided and all mechanical appliances required as permanent equipment after treatment has been completed shall continue to be provided or replaced without regard to the date of injury or date treatment was completed, notwithstanding any other provision of law.
(6) A worker, whose injury is of such short duration as to bring him or her within the time limit provisions of RCW 51.32.090, shall nevertheless receive during the omitted period medical, surgical, and hospital care and service and transportation under the provisions of this chapter.
(7) Whenever
in the sole discretion of the supervisor it is reasonable and necessary to
provide residence modifications necessary to meet the needs and requirements of
the worker who has sustained catastrophic injury, the department ((or
self-insurer)) may be ordered to pay an amount not to exceed the state's
average annual wage for one year as determined under RCW 50.04.355, as now
existing or hereafter amended, toward the cost of such modifications or
construction. Such payment shall only be made for the construction or
modification of a residence in which the injured worker resides. Only one
residence of any worker may be modified or constructed under this subsection,
although the supervisor may order more than one payment for any one home, up to
the maximum amount permitted by this section.
(8)
Whenever in the sole discretion of the supervisor it is reasonable and
necessary to modify a motor vehicle owned by a worker who has become an amputee
or becomes paralyzed because of an industrial injury, the supervisor may order
up to fifty percent of the state's average annual wage for one year, as
determined under RCW 50.04.355, as now existing or hereafter amended, to be
paid by the department ((or self-insurer)) toward the costs thereof.
(9) The benefits provided by subsections (7) and (8) of this section are available to any otherwise eligible worker regardless of the date of industrial injury.
Sec. 27. RCW 51.36.050 and 1979 ex.s. c 42 s 1 are each amended to read as follows:
The
department may operate and control a rehabilitation center and may contract
with ((self-insurers, and)) any other persons who may be interested, for
use of any such center on such terms as the director deems reasonable.
Sec. 28. RCW 51.36.060 and 1989 c 12 s 17 are each amended to read as follows:
Physicians
examining or attending injured workers under this title shall comply with rules
and regulations adopted by the director, and shall make such reports as may be
requested by the department ((or self-insurer)) upon the condition or
treatment of any such worker, or upon any other matters concerning such workers
in their care. All medical information in the possession or control of any
person and relevant to the particular injury in the opinion of the department
pertaining to any worker whose injury or occupational disease is the basis of a
claim under this title shall be made available at any stage of the proceedings
to the employer, the claimant's representative, and the department upon
request, and no person shall incur any legal liability by reason of releasing
such information.
Sec. 29. RCW 51.36.070 and 1977 ex.s. c 350 s 60 are each amended to read as follows:
Whenever
the director or the self-insurer deems it necessary in order to resolve any
medical issue, a worker shall submit to examination by a physician or
physicians selected by the director, with the rendition of a report to the
person ordering the examination. The director((, in his or her discretion,
may)) shall charge the cost of such examination or examinations ((to
the self-insurer or)) to the medical aid fund ((as the case may be)).
The cost of said examination shall include payment to the worker of reasonable
expenses connected therewith.
Sec. 30. RCW 51.44.040 and 1982 c 63 s 14 are each amended to read as follows:
(1) There shall be in the office of the state treasurer, a fund to be known and designated as the "second injury fund", which shall be used only for the purpose of defraying charges against it as provided in RCW 51.16.120 and 51.32.250, as now or hereafter amended. Said fund shall be administered by the director. The state treasurer shall be the custodian of the second injury fund and shall be authorized to disburse moneys from it only upon written order of the director.
(2) Payments to the second injury fund from the accident fund shall be made pursuant to rules and regulations promulgated by the director.
(((3)
Assessments for the second injury fund shall be imposed on self-insurers
pursuant to rules and regulations promulgated by the director to ensure that
self-insurers shall pay to such fund in the proportion that the payments made
from such fund on account of claims made against self-insurers bears to the
total sum of payments from such fund.))
Sec. 31. RCW 51.44.070 and 1989 c 190 s 1 are each amended to read as follows:
(((1)))
For every case resulting in death or permanent total disability the department
shall transfer on its books from the accident fund of the proper class and/or
appropriate account to the "reserve fund" a sum of money for that
case equal to the estimated present cash value of the monthly payments provided
for it, to be calculated upon the basis of an annuity covering the payments in
this title provided to be made for the case. Such annuity values shall be
based upon rates of mortality, disability, remarriage, and interest as
determined by the department, taking into account the experience of the reserve
fund in such respects.
((Similarly,
a self-insurer in these circumstances shall pay into the reserve fund a sum of
money computed in the same manner, and the disbursements therefrom shall be
made as in other cases.
(2)
As an alternative to payment procedures otherwise provided under law, in the
event of death or permanent total disability to workers of self-insured
employers, a self-insured employer may upon establishment of such obligation
file with the department a bond, or an assignment of account from a federally
or state chartered commercial banking institution authorized to conduct
business in the state of Washington, in an amount deemed by the department to
be reasonably sufficient to insure payment of the pension benefits provided by
law. The department shall adopt rules governing assignments of account. Such
rules shall ensure that the funds are available if needed, even in the case of
failure of the banking institution or of the employer's business.
The
annuity value for every such case shall be determined by the department based
upon the department's experience as to rates of mortality, disability,
remarriage, and interest. The amount of the required bond or assignment of
account may be reviewed and adjusted periodically by the department, based upon
periodic redeterminations by the department as to the outstanding annuity value
for the case.
Under
such alternative, the department shall make the monthly payments from the
pension reserve fund for the benefits provided for by RCW 51.32.050 and
51.32.060 to the self-insured beneficiary or beneficiaries and the department
shall be reimbursed for all such payments from the particular self-insured
employer through periodic charges not less than quarterly in a manner to be
determined by the director.
Any
self-insured employer electing this alternative method of providing for payment
to the beneficiary or beneficiaries shall additionally pay to the department a
deposit equal to the first three months' payments otherwise required under RCW
51.32.050 and 51.32.060. Such deposit shall be placed in the reserve fund in
accordance with RCW 51.44.140 and shall be returned to the respective
self-insured employer when monthly payments are no longer required for such
particular obligation.
If
a self-insurer delays or refuses to reimburse the department beyond fifteen
days after the reimbursement charges become due, there shall be a penalty paid
by the self-insurer upon order of the director of an additional amount equal to
twenty-five percent of the amount then due which shall be paid into the pension
reserve fund. Such an order shall conform to the requirements of RCW
51.52.050.))
Sec. 32. RCW 51.48.050 and 1980 c 14 s 13 are each amended to read as follows:
It
shall be unlawful for any employer to directly or indirectly demand or collect
from any of his or her workers any sum of money whatsoever for or on account of
medical, surgical, hospital, or other treatment or transportation of injured
workers, ((other than as specified in RCW 51.16.140,)) and any employer
who directly or indirectly violates the foregoing provisions of this section
shall be liable to the state for the benefit of the medical aid fund in ten
times the amount so demanded or collected, and such employer and every officer,
agent, or servant of such employer knowingly participating therein shall also
be guilty of a misdemeanor.
Sec. 33. RCW 51.52.050 and 1987 c 151 s 1 are each amended to read as follows:
Whenever the department has made any order, decision, or award, it shall promptly serve the worker, beneficiary, employer, or other person affected thereby, with a copy thereof by mail, which shall be addressed to such person at his or her last known address as shown by the records of the department. The copy, in case the same is a final order, decision, or award, shall bear on the same side of the same page on which is found the amount of the award, a statement, set in black faced type of at least ten point body or size, that such final order, decision, or award shall become final within sixty days from the date the order is communicated to the parties unless a written request for reconsideration is filed with the department of labor and industries, Olympia, or an appeal is filed with the board of industrial insurance appeals, Olympia: PROVIDED, That a department order or decision making demand, whether with or without penalty, for repayment of sums paid to a provider of medical, dental, vocational, or other health services rendered to an industrially injured worker, shall state that such order or decision shall become final within twenty days from the date the order or decision is communicated to the parties unless a written request for reconsideration is filed with the department of labor and industries, Olympia, or an appeal is filed with the board of industrial insurance appeals, Olympia.
Whenever
the department has taken any action or made any decision relating to any phase
of the administration of this title the worker, beneficiary, employer, or other
person aggrieved thereby may request reconsideration of the department, or may
appeal to the board. In an appeal before the board, the appellant shall have
the burden of proceeding with the evidence to establish a prima facie case for
the relief sought in such appeal: PROVIDED, That in an appeal from an order of
the department that alleges fraud, the department ((or self-insured employer))
shall initially introduce all evidence in its case in chief. Any such person
aggrieved by the decision and order of the board may thereafter appeal to the
superior court, as prescribed in this chapter.
Sec. 34. RCW 51.52.110 and 1988 c 202 s 49 are each amended to read as follows:
Within thirty days after a decision of the board to deny the petition or petitions for review upon such appeal has been communicated to such worker, beneficiary, employer or other person, or within thirty days after the final decision and order of the board upon such appeal has been communicated to such worker, beneficiary, employer or other person, or within thirty days after the appeal is denied as herein provided, such worker, beneficiary, employer or other person aggrieved by the decision and order of the board may appeal to the superior court. If such worker, beneficiary, employer, or other person fails to file with the superior court its appeal as provided in this section within said thirty days, the decision of the board to deny the petition or petitions for review or the final decision and order of the board shall become final.
In
cases involving injured workers, an appeal to the superior court shall be to
the superior court of the county of residence of the worker or beneficiary, as
shown by the department's records, or to the superior court of the county
wherein the injury occurred or where neither the county of residence nor the
county wherein the injury occurred are in the state of Washington then the
appeal may be directed to the superior court for Thurston county. In all other
cases the appeal shall be to the superior court of Thurston county. Such
appeal shall be perfected by filing with the clerk of the court a notice of
appeal and by serving a copy thereof by mail, or personally, on the director
and on the board. If the case is one involving a ((self-insurer)) claim
formerly self-insured under this title, a copy of the notice of appeal
shall also be served by mail, or personally, on such former
self-insurer. The department shall, in all cases not involving a self-insurer,
within twenty days after the receipt of such notice of appeal, serve and file
its notice of appearance and such appeal shall thereupon be deemed at issue.
If the case is one involving a former self-insurer, such self-insurer
shall, within twenty days after receipt of such notice of appeal, serve and
file its notice of appearance and such appeal shall thereupon be deemed to be
at issue. In such cases the department may appear and take part in any
proceedings. The board shall serve upon the appealing party, the director, the
self-insurer if the case involves a former self-insurer, and any other
party appearing at the board's proceeding, and file with the clerk of the court
before trial, a certified copy of the board's official record which shall
include the notice of appeal and other pleadings, testimony and exhibits, and
the board's decision and order, which shall become the record in such case. No
bond shall be required on appeals to the superior court or on review by the
supreme court or the court of appeals, except that an appeal by the employer
from a decision and order of the board under RCW 51.48.070, shall be
ineffectual unless, within five days following the service of notice thereof, a
bond, with surety satisfactory to the court, shall be filed, conditioned to
perform the judgment of the court. Except in the case last named an appeal
shall not be a stay: PROVIDED, HOWEVER, That whenever the board has made any
decision and order reversing an order of the supervisor of industrial insurance
on questions of law or mandatory administrative actions of the director, the
department shall have the right of appeal to the superior court.
Sec. 35. RCW 51.52.120 and 1990 c 15 s 1 are each amended to read as follows:
(1) It shall be unlawful for an attorney engaged in the representation of any worker or beneficiary to charge for services in the department any fee in excess of a reasonable fee, of not more than thirty percent of the increase in the award secured by the attorney's services. Such reasonable fee shall be fixed by the director or the director's designee for services performed by an attorney for such worker or beneficiary, if written application therefor is made by the attorney, worker, or beneficiary within one year from the date the final decision and order of the department is communicated to the party making the application.
(2)
If, on appeal to the board, the order, decision, or award of the department is
reversed or modified and additional relief is granted to a worker or
beneficiary, or in cases where a party other than the worker or beneficiary is
the appealing party and the worker's or beneficiary's right to relief is
sustained by the board, the board shall fix a reasonable fee for the services
of his or her attorney in proceedings before the board if written application
therefor is made by the attorney, worker, or beneficiary within one year from
the date the final decision and order of the board is communicated to the party
making the application. In fixing the amount of such attorney's fee, the board
shall take into consideration the fee allowed, if any, by the director, for
services before the department, and the board may review the fee fixed by said
director. Any attorney's fee set by the department or the board may be reviewed
by the superior court upon application of such attorney, worker, or
beneficiary. The department ((or self-insured employer, as the case may be,))
shall be served a copy of the application and shall be entitled to appear and
take part in the proceedings. Where the board, pursuant to this section, fixes
the attorney's fee, it shall be unlawful for an attorney to charge or receive
any fee for services before the board in excess of that fee fixed by the
board. Any person who violates any provision of this section shall be guilty
of a misdemeanor.
Sec. 36. RCW 51.52.130 and 1982 c 63 s 23 are each amended to read as follows:
If, on
appeal to the court from the decision and order of the board, said decision and
order is reversed or modified and additional relief is granted to a worker or
beneficiary, or in cases where a party other than the worker or beneficiary is
the appealing party and the worker's or beneficiary's right to relief is
sustained by the court, a reasonable fee for the services of the worker's or
beneficiary's attorney shall be fixed by the court. In fixing the fee the
court shall take into consideration the fee or fees, if any, fixed by the
director and the board for such attorney's services before the department and
the board. If the court finds that the fee fixed by the director or by the
board is inadequate for services performed before the department or board, or
if the director or the board has fixed no fee for such services, then the court
shall fix a fee for the attorney's services before the department, or the
board, as the case may be, in addition to the fee fixed for the services in the
court. If the decision and order of the board is reversed or modified and if
the accident fund is affected by the litigation then the attorney's fee fixed
by the court for services before the court only, and the fees of medical and
other witnesses and the costs shall be payable out of the administrative fund
of the department. ((In the case of self-insured employers, if the decision
and order of the board is reversed or modified resulting in additional benefits
by the litigation that would be paid from the accident fund if the employer
were not self-insured, then the attorney fees fixed by the court for services
before the court, only, and the fees of medical and other witnesses and the
costs shall be payable directly by the self-insured employer.))
NEW SECTION. Sec. 37. A new section is added to chapter 51.28 RCW to read as follows:
(1) Every employer subject to the provisions of this title shall post and keep posted in a conspicuous place or places in and about his or her place or places of business a reasonable number of typewritten or printed notices of compliance substantially identical to a form prescribed by the director, stating that such employer is subject to the provisions of this title.
(2) Any employer who has failed to open an account with the department shall not post or permit to be posted on or about his or her place of business or premises any notice of compliance with this title and any willful violation of this subsection by any officer or supervisory employee of an employer shall be a misdemeanor.
NEW SECTION. Sec. 38. A new section is added to chapter 51.98 RCW to read as follows:
After June 30, 1992, all claims filed under this title, without regard to the date of injury, shall be administered by the state fund. However, injuries occurring before July 1, 1992, shall be adjudicated and finally determined under the law in effect at the time of injury, unless otherwise provided in this title.
NEW SECTION. Sec. 39. The following acts or parts of acts are each repealed:
(1) RCW 51.14.010 and 1971 ex.s. c 289 s 26;
(2) RCW 51.14.020 and 1990 c 209 s 1, 1986 c 57 s 1, 1977 ex.s. c 323 s 9, 1972 ex.s. c 43 s 16, & 1971 ex.s. c 289 s 27;
(3) RCW 51.14.030 and 1977 ex.s. c 323 s 10 & 1971 ex.s. c 289 s 28;
(4) RCW 51.14.040 and 1971 ex.s. c 289 s 29;
(5) RCW 51.14.050 and 1971 ex.s. c 289 s 30;
(6) RCW 51.14.060 and 1986 c 57 s 2 & 1971 ex.s. c 289 s 31;
(7) RCW 51.14.070 and 1986 c 57 s 3 & 1971 ex.s. c 289 s 36;
(8) RCW 51.14.073 and 1986 c 57 s 4;
(9) RCW 51.14.077 and 1986 c 57 s 6;
(10) RCW 51.14.080 and 1986 c 57 s 7 & 1971 ex.s. c 289 s 32;
(11) RCW 51.14.090 and 1983 c 21 s 1 & 1971 ex.s. c 289 s 33;
(12) RCW 51.14.095 and 1983 c 21 s 2;
(13) RCW 51.14.100 and 1971 ex.s. c 289 s 34;
(14) RCW 51.14.110 and 1971 ex.s. c 289 s 35;
(15) RCW 51.14.150 and 1983 c 174 s 2 & 1982 c 191 s 7;
(16) RCW 51.14.160 and 1983 c 174 s 3 & 1982 c 191 s 8;
(17) RCW 51.32.190 and 1982 1st ex.s. c 20 s 3, 1977 ex.s. c 350 s 54, 1972 ex.s. c 43 s 25, & 1971 ex.s. c 289 s 47;
(18) RCW 51.32.195 and 1987 c 290 s 1;
(19) RCW 51.32.200 and 1971 ex.s. c 289 s 48;
(20) RCW 51.36.085 and 1987 c 316 s 4;
(21) RCW 51.44.140 and 1972 ex.s. c 43 s 30 & 1971 ex.s. c 289 s 58;
(22) RCW 51.44.150 and 1971 ex.s. c 289 s 59;
(23) RCW 51.48.017 and 1985 c 347 s 3 & 1971 ex.s. c 289 s 66; and
(24) RCW 51.48.110 and 1986 c 56 s 1 & 1971 ex.s. c 289 s 65.
NEW SECTION. Sec. 40. This act shall take effect July 1, 1992.