AN ACT Relating to
refining industrial insurance actions; and amending RCW 51.12.120, 51.24.030,
51.24.050, 51.24.060, 51.24.090, 51.32.050, and 51.52.060.
BE IT ENACTED BY THE
LEGISLATURE OF THE STATE OF WASHINGTON:
Sec. 1. RCW 51.12.120 and 1977
ex.s. c 350 s 23 are each amended to read as follows:
(1) If a worker, while
working outside the territorial limits of this state, suffers an injury on
account of which he or she, or his or her beneficiaries, would have been
entitled to compensation under this title had such injury occurred within this
state, such worker, or his or her beneficiaries, shall be entitled to
compensation under this title: PROVIDED, That if at the time of such injury:
(a) His or her
employment is principally localized in this state; or
(b) He or she is
working under a contract of hire made in this state for employment not
principally localized in any state; or
(c) He or she is
working under a contract of hire made in this state for employment principally
localized in another state whose workers' compensation law is not applicable to
his or her employer; or
(d) He or she is
working under a contract of hire made in this state for employment outside the
United States and Canada.
(2) The payment or
award of compensation or other recoveries, including settlement proceeds,
under the workers' compensation law of another state, territory, province, or
foreign nation to a worker or his or her beneficiaries otherwise entitled on
account of such injury to compensation under this title shall not be a bar to a
claim for compensation under this title: PROVIDED, That claim under this title
is timely filed. If compensation is paid or awarded under this title, the
total amount of compensation or other recoveries, including settlement
proceeds, paid or awarded the worker or beneficiary under such other
workers' compensation law shall be credited against the compensation due the
worker or beneficiary under this title.
(3) If a worker or
beneficiary is entitled to compensation under this title by reason of an injury
sustained in this state while in the employ of an employer who is domiciled in
another state and who has neither opened an account with the department nor
qualified as a self-insurer under this title, such an employer or his or her
insurance carrier shall file with the director a certificate issued by the
agency which administers the workers' compensation law in the state of the
employer's domicile, certifying that such employer has secured the payment of
compensation under the workers' compensation law of such other state and that
with respect to said injury such worker or beneficiary is entitled to the
benefits provided under such law. In such event:
(a) The filing of such
certificate shall constitute appointment by the employer or his or her
insurance carrier of the director as its agent for acceptance of the service of
process in any proceeding brought by any claimant to enforce rights under this
title;
(b) The director shall
send to such employer or his or her insurance carrier, by registered or
certified mail to the address shown on such certificate, a true copy of any
notice of claim or other process served on the director by the claimant in any
proceeding brought to enforce rights under this title;
(c)(i) If such employer
is a self-insurer under the workers' compensation law of such other state, such
employer shall, upon submission of evidence or security, satisfactory to the
director, of his or her ability to meet his or her liability to such claimant
under this title, be deemed to be a qualified self-insurer under this title;
(ii) If such employer's
liability under the workers' compensation law of such other state is insured,
such employer's carrier, as to such claimant only, shall be deemed to be
subject to this title: PROVIDED, That unless its contract with said employer requires
it to pay an amount equivalent to the compensation benefits provided by this
title, the insurer's liability for compensation shall not exceed its liability
under the workers' compensation law of such other state;
(d) If the total amount
for which such employer's insurer is liable under (c)(ii) above is less than
the total of the compensation to which such claimant is entitled under this
title, the director may require the employer to file security satisfactory to
the director to secure the payment of compensation under this title; ((and))
(e) If such employer
has neither qualified as a self-insurer nor secured insurance coverage under
the workers' compensation law of another state, such claimant shall be paid
compensation by the department; and
(f) Any such employer
shall have the same rights and obligations as other employers subject to this
title and where he or she has not provided coverage or sufficient coverage to
secure the compensation provided by this title to such claimant, the director
may impose a penalty payable to the department of a sum not to exceed fifty
percent of the cost to the department of any deficiency between the
compensation provided by this title and that afforded such claimant by such
employer or his or her insurance carrier if any.
(4) As used in this
section:
(a) A person's
employment is principally localized in this or another state when (i) his or
her employer has a place of business in this or such other state and he or she
regularly works at or from such place of business, or (ii) if clause (i)
foregoing is not applicable, he or she is domiciled in and spends a substantial
part of his or her working time in the service of his or her employer in this
or such other state;
(b) "Workers'
compensation law" includes "occupational disease law" for the
purposes of this section.
(5) A worker whose
duties require him or her to travel regularly in the service of his or her
employer in this and one or more other states may agree in writing with his or
her employer that his or her employment is principally localized in this or
another state, and, unless such other state refuses jurisdiction, such
agreement shall govern as to any injury occurring after the effective date of
the agreement.
(6) The director shall
be authorized to enter into agreements with the appropriate agencies of other
states and provinces of Canada which administer their workers' compensation law
with respect to conflicts of jurisdiction and the assumption of jurisdiction in
cases where the contract of employment arises in one state or province and the
injury occurs in another, and when any such agreement has been executed and
promulgated as a regulation of the department under chapter 34.05 RCW, it shall
bind all employers and workers subject to this title and the jurisdiction of
this title shall be governed by this regulation.
Sec. 2. 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.
(5) For the purposes
of this chapter, "recovery" includes all damages except loss of
consortium.
Sec. 3. 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 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 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 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. 4. RCW 51.24.060 and 1993 c
496 s 2 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: PROVIDED, That the
department and/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;
(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
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 under this title: PROVIDED, That the department's and/or
self-insurer's proportionate share shall not exceed one hundred percent of the
costs and reasonable attorneys' fees;
(ii) The department's
and/or self-insurer's proportionate share of the costs and reasonable
attorneys' fees shall be determined by dividing the gross recovery amount into
the benefits paid amount and multiplying this percentage times the costs and
reasonable attorneys' fees incurred by the worker or beneficiary;
(iii) The department's
and/or self-insurer's reimbursement share shall be determined by subtracting
their proportionate share of the costs and reasonable attorneys' fees from the
benefits paid amount;
(d) Any remaining
balance shall be paid to the injured worker or beneficiary; and
(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 minus the
department's and/or self-insurer's proportionate share of the costs and
reasonable attorneys' fees in regards to the remaining balance. This
proportionate share shall be determined by dividing the gross recovery amount
into the remaining balance amount and multiplying this percentage times the
costs and reasonable attorneys' fees incurred by the worker or beneficiary.
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.
(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, the
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))) (5)
It shall be the duty of the person to whom any recovery is paid before
distribution under this section to advise the department or 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))) (6)
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))) (7)
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((,)); by certified mail, return
receipt requested; 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. 5. 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 self-insurer:
PROVIDED, That for the purposes of this chapter, "entitlement" means
benefits and compensation paid and ((payable)) estimated by the
department to be paid in the future.
(2) If a compromise or
settlement is void because of subsection (1) of this section, the department or
self-insurer may petition the court in which the action was filed for an order
assigning the cause of action to the department or self-insurer. If an action
has not been filed, the department or self-insurer may proceed as provided in
chapter 7.24 RCW.
Sec. 6. RCW 51.32.050 and 1993 c
521 s 1 are each amended to read as follows:
(1) Where death results
from the injury the expenses of burial not to exceed two ((thousand dollars))
hundred percent of the average monthly wage in the state as defined in RCW
51.08.018 shall be paid.
(2)(a) Where death
results from the injury, a surviving spouse of a deceased worker eligible for
benefits under this title shall receive monthly for life or until remarriage
payments according to the following schedule:
(i) If there are no
children of the deceased worker, sixty percent of the wages of the deceased
worker but not less than one hundred eighty-five dollars;
(ii) If there is one
child of the deceased worker and in the legal custody of such spouse, sixty-two
percent of the wages of the deceased worker but not less than two hundred
twenty-two dollars;
(iii) If there are two
children of the deceased worker and in the legal custody of such spouse,
sixty-four percent of the wages of the deceased worker but not less than two
hundred fifty-three dollars;
(iv) If there are three
children of the deceased worker and in the legal custody of such spouse,
sixty-six percent of the wages of the deceased worker but not less than two
hundred seventy-six dollars;
(v) If there are four
children of the deceased worker and in the legal custody of such spouse,
sixty-eight percent of the wages of the deceased worker but not less than two
hundred ninety-nine dollars; or
(vi) If there are five
or more children of the deceased worker and in the legal custody of such
spouse, seventy percent of the wages of the deceased worker but not less than
three hundred twenty-two dollars.
(b) Where the surviving
spouse does not have legal custody of any child or children of the deceased
worker or where after the death of the worker legal custody of such child or
children passes from such surviving spouse to another, any payment on account
of such child or children not in the legal custody of the surviving spouse
shall be made to the person or persons having legal custody of such child or
children. The amount of such payments shall be five percent of the monthly
benefits payable as a result of the worker's death for each such child but such
payments shall not exceed twenty-five percent. Such payments on account of
such child or children shall be subtracted from the amount to which such
surviving spouse would have been entitled had such surviving spouse had legal
custody of all of the children and the surviving spouse shall receive the
remainder after such payments on account of such child or children have been
subtracted. Such payments on account of a child or children not in the legal
custody of such surviving spouse shall be apportioned equally among such
children.
(c) Payments to the
surviving spouse of the deceased worker shall cease at the end of the month in
which remarriage occurs: PROVIDED, That a monthly payment shall be made to the
child or children of the deceased worker from the month following such
remarriage in a sum equal to five percent of the wages of the deceased worker
for one child and a sum equal to five percent for each additional child up to a
maximum of five such children. Payments to such child or children shall be
apportioned equally among such children. Such sum shall be in place of any
payments theretofore made for the benefit of or on account of any such child or
children. If the surviving spouse does not have legal custody of any child or
children of the deceased worker, or if after the death of the worker, legal
custody of such child or children passes from such surviving spouse to another,
any payment on account of such child or children not in the legal custody of
the surviving spouse shall be made to the person or persons having legal
custody of such child or children.
(d) In no event shall
the monthly payments provided in subsection (2) of this section exceed the
applicable percentage of the average monthly wage in the state as computed
under RCW 51.08.018 as follows:
AFTER PERCENTAGE
June 30, 1993 105%
June 30, 1994 110%
June 30, 1995 115%
June 30, 1996 120%
(e) In addition to the
monthly payments provided for in subsection (2) (a) through (((2)))(c)
of this section, a surviving spouse or child or children of such worker if
there is no surviving spouse, or dependent parent or parents, if there is no
surviving spouse or child or children of any such deceased worker shall be
forthwith paid ((the)) a sum ((of one thousand six hundred
dollars)) equal to one hundred percent of the average monthly wage in
the state as defined in RCW 51.08.018, any such children, or parents to
share and share alike in said sum.
(f) Upon remarriage of
a surviving spouse the monthly payments for the child or children shall
continue as provided in this section, but the monthly payments to such
surviving spouse shall cease at the end of the month during which remarriage
occurs. However, after September 8, 1975, an otherwise eligible surviving
spouse of a worker who died at any time prior to or after September 8, 1975,
shall have an option of:
(i) Receiving, once and
for all, a lump sum of twenty-four times the monthly compensation rate in
effect on the date of remarriage allocable to the spouse for himself or herself
pursuant to subsection (2)(a)(i) of this section and subject to any
modifications specified under subsection (2)(d) of this section and RCW
51.32.075(3) or fifty percent of the then remaining annuity value of his or her
pension, whichever is the lesser: PROVIDED, That if the injury occurred prior
to July 28, 1991, the remarriage benefit lump sum available shall be as
provided in the remarriage benefit schedules then in effect; or
(ii) If a surviving
spouse does not choose the option specified in subsection (2)(f)(i) of
this section to accept the lump sum payment, the remarriage of the surviving
spouse of a worker shall not bar him or her from claiming the lump sum payment
authorized in subsection (2)(f)(i) of this section during the life of
the remarriage, or shall not prevent subsequent monthly payments to him or to
her if the remarriage has been terminated by death or has been dissolved or
annulled by valid court decree provided he or she has not previously accepted
the lump sum payment.
(g) If the surviving
spouse during the remarriage should die without having previously received the
lump sum payment provided in subsection (2)(f)(i) of this section, his
or her estate shall be entitled to receive the sum specified under subsection
(2)(f)(i) of this section or fifty percent of the then remaining annuity value
of his or her pension whichever is the lesser.
(h) The effective date
of resumption of payments under subsection (2)(f)(ii) of this section to
a surviving spouse based upon termination of a remarriage by death, annulment,
or dissolution shall be the date of the death or the date the judicial decree
of annulment or dissolution becomes final and when application for the payments
has been received.
(i) If it should be
necessary to increase the reserves in the reserve fund or to create a new
pension reserve fund as a result of the amendments in chapter 45, Laws of 1975‑'76
2nd ex. sess., the amount of such increase in pension reserve in any such case
shall be transferred to the reserve fund from the supplemental pension fund.
(3) If there is a child
or children and no surviving spouse of the deceased worker or the surviving
spouse is not eligible for benefits under this title, a sum equal to
thirty-five percent of the wages of the deceased worker shall be paid monthly
for one child and a sum equivalent to fifteen percent of such wage shall be
paid monthly for each additional child, the total of such sum to be divided among
such children, share and share alike: PROVIDED, That benefits under this
subsection or subsection (4) of this section shall not exceed the lesser of
sixty-five percent of the wages of the deceased worker at the time of his or
her death or the applicable percentage of the average monthly wage in the state
as defined in RCW 51.08.018, as follows:
AFTER PERCENTAGE
June 30, 1993 105%
June 30, 1994 110%
June 30, 1995 115%
June 30, 1996 120%
(4) In the event a
surviving spouse receiving monthly payments dies, the child or children of the
deceased worker shall receive the same payment as provided in subsection (3) of
this section.
(5) If the worker
leaves no surviving spouse or child, but leaves a dependent or dependents, a
monthly payment shall be made to each dependent equal to fifty percent of the
average monthly support actually received by such dependent from the worker
during the twelve months next preceding the occurrence of the injury, but the
total payment to all dependents in any case shall not exceed the lesser of
sixty-five percent of the wages of the deceased worker at the time of his or
her death or the applicable percentage of the average monthly wage in the state
as defined in RCW 51.08.018 as follows:
AFTER PERCENTAGE
June 30, 1993 105%
June 30, 1994 110%
June 30, 1995 115%
June 30, 1996 120%
If any dependent is under
the age of eighteen years at the time of the occurrence of the injury, the
payment to such dependent shall cease when such dependent reaches the age of
eighteen years except such payments shall continue until the dependent reaches
age twenty-three while permanently enrolled at a full time course in an
accredited school. The payment to any dependent shall cease if and when, under
the same circumstances, the necessity creating the dependency would have ceased
if the injury had not happened.
(6) For claims filed
prior to July 1, 1986, if the injured worker dies during the period of
permanent total disability, whatever the cause of death, leaving a surviving
spouse, or child, or children, the surviving spouse or child or children shall
receive benefits as if death resulted from the injury as provided in
subsections (2) through (4) of this section. Upon remarriage or death of such
surviving spouse, the payments to such child or children shall be made as
provided in subsection (2) of this section when the surviving spouse of a
deceased worker remarries.
(7) For claims filed on
or after July 1, 1986, every worker who becomes eligible for permanent total
disability benefits shall elect an option as provided in RCW 51.32.067.
Sec. 7. RCW 51.52.060 and 1986 c
200 s 11 are each amended to read as follows:
Except as otherwise
specifically provided in this section, any worker, beneficiary, employer, health
services provider, or other person aggrieved by an order, decision, or
award of the department must, before he or she appeals to the courts, file with
the board and the director, by mail or personally, within sixty days from the
day on which such copy of such order, decision, or award was communicated to
such person, a notice of appeal to the board: PROVIDED, That a health services
provider or other person aggrieved by a department order or decision making
demand, whether with or without penalty, solely for repayment of sums
paid to a provider of medical, dental, vocational, or other health services
rendered to an industrially injured worker must, before he or she appeals to
the courts, file with the board and the director, by mail or personally, within
twenty days from the day on which such copy of such order or decision was
communicated to the health services provider upon whom the department order or
decision was served, a notice of appeal to the board. Within ten days of the
date on which an appeal has been granted by the board, the board shall notify
the other interested parties thereto of the receipt thereof and shall forward a
copy of said notice of appeal to such other interested parties. Within twenty
days of the receipt of such notice of the board, the worker or the employer may
file with the board a cross-appeal from the order of the department from which
the original appeal was taken: PROVIDED, That nothing contained in this
section shall be deemed to change, alter or modify the practice or procedure of
the department for the payment of awards pending appeal: AND PROVIDED, That
failure to file notice of appeal with both the board and the department shall
not be ground for denying the appeal if the notice of appeal is filed with
either the board or the department: AND PROVIDED, That, if within the time
limited for filing a notice of appeal to the board from an order, decision, or
award of the department, the department shall direct the submission of further
evidence or the investigation of any further fact, the time for filing such
notice of appeal shall not commence to run until such person shall have been
advised in writing of the final decision of the department in the matter:
PROVIDED, FURTHER, That in the event the department shall direct the submission
of further evidence or the investigation of any further fact, as above
provided, the department shall render a final order, decision, or award within
ninety days from the date such further submission of evidence or investigation
of further fact is ordered which time period may be extended by the department
for good cause stated in writing to all interested parties for an additional
ninety days: PROVIDED, FURTHER, That the department, either within the time
limited for appeal, or within thirty days after receiving a notice of appeal,
may modify, reverse or change any order, decision, or award, or may hold any
such order, decision, or award in abeyance for a period of ninety days which
time period may be extended by the department for good cause stated in writing
to all interested parties for an additional ninety days pending further
investigation in light of the allegations of the notice of appeal, and the
board shall thereupon deny the appeal, without prejudice to the appellant's
right to appeal from any subsequent determinative order issued by the department.
NEW SECTION. Sec.
8. If any provision of this
act or its application to any person or circumstance is held invalid, the
remainder of the act or the application of the provision to other persons or
circumstances is not affected.
