AN ACT Relating to the
authority of the department of labor and industries to hold industrial
insurance orders in abeyance; and amending RCW 51.52.060 and 51.32.160.
BE IT ENACTED BY THE
LEGISLATURE OF THE STATE OF WASHINGTON:
Sec. 1. RCW 51.52.060 and 1986 c
200 s 11 are each amended to read as follows:
((Any)) (1)(a)
A worker, beneficiary, employer, 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)) a copy of ((such))
the order, decision, or award was communicated to such person, a notice
of appeal to the board((: PROVIDED, That)). However, a health
services provider or other person aggrieved by 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 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)) a copy of ((such)) the
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.
(b) Failure to file
a notice of appeal with both the board and the department shall not be grounds
for denying the appeal if the notice of appeal is filed with either the board
or the department.
(2) 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)) to the appeal
of the receipt ((thereof)) of the appeal and shall forward a copy
of ((said)) the notice of appeal to ((such)) the
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,)).
(3) 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)) directs
the submission of further evidence or the investigation of any further fact,
the time for filing ((such)) the notice of appeal shall not
commence to run until ((such)) the person ((shall have)) has
been advised in writing of the final decision of the department in the matter((:
PROVIDED, FURTHER, That)). In the event the department ((shall))
directs the submission of further evidence or the investigation of any
further fact, as ((above)) provided in this section, 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)).
(4) The
department, either within the time limited for appeal, or within thirty days
after receiving a notice of appeal, may:
(a) Modify,
reverse, or change any order, decision, or award((, or may));
or
(b)(i) Except as
provided in (b)(ii) of this subsection, hold ((any such)) an
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));
or
(ii) Hold an order,
decision, or award issued under RCW 51.32.160 in abeyance for a period not to
exceed ninety days from the date of receipt of an application under RCW
51.32.160. The department may extend the ninety-day time period for an
additional sixty days for good cause.
For purposes of this
subsection, good cause includes delay that results from conduct of the claimant
that is subject to sanction under RCW 51.32.110.
The board shall
((thereupon)) deny the appeal upon the issuance of an order under (b)
(i) or (ii) of this subsection holding an earlier order, decision, or award in
abeyance, without prejudice to the appellant's right to appeal from any
subsequent determinative order issued by the department.
This subsection
(4)(b) does not apply to applications deemed granted under RCW 51.32.160.
(5) An employer
shall have the right to appeal an application deemed granted under RCW
51.32.160 on the same basis as any other application adjudicated pursuant to
that section.
(6) A provision of
this section shall not be deemed to change, alter, or modify the practice or
procedure of the department for the payment of awards pending appeal.
Sec. 2. RCW 51.32.160 and 1988 c
161 s 11 are each amended to read as follows:
(1)(a) 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. The department shall promptly mail a copy of the
application to the employer at the employer's last known address as shown by
the records of the department.
(b)
"Closing order" as used in this section means an order based on
factors which include medical recommendation, advice, or examination. (c)
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.
(d) 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.
(2) 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.
(3) 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.
