AN ACT Relating to
self-insurance administrative procedures; and amending RCW 51.14.090 and
51.32.190.
BE IT ENACTED BY THE
LEGISLATURE OF THE STATE OF WASHINGTON:
Sec. 1. RCW 51.14.090 and 1983 c
21 s 1 are each amended to read as follows:
(1) Upon the petition
of any employee or union or association having a substantial number of
employees in the employ of the self-insurer the director ((shall)) or
the director's designee may, in the director or designee's sole discretion,
hold a hearing to determine whether or not there are grounds for the withdrawal
of certification of a self-insurer or for corrective action by the department.
(2) The director shall
serve upon the self-insurer and upon any employee or union or association
having a substantial number of employees in the employ of said self-insurer,
personally or by certified mail, a notice of intention to withdraw, or not to
withdraw, certification of the self-insurer, which notice shall describe the
nature and location or locations of the plants or operations involved; and the
specific nature of the reasons for the decision. Similar notice shall be
provided for decisions regarding corrective actions. The corrective action
notice shall also include a directive to the self-insurer specifying the
program deficiencies to be eliminated.
(3) If the decision is
to withdraw certification, it shall include: The period of time within
which the ground or grounds therefor existed or arose; ((a directive to the
self-insurer specifying the manner in which the grounds may be eliminated;))
and the date, not less than ((thirty)) ninety days after the
self-insurer's receipt of the notice, when the certification will be withdrawn
((in the absence of a satisfactory elimination of the grounds for withdrawal
of the certificate)).
(4) An appeal of any
action taken by the director under this section may be taken by the
self-insurer, or by any employee or union or association having a substantial
number of employees in the employ of the self-insurer. Proceedings on the
appeal shall be as prescribed in this title. Appeal by a self-insurer of
notice of intention to withdraw certification or to take corrective action
shall not act as a stay of the withdrawal or corrective action, unless the
board or court, for good cause shown, orders otherwise.
(5) The director may
adopt rules to carry out the purposes of this section.
Sec. 2. RCW 51.32.190 and 1982
1st ex.s. c 20 s 3 are each amended to read as follows:
(1) If the self-insurer
denies a claim for compensation, written notice of such denial, clearly
informing the claimant of the reasons therefor and that the director will rule
on the matter shall be mailed or given to the claimant and the director within
thirty days after the self-insurer has notice of the claim.
(2) Until such time as
the department has entered an order in a disputed case acceptance of
compensation by the claimant shall not be considered a binding determination of
his or her rights under this title. Likewise the payment of compensation shall
not be considered a binding determination of the obligations of the
self-insurer as to future compensation payments.
(3) Upon making the
first payment of income benefits, ((and upon stopping or changing of such
benefits except where a determination of the permanent disability has been made
as elsewhere provided in this title,)) the self-insurer shall immediately
notify the director in accordance with a form to be prescribed by the director
((that the payment of income benefits has begun or has been stopped or
changed)). Upon request of the department on a form prescribed by the
department, the self-insurer shall submit a record of the payment of income
benefits including initial, termination or terminations, and change or changes
to the benefits. Where temporary disability compensation is payable, the
first payment thereof shall be made within fourteen days after notice of claim
and shall continue at regular semimonthly or biweekly intervals.
(4) If, after the
payment of compensation without an award, the self-insurer elects to controvert
the right to compensation, the payment of compensation shall not be considered
a binding determination of the obligations of the self-insurer as to future
compensation payments. The acceptance of compensation by the worker or his or
her beneficiaries shall not be considered a binding determination of their
rights under this title.
(5) The director:
(a) May, upon his or her own initiative at any time in a case in which
payments are being made without an award((,)); and (b) shall,
upon receipt of information from any person claiming to be entitled to
compensation, from the self-insurer, or otherwise that the right to
compensation is controverted, or that payment of compensation has been opposed,
stopped or changed, whether or not claim has been filed, promptly make such
inquiry as circumstances require, cause such medical examinations to be made,
hold such hearings, require the submission of further information, make such
orders, decisions or awards, and take such further action as he or she
considers will properly determine the matter and protect the rights of all
parties.
(6) The director, upon
his or her own initiative, may make such inquiry as circumstances require or is
necessary to protect the rights of all the parties and he or she may enact
rules and regulations providing for procedures to ensure fair and prompt
handling by self-insurers of the claims of workers and beneficiaries.
