1292-S.E AMS HEAV BRUM 025

ESHB 1292 - S AMD - 496

By Senator Heavey

    Beginning on page 3, after line 31, strike all material through "claim." on page 4, line 35, and insert the following:

    "(5) Within one year after a claim involving time loss and vocational rehabilitation services has been closed if the worker is terminated from employment with the employer of record, the worker shall be eligible for vocational rehabilitation services under subsection (1)(b) of this section to include loss of earning power.  This subsection (5) does not apply to a worker who is terminated for malfeasance and is not eligible for unemployment payments."

    (6)(a) If the department determines that a retrospective rating employer or group, or an authorized claims administrator, may have violated the authority granted in this section, the department shall notify the employer, group, or authorized claims administrator in writing outlining the violation and the corrective action required.  The notice must specify a reasonable period of time for corrective action.  The employer, group, or authorized claims administrator is subject to penalties under this subsection for the violation or for failing to take the required corrective action within the specified period, or both.

    (b) If the department finds a pattern of improper claims closure or other violations of the authority granted in subsection (2) or (3) of this section, the director, or his or her designee, shall suspend the retrospective rating employer's or group's, or authorized claims administrator's, authority to assist the department in the processing of claims under this section for a period of up to two years.  The department shall issue an order and notice under RCW 51.52.050 which states the grounds for the suspension.  As provided in chapter 51.52 RCW, the order becomes final within sixty days from the date the order is communicated to the employer, group, or authorized claims administrator unless a written request for reconsideration is filed with the department or an appeal is filed with the board of industrial insurance appeals.

    (c) This subsection does not limit the department's authority to impose penalties under chapter 51.48 RCW.

    (7) The director shall adopt under chapter 34.05 RCW all necessary rules governing the administration of this section.  The rules should encourage broad participation in retrospective rating plans by employers and groups of employers consistent with insurance principles.  The retrospective rating plan employer's or group's, or authorized claims administrator's, exercise of authority under this section may require prior notification to the department, but the rules must minimize the department's need to respond and must ensure that a failure to respond or a delay in response by the department does not impede the timely administration of the claim."

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