H-4027              _______________________________________________

                                                   HOUSE BILL NO. 1884

                        _______________________________________________

State of Washington                              49th Legislature                              1986 Regular Session

By Representatives Patrick and Chandler

Read first time 1/24/86 and referred to Committee on Commerce & Labor.

AN ACT Relating to industrial insurance; and amending RCW 51.32.190.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF WASHINGTON:

        Sec. 1.  Section 47, chapter 289, Laws of 1971 ex. sess. as last amended by section 3, chapter 20, Laws of 1982 1st ex. sess. and RCW 51.32.190 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.  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)) within ninety days, and with notice to all parties, 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, with notice to all parties 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.

(7) At the conclusion of any inquiry or further investigation by the director under subsection (5) or (6) of this section, and in any event, within ninety days from the date such inquiry or further investigation begins, the department shall issue an appealable order in accordance with RCW 51.52.050, and if no further order is issued, the action taken is approved.

(8) During the pendency of any inquiry or further investigation by the director in a self-insured claim under subsection (5) or (6) of this section or under RCW 51.52.060, the self-insurer retains jurisdiction to administer such claim and the benefits provided under this title.