HOUSE BILL REPORT

HB 2700

BYRepresentatives Cole, Vekich, Prentice, Jones and Leonard

Establishing procedures for industrial insurance claims.

House Committe on Commerce & Labor

Majority Report:  Do pass as amended.  (8)

      Signed by Representatives Vekich, Chair; Cole, Vice Chair; Forner, Jones, R. King, Leonard, O'Brien and Prentice.

Minority Report:  Do not pass.  (2)

      Signed by Smith, Ranking Republican Member; and Wolfe.

House Staff:Chris Cordes (786-7117)

AS REPORTED BY COMMITTEE ON COMMERCE & LABOR JANUARY 30, 1990

BACKGROUND:

Qualifying employers are allowed to self-insure their workers' compensation programs.  Self-insurers provide for administration of their injured worker's claims, under regulation by the Department of Labor and Industries.

In an industrial insurance appeal to superior court, the injured worker's attorneys' fees and costs are paid by the department if a decision of the Board of Industrial Insurance Appeals is reversed or modified and the accident fund is affected by the litigation.  In self-insurer cases, the employer must pay the attorneys' fees and costs if the board's decision is reversed or modified and additional benefits are ordered that would have been paid from the accident fund in state fund cases.

SUMMARY:

BILL AS AMENDED:  A self-insured employer is required to provide a free copy of the employee's claim file within 15 days of a request by the employee or employee's representative.

A self-insured employer must notify the Department of Labor and Industries of any employee protest relating to an industrial insurance claim by the end of the next working day or be subject to penalties.  Compliance with any applicable appeal period will be based on the date the self-insurer or the department received the protest, whichever is earlier. 

Medical reports must be submitted by a self-insured employer with each request for closure of an industrial insurance claim.

A self-insured employer must request allowance or denial of a claim within 60 days of the date the claim is filed or the claim will be deemed allowed.  The self-insurer may request extension of the time limit for an additional 30 days if written notice is provided to the employee.

In an industrial insurance appeal to superior court that reverses or modifies the decision of the Board of Industrial Insurance Appeals, the requirement is deleted that the accident fund must be affected by the litigation for the injured worker's attorneys' fees and costs to be paid by the department.  In cases involving self- insured employers, the requirement is deleted that in appeals brought by the worker resulting in additional benefits, the benefits must be those that would have been paid from the accident fund for the attorneys' fees and costs to be paid by the self- insurer.  A requirement is added that in appeals brought by an employer in which the board's order is sustained, affirming the worker's benefits, the attorneys' fees and costs must be paid by the employer.

AMENDED BILL COMPARED TO ORIGINAL:  A provision is added that if a worker has submitted a protest to the self-insurer, compliance with any applicable appeal period will be determined based on the date that the self-insurer or the department received the protest, whichever is earlier.

Fiscal Note:      Not Requested.

House Committee ‑ Testified For:    Jeff Johnson, Washington State Labor Council; Michael Welch, Washington State Trial Lawyers Association; and Bob Dilger; Washington State Building and Construction Trades Council.

(Neutral):  Jody Moran, Department of Labor and Industries.

House Committee - Testified Against:      Lee Eberle, Washington Self-Insurers Association.

House Committee - Testimony For:    The bill promotes good claims management by self-insurers. Without these provisions, injured workers sometimes have difficulty getting their records and the Department of Labor and Industries may not have the information needed to adjudicate a claim.  Requiring self-insurers to act promptly is not a hardship.

(Neutral):  Some of the provisions in the bill are at least partially addressed in other parts of the industrial insurance law, and some conflicts might need to be addressed.  It may be useful to consider a provision that will stop the clock on an appeal for the worker if the protest is forwarded to the self-insurer.

House Committee - Testimony Against:      Awarding attorney fees is contrary to the general practice under Washington law.  The bill does not clearly define a "protest." Provisions of current law already deal with the procedures for allowing or denying claims.