SENATE BILL REPORT

EHB 1267

BYRepresentatives Vekich, Jones, Cole, Wang and Leonard

Establishing procedures regarding self-insured industrial insurance claims.

House Committe on Commerce & Labor

Senate Committee on Economic Development & Labor

Senate Hearing Date(s):March 28, 1989

Senate Staff:David Cheal (786-7576)

AS OF MARCH 27, 1989

BACKGROUND:

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

SUMMARY:

In an industrial insurance case, if an appeal is made to the superior court and the order of the Board of Industrial Insurance Appeals is sustained resulting in affirmance of the worker's benefits, then the self-insured employer must pay the attorneys' fees and other costs of the appeal.

The self-insured employer is required to provide a copy of the employee's claim file within 15 days of a request by the employee or employee's representative.

A self-insurer 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.

A self-insurer is required to submit a medical report with each request for closure of an industrial insurance claim.

Self-insurers may require medical examinations of their injured workers only to:  determine questions of medical cause upon claim filing; determine medical treatment; or determine questions of permanent partial disability or benefits at the conclusion of claim evaluation.  Unless medical management of the claim changes, the self-insurer may not require other medical examinations.  Self- insurers may not restrict the ability of their injured workers to choose their own physician.

A self-insurer 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 an additional 30 days extension of the time limit if written notice is provided to the employee.

Workers aggrieved by violations of the act may bring suit in superior court.  In addition to damages, costs and reasonable attorneys' fees may be awarded.

Appropriation:    none

Revenue:    none

Fiscal Note:      available