S-2430               _______________________________________________

                                         SUBSTITUTE SENATE BILL NO. 5602

                        _______________________________________________

State of Washington                               51st Legislature                              1989 Regular Session

By Senate Committee on Economic Development & Labor (originally sponsored by Senators Rasmussen, McMullen and Niemi)

Read first time 3/1/89.

AN ACT Relating to disputed industrial insurance claims; and adding a new section to chapter 51.32 RCW.

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

NEW SECTION. Sec. 1.  A new section is added to chapter 51.32 RCW to read as follows:

          (1) Whenever an application for benefits is filed that is otherwise compensable but requires a determination of whether benefits should be paid by the state fund or one or more self-insurers, the department or employer may petition directly to the department's mediation unit to make that determination.

          (2) The initial determination by the mediation unit shall be based on documentary evidence only. Potentially liable employers shall be notified by the department and shall be given ten days to submit documents.

          (3) Once documents have been submitted, the department shall promptly issue an interlocutory order according to the recommendation of the mediation unit.  The interlocutory order shall designate a paying entity to provide the worker with benefits until a final disposition is made as to which of the two or more entities is responsible for payment of the benefits.  Benefits shall be paid at the lesser of the two benefit entitlements that may apply to the claim.

          (4) If, upon final determination, the entity that paid benefits under subsection (3) of this section is determined not to be responsible for payment, such entity shall promptly be reimbursed by the responsible entity for all amounts paid, unless subsection (5) of this section applies.

          (5) If, upon final determination, neither the department nor a self-insurer is determined to be responsible for the benefits, the recipient of benefits shall repay the entity having paid the benefits and recoupment may be made from future payments due the recipient on any claim with the state fund or self-insurer, as the case may be.  The director may exercise his or her discretion to waive, in whole or in part, the amount of any such repayments where the recovery would be against equity and good conscience.

          (6) If the department's determination under this section is appealed, benefits shall continue to be paid until the responsible entity is finally determined.

          (7) The department shall have authority to adopt rules to implement this section.