1242.E AMC CONF S5952.1
EHB 1242 - CONF REPT
By Conference Committee
Strike everything after the enacting clause and insert the following:
"Sec. 1. RCW 51.52.050 and 1987 c 151 s 1 are each amended to read as follows:
(1) Whenever the
department has made any order, decision, or award, it shall promptly serve the
worker, beneficiary, employer, or other person affected thereby, with a copy
thereof by mail, which shall be addressed to such person at his or her last
known address as shown by the records of the department. The copy, in case the
same is a final order, decision, or award, shall bear on the same side of the
same page on which is found the amount of the award, a statement, set in black
faced type of at least ten point body or size, that such final order, decision,
or award shall become final within sixty days from the date the order is
communicated to the parties unless a written request for reconsideration is
filed with the department of labor and industries, Olympia, or an appeal is
filed with the board of industrial insurance appeals, Olympia((: PROVIDED,
That)). However, a department order or decision making demand,
whether with or without penalty, for repayment of sums paid to a provider of
medical, dental, vocational, or other health services rendered to an
industrially injured worker, shall state that such order or decision shall
become final within twenty days from the date the order or decision is
communicated to the parties unless a written request for reconsideration is
filed with the department of labor and industries, Olympia, or an appeal is
filed with the board of industrial insurance appeals, Olympia.
(2) Whenever the department has taken any action or made any decision relating to any phase of the administration of this title, the worker, beneficiary, employer, or other person aggrieved thereby may request reconsideration of the department, or may appeal to the board. If an employer requests reconsideration of a department order in favor of an injured worker, the employer must submit all information relevant to the request within one hundred twenty days of requesting reconsideration and the department may consider only the information that is timely submitted. For good cause shown, the department may extend the time period for an additional thirty days. If the injured worker submits new information after the employer time limits established in this subsection the department shall allow a reasonable period of time for the employer to submit rebuttal information. Temporary total disability compensation or medical aid benefits granted to a worker by an order under reconsideration shall continue while the reconsideration is pending.
(3) In an appeal
before the board, the appellant shall have the burden of proceeding with the
evidence to establish a prima facie case for the relief sought in such appeal((:
PROVIDED, That)). However, in an appeal from an order of the
department that alleges fraud, the department or self-insured employer shall
initially introduce all evidence in its case in chief. ((Any such)) A
person aggrieved by the decision and order of the board may thereafter appeal
to the superior court, as prescribed in this chapter.
Sec. 2. RCW 51.52.060 and 1986 c 200 s 11 are each amended to read as follows:
((Any)) (1)(a)
A worker, beneficiary, employer, or other person aggrieved by an order,
decision, or award of the department must, before he or she appeals to the
courts, file with the board and the director, by mail or personally, within
sixty days from the day on which ((such)) a copy of ((such))
the order, decision, or award was communicated to such person, a notice
of appeal to the board((: PROVIDED, That)). However, a health
services provider or other person aggrieved by a department order or decision
making demand, whether with or without penalty, for repayment of sums paid to a
provider of medical, dental, vocational, or other health services rendered to
an industrially injured worker must, before he or she appeals to the courts,
file with the board and the director, by mail or personally, within twenty days
from the day on which ((such)) a copy of ((such)) the
order or decision was communicated to the health services provider upon whom
the department order or decision was served, a notice of appeal to the board.
(b) Failure to file a notice of appeal with both the board and the department shall not be grounds for denying the appeal if the notice of appeal is filed with either the board or the department.
(2) Within ten
days of the date on which an appeal has been granted by the board, the board
shall notify the other interested parties ((thereto)) to the appeal
of the receipt ((thereof)) of the appeal and shall forward a copy
of ((said)) the notice of appeal to ((such)) the
other interested parties. Within twenty days of the receipt of such notice of
the board, the worker or the employer may file with the board a cross-appeal
from the order of the department from which the original appeal was taken((:
PROVIDED, That nothing contained in this section shall be deemed to change,
alter or modify the practice or procedure of the department for the payment of
awards pending appeal: AND PROVIDED, That failure to file notice of appeal
with both the board and the department shall not be ground for denying the
appeal if the notice of appeal is filed with either the board or the
department: AND PROVIDED, That,)).
(3) If within
the time limited for filing a notice of appeal to the board from an order,
decision, or award of the department, the department ((shall)) directs
the submission of further evidence or the investigation of any further fact,
the time for filing ((such)) the notice of appeal shall not
commence to run until ((such)) the person ((shall have)) has
been advised in writing of the final decision of the department in the matter((:
PROVIDED, FURTHER, That)). In the event the department ((shall))
directs the submission of further evidence or the investigation of any
further fact, as ((above)) provided in this section, the
department shall render a final order, decision, or award within ninety days
from the date ((such)) further submission of evidence or investigation
of further fact is ordered which time period may be extended by the department
for good cause stated in writing to all interested parties for an additional
ninety days((: PROVIDED, FURTHER, That)).
(4) The department, either within the time limited for appeal, or within thirty days after receiving a notice of appeal, may:
(a) Modify,
reverse, or change any order, decision, or award((, or may)); or
(b)(i) Except as
provided in (b)(ii) of this subsection, hold ((any such)) an
order, decision, or award in abeyance for a period of ninety days which time
period may be extended by the department for good cause stated in writing to
all interested parties for an additional ninety days pending further
investigation in light of the allegations of the notice of appeal((, and));
or
(ii) Hold an order, decision, or award issued under RCW 51.32.160 in abeyance for a period not to exceed ninety days from the date of receipt of an application under RCW 51.32.160. The department may extend the ninety-day time period for an additional sixty days for good cause.
The board shall
((thereupon)) deny the appeal upon the issuance of an order under (b)
(i) or (ii) of this subsection holding an earlier order, decision, or award in
abeyance, without prejudice to the appellant's right to appeal from any
subsequent determinative order issued by the department.
This subsection (4)(b) does not apply to applications deemed granted under RCW 51.32.160.
(5) A provision of this section shall not be deemed to change, alter, or modify the practice or procedure of the department for the payment of awards pending appeal. However, if an employer appeals to the board a department order granting temporary total disability compensation or medical aid benefits under chapter 51.36 RCW, or both, to a worker, the worker shall be entitled to the compensation or benefits while the appeal is pending before the board, subject to the requirements of RCW 51.32.240(3).
Sec. 3. RCW 51.16.140 and 1989 c 385 s 3 are each amended to read as follows:
(1) Every employer who is not a self-insurer shall deduct from the pay of each of his or her workers:
(a) One-half of
the amount ((he or she)) the employer is required to pay, for
medical benefits within each risk classification. Such amount shall be
periodically determined by the director and reported by him or her to all
employers under this title: PROVIDED, That the state governmental unit shall
pay the entire amount into the medical aid fund for volunteers, as defined in
RCW 51.12.035, and the state apprenticeship council shall pay the entire amount
into the medical aid fund for registered apprentices or trainees, for the
purposes of RCW 51.12.130. The deduction under this section is not authorized
for premiums assessed under RCW 51.16.210; and
(b) Except as limited by subsection (2) of this section, a surcharge of one-half of one percent of the premium deduction made under (a) of this subsection.
(2) The amount deducted under subsection (1)(b) of this section shall be paid by the employer along with the employer premiums required under this title. The amounts remitted shall be deposited into the benefit repayment fund. The deduction may not be made under subsection (1)(b) of this section in any calendar quarter if in the immediately preceding calendar quarter the amount in the benefit payment fund is three hundred thousand dollars or more.
(((2))) (3)
It shall be unlawful for the employer, unless specifically authorized by this
title, to deduct or obtain any part of the premium or other costs required to
be by him or her paid from the wages or earnings of any of his or her workers,
and the making of or attempt to make any such deduction shall be a gross
misdemeanor.
Sec. 4. RCW 51.16.060 and 1985 c 315 s 1 are each amended to read as follows:
Every employer not qualifying as a self-insurer, shall insure with the state and shall, on or before the last day of January, April, July and October of each year thereafter, furnish the department with a true and accurate payroll for the period in which workers were employed by it during the preceding calendar quarter, the total amount paid to such workers during such preceding calendar quarter, and a segregation of employment in the different classes established pursuant to this title, and shall pay its premium thereon to the appropriate fund. Premiums for a calendar quarter, whether reported or not, shall become due and delinquent on the day immediately following the last day of the month following the calendar quarter. The sufficiency of such statement shall be subject to the approval of the director: PROVIDED, That the director may in his or her discretion and for the effective administration of this title require an employer in individual instances to furnish a supplementary report containing the name of each individual worker, his or her hours worked, his or her rate of pay and the class or classes in which such work was performed: PROVIDED FURTHER, That in the event an employer shall furnish the department with four consecutive quarterly reports wherein each such quarterly report indicates that no premium is due the department may close the account: PROVIDED FURTHER, That the department may promulgate rules and regulations in accordance with chapter 34.05 RCW to establish other reporting periods and payment due dates in lieu of reports and payments following each calendar quarter, and may also establish terms and conditions for payment of premiums and assessments based on estimated payrolls, with such payments being subject to approval as to sufficiency of the estimated payroll by the department, and also subject to appropriate periodic adjustments made by the department based on actual payroll: AND PROVIDED FURTHER, That a temporary help company which provides workers on a temporary basis to its customers shall be considered the employer for purposes of reporting and paying premiums and assessments under this title according to the appropriate rate classifications as determined by the department: PROVIDED, That the employer shall be liable for paying premiums and assessments, should the temporary help company fail to pay the premiums and assessments under this title.
Except as limited under RCW 51.16.140(2), each employer, except employers qualifying as a self insurer, is hereby assessed a surcharge in addition to other premiums due in an amount equal to the surcharge deducted from the pay of his or her workers under RCW 51.16.140. This amount shall be forwarded to the department each calendar quarter together with other premiums and assessments due under this title. Amounts remitted under this surcharge shall be deposited into the benefit repayment fund.
NEW SECTION. Sec. 5. A new section is added to chapter 51.44 RCW to read as follows:
The benefit repayment fund is created in the custody of the state treasurer. All receipts from the deductions required under RCW 51.16.140(1)(b) shall be deposited into the fund. Transfers from the benefit repayment fund to the medical aid fund or the accident fund shall be made when benefits are paid under RCW 51.52.050(2) or 51.52.060(5) and the department order granting benefits is reversed or modified resulting in an overpayment of benefits to the worker."
EHB 1242 - CONF REPT
By Conference Committee
On page 1, line 2 of the title, after "appeals;" strike the remainder of the title and insert "amending RCW 51.52.050, 51.52.060, 51.16.140, and 51.16.060; and adding a new section to chapter 51.44 RCW."
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