H-3958.1 _______________________________________________
SUBSTITUTE HOUSE BILL 1243
_______________________________________________
State of Washington 53rd Legislature 1994 Regular Session
By House Committee on Commerce & Labor (originally sponsored by Representatives King, Heavey, G. Cole, Jones and Veloria)
Read first time 02/04/94.
AN ACT Relating to reconsideration of department of labor and industries' industrial insurance orders; and amending RCW 51.52.050 and 51.52.060.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF WASHINGTON:
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 thirty 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. Temporary total disability compensation or medical aid benefits granted to a worker by an order under reconsideration shall continue while the reconsideration is pending, subject to the requirements of RCW 51.32.240(3).
(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.
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