BILL REQ. #: H-5307.1
State of Washington | 60th Legislature | 2008 Regular Session |
READ FIRST TIME 02/05/08.
AN ACT Relating to industrial insurance benefits on appeal; amending RCW 51.52.050; and creating a new section.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF WASHINGTON:
Sec. 1 RCW 51.52.050 and 2004 c 243 s 8 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)(a) 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.
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)).
(b) An order by the department awarding benefits shall become
effective and benefits due on the date issued. Subject to (b)(i) and
(ii) of this subsection, if the department order is appealed the order
shall not be stayed pending a final decision on the merits unless
ordered by the board. Any party may move for a stay of the order on
appeal, in whole or in part. The motion must be filed within fifteen
days of the order granting appeal. The board shall conduct an
expedited review of the claim file provided by the department as it
existed on the date of the department order. The board shall issue a
final decision within twenty-five days of the filing of the motion for
stay or the order granting appeal, whichever is later. The board's
final decision may be appealed to superior court in accordance with RCW
51.52.110. The board shall grant a motion to stay if the moving party
demonstrates that it is more likely than not to prevail on the facts as
they existed at the time of the order on appeal. The board shall not
consider the likelihood of recoupment of benefits as a basis to grant
or deny a motion to stay.
(i) If upon reconsideration requested by a worker or medical
provider, the department has ordered an increase in a permanent partial
disability award from the amount reflected in an earlier order, the
award reflected in the earlier order shall not be stayed pending a
final decision on the merits. However, the increase is stayed without
further action by the board pending a final decision on the merits.
(ii) If a self-insured employer appeals an order setting the
claimant's time loss rate, the claimant shall receive any time loss or
pension benefits based upon the rate calculation that the employer most
recently submitted to the department and payment of benefits at this
rate shall not be stayed pending a final decision on the merits.
However, payment of time loss or pension benefits at the increased rate
in the order on appeal is stayed without further action by the board
pending a final decision on the merits.
(c) In an appeal from an order of the department that alleges
willful misrepresentation, the department or self-insured employer
shall initially introduce all evidence in its case in chief. Any such
person aggrieved by the decision and order of the board may thereafter
appeal to the superior court, as prescribed in this chapter.
NEW SECTION. Sec. 2 This act applies to orders issued on or
after the effective date of this act.