BILL REQ. #:  S-4485.1 

READ FIRST TIME 02/03/12.   

     AN ACT Relating to claim files and compensation under the industrial insurance laws; amending RCW 51.28.070 and 51.52.120; and creating a new section.

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

Sec. 1   RCW 51.28.070 and 1990 c 209 s 2 are each amended to read as follows:
     Information contained in the claim files and records of injured workers, information submitted to the board of industrial insurance appeals or to the department pursuant to the negotiation and approval of a claims resolution structured settlement agreement, and information developed during conferences or hearings on claims resolution structured settlement agreements, under the provisions of this title, shall be deemed confidential and shall not be open to public inspection (other than to public employees in the performance of their official duties), but representatives of a claimant, be it an individual or an organization, may review a claim file or receive specific information therefrom upon the presentation of the signed authorization of the claimant. A claimant may review his or her claim file if the director determines, pursuant to criteria adopted by rule, that the review is in the claimant's interest. Employers or their duly authorized representatives may review any files of their own injured workers in connection with any pending claims. Physicians treating or examining workers claiming benefits under this title, or physicians giving medical advice to the department regarding any claim may, at the discretion of the department, inspect the claim files and records of injured workers, and other persons may make such inspection, at the department's discretion, when such persons are rendering assistance to the department at any stage of the proceedings on any matter pertaining to the administration of this title.

NEW SECTION.  Sec. 2   The department of labor and industries shall provide the appropriate committees of the legislature by December 31, 2012, with a plan to define the term "claim file" for state fund and self-insured industrial insurance claims. The plan shall include a timeline for gathering input from representatives of employers and workers, and for adopting rules under the administrative procedure act or for submitting recommended statutory language, as appropriate. The plan and rules or recommended legislation shall also address when claim files must be submitted by self-insured employers to the department of labor and industries and to injured workers or their representatives, and any recommended consequences for failure to comply.

Sec. 3   RCW 51.52.120 and 2011 1st sp.s. c 37 s 304 are each amended to read as follows:
     (1) Except for claim resolution structured settlement agreements, it shall be unlawful for an attorney engaged in the representation of any worker or beneficiary to charge for services in the department any fee in excess of a reasonable fee, of not more than thirty percent of the increase in the award secured by the attorney's services. Such reasonable fee shall be fixed by the director or the director's designee for services performed by an attorney for such worker or beneficiary, if written application therefor is made by the attorney, worker, or beneficiary within one year from the date the final decision and order of the department is communicated to the party making the application.
     (2) If, on appeal to the board, the order, decision, or award of the department is reversed or modified and additional relief is granted to a worker or beneficiary, or in cases where a party other than the worker or beneficiary is the appealing party and the worker's or beneficiary's right to relief is sustained by the board, the board shall fix a reasonable fee for the services of his or her attorney in proceedings before the board if written application therefor is made by the attorney, worker, or beneficiary within one year from the date the final decision and order of the board is communicated to the party making the application. In fixing the amount of such attorney's fee, the board shall take into consideration the fee allowed, if any, by the director, for services before the department, and the board may review the fee fixed by the director. Any attorney's fee set by the department or the board may be reviewed by the superior court upon application of such attorney, worker, or beneficiary. The department or self-insured employer, as the case may be, shall be served a copy of the application and shall be entitled to appear and take part in the proceedings. Where the board, pursuant to this section, fixes the attorney's fee, it shall be unlawful for an attorney to charge or receive any fee for services before the board in excess of that fee fixed by the board.
     (3) For claim resolution structured settlement agreements, fees for attorney services are limited to fifteen percent of the total amount to be paid to the worker after the agreement becomes final. The board will also decide on any disputes as to attorneys' fees for services related to claim resolution structured settlement agreements consistent with the procedures in subsection (2) of this section.
     (4) If, on appeal to the board from a decision or order of the department denying the reopening of a claim previously resolved with a structured settlement agreement, the decision is reversed or modified and the relief sought by the claimant is fully or partially awarded, a reasonable fee for the services of the worker's attorney shall be fixed by the board, and the board shall order reimbursement for all reasonable costs of litigation, including fees of the medical and other witnesses. In cases of self-insured employers, the attorney fees fixed by the board and the costs set by the board shall be payable directly by the self-insured employer. In all other cases, the fees and costs shall be paid by the department.
     (5) In an appeal to the board involving the presumption established under RCW 51.32.185, the attorney's fee shall be payable as set forth under RCW 51.32.185.
     (((5))) (6) Any person who violates this section is guilty of a misdemeanor.