HOUSE BILL REPORT

HB 2497

BYRepresentatives Jones, Smith, Vekich, Walker, Prentice, Wolfe, R. King, Winsley and Rector; by request of Department of Labor and Industries

Processing disputed industrial insurance claims.

House Committe on Commerce & Labor

Majority Report:  Do pass.  (11)

      Signed by Representatives Vekich, Chair; Cole, Vice Chair; Smith, Ranking Republican Member; Forner, Jones, R. King, Leonard, O'Brien, Prentice, Walker and Wolfe.

House Staff:Chris Cordes (786-7117)

AS PASSED HOUSE FEBRUARY 6, 1990

BACKGROUND:

If a worker suffers a repeat injury (or illness) following an original injury, there may be a question whether the second occurrence is a new injury or merely an aggravation of the previous injury.  Identifying the responsible employer may depend on the determination.  The authority of the Department of Labor and Industries to make the determination is unclear, especially if the determination raises a dispute over claim responsibility between self-insured employers, or a self-insured employer and the department.

SUMMARY:

In an industrial insurance claim, if a question arises whether to reopen an accepted claim or to allow a new injury or illness claim, the Department of Labor and Industries is responsible for making the determination.  Pending the department's determination, benefits must be paid to the claimant by the entity that would be responsible if the claim were found to be a new injury.  Benefits must be paid at the lesser of the two applicable benefit amounts that may apply to the claim.  During any appeal of the department's determination, the claimant must continue to receive benefits.

After a final determination of responsibility, the benefits must be repaid by the entity found to be responsible for the claim, or by the claimant if no entity is responsible for the claim.  The director may waive repayment by the claimant if recovery would be against equity and good conscience.

Fiscal Note:      Not Requested.

House Committee ‑ Testified For:    Jody Moran, Department of Labor and Industries; Sam Kinville, Washington State Council of County and City Employees; Jeff Johnson, Washington State Labor Council; Clif Finch, Association of Washington Business; Melanie Stewart, Washington Self-Insurers Association.

House Committee - Testified Against:      Michael Temple, Washington State Trial Lawyers.

House Committee - Testimony For:    It is inequitable for an injured worker to be denied benefits when the injury is clearly covered by industrial insurance, but the responsible employer is not immediately identified.  Under current law, the worker may wait more than a year before the jurisdictional issues are settled.  The bill allows for immediate benefits and a procedure for determining the responsible employer.  The Workers' Compensation Advisory Board supported this legislation requested by the Department of Labor and Industries.

House Committee - Testimony Against:      It is not good policy to provide that benefits will be paid at the lesser amount that may apply to the injured worker's claim. If the worker is entitled to higher benefits, the worker may still wait for a long time before the entire amount of the benefits is finally paid.