2014 -- S 3053 SUBSTITUTE A AS AMENDED | |
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LC005819/SUB A | |
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STATE OF RHODE ISLAND | |
IN GENERAL ASSEMBLY | |
JANUARY SESSION, A.D. 2014 | |
____________ | |
A N A C T | |
RELATING TO LABOR AND LABOR RELATIONS - WORKERS' COMPENSATION - | |
GENERAL PROVISIONS | |
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Introduced By: Senators P Fogarty, Goodwin, Ruggerio, Ciccone, and Doyle | |
Date Introduced: May 29, 2014 | |
Referred To: Senate Labor | |
It is enacted by the General Assembly as follows: | |
1 | SECTION 1. Section 28-29-30 of the General Laws in Chapter 28-29 entitled "Workers' |
2 | Compensation - General Provisions" is hereby amended to read as follows: |
3 | 28-29-30. Advisory council. -- (a) There is created a workers' compensation advisory |
4 | council consisting of fifteen (15) sixteen (16) members as follows: |
5 | (1) The chief judge of the workers' compensation court and one additional judge of the |
6 | workers' compensation court and one member of the Bar who primarily represents injured |
7 | workers before the workers' compensation court, both the to be selected by the chief judge; |
8 | (2) The director of business regulation; |
9 | (3) The director of administration; |
10 | (4) Three (3) representatives from labor appointed by the governor, one of whom shall |
11 | be an injured worker; |
12 | (5) Three (3) representatives from business appointed by the governor, one of whom |
13 | shall be a self-insured employer, and one of whom shall represent cities and towns; |
14 | (6) One representative from the general public appointed by the governor; |
15 | (7) The chairperson of the senate labor committee or his or her designee; and |
16 | (8) The chairperson of the house labor committee or his or her designee; |
17 | (9) The director of labor and training; and |
18 | (10) The chief executive officer of the workers' compensation insurance fund or his or |
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1 | her designee. |
2 | (b) It shall be the duty of the council to advise the governor and the general assembly, on |
3 | an annual basis, on the administration of the workers' compensation system. |
4 | SECTION 2. Sections 28-33-8, 28-33-17 and 28-33-18.3 of the General Laws in Chapter |
5 | 28-33 entitled "Workers' Compensation - Benefits" are hereby amended to read as follows: |
6 | 28-33-8. Employee's choice of physician, dentist, or hospital -- Payment of charges -- |
7 | Physician reporting schedule. -- (a) (1) An injured employee shall have freedom of choice to |
8 | obtain health care, diagnosis, and treatment from any qualified health care provider initially. The |
9 | initial health care provider of record may, without prior approval, refer the injured employee to |
10 | any qualified specialist for independent consultation or assessment, or specified treatment. If the |
11 | insurer or self-insured employer has a preferred-provider network approved and kept on record by |
12 | the medical advisory board, any change by the employee from the initial health care provider of |
13 | record shall only be to a health care provider listed in the approved preferred-provider network; |
14 | provided, however, that any contract proffered or maintained which that restricts or limits the |
15 | health care provider's ability to make referrals pursuant to the provisions of this section,; restricts |
16 | the injured employee's first choice of health care provider,; substitutes or overrules the treatment |
17 | protocols maintained by the medical advisory board, or attempts to evade or limit the jurisdiction |
18 | of the workers' compensation court shall be void as against public policy. If the employee seeks |
19 | to change to a health care provider not in the approved preferred-provider network, the employee |
20 | must obtain the approval of the insurer or self-insured employer. Nothing contained in this |
21 | section shall prevent the treatment, care, or rehabilitation of an employee by more than one |
22 | physician, dentist, or hospital. The employee's first visit to any facility providing emergency care |
23 | or to a physician or medical facility under contract with or agreement with the employer or |
24 | insurer to provide priority care, shall not constitute the employee's initial choice to obtain health |
25 | care, diagnosis, or treatment. |
26 | (2) In addition to the treatment of qualified health care providers, the employee shall have |
27 | the freedom to obtain a rehabilitation evaluation by a rehabilitation counselor certified by the |
28 | director pursuant to § 28-33-41 in cases where the employee has received compensation for a |
29 | period of more than three (3) months, and the employer shall pay the reasonable fees incurred by |
30 | the rehabilitation counselor for the initial assessment. |
31 | (b) Within three (3) days of an initial visit following an injury, the health care provider |
32 | shall provide to the insurer or self-insured employer, and the employee and his or her attorney, a |
33 | notification of compensable injury form to be approved by the administrator of the medical |
34 | advisory board. Within three (3) days of the injured employee's release or discharge, return to |
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1 | work, and/or recovery from an injury covered by chapters 29 - 38 of this title, the health care |
2 | provider shall provide a notice of release to the insurer or self-insured employer, and the |
3 | employee and his or her attorney, on a form approved by the division. A twenty dollar ($20.00) |
4 | fee may be charged by the health care provider to the insurer or self-insured employer for the |
5 | notification of compensable injury forms or notice of release forms or for affidavits filed pursuant |
6 | to subsection (c) of this section, but only if filed in a timely manner. No claim for care or |
7 | treatment by a physician, dentist, or hospital chosen by an employee shall be valid and |
8 | enforceable as against his or her employer, the employer's insurer, or the employee, unless the |
9 | physician, dentist, or hospital gives written notice of the employee's choice to the |
10 | employer/insurance carrier within fifteen (15) days after the beginning of the services or |
11 | treatment. The health care provider shall, in writing, submit present to the employer or insurance |
12 | carrier an itemized bill and report for the services or treatment and a final itemized bill for all |
13 | unpaid services or treatment within three (3) months after the conclusion of the treatment. The |
14 | employee shall not be personally liable to pay any physician, dentist, or hospital bills in cases |
15 | where the physician, dentist, or hospital has forfeited the right to be paid by the employer or |
16 | insurance carrier because of noncompliance with this section. |
17 | (c) (1) At six (6) weeks from the date of injury, then every twelve (12) weeks thereafter |
18 | until maximum medical improvement, any qualified physician or other health care professional |
19 | providing medical care or treatment to any person for an injury covered by chapters 29 - 38 of |
20 | this title shall file an itemized bill and an affidavit with the insurer, the employee and his or her |
21 | attorney, and the medical advisory board. A ten percent (10%) discount may be taken on the |
22 | itemized bill affidavits not filed in a timely manner and received by the insurer one week or more |
23 | late. The affidavit shall be on a form designed and provided by the administrator of the medical |
24 | advisory board and shall state: |
25 | (i) The type of medical treatment provided to date, including type and frequency of |
26 | treatment(s); |
27 | (ii) Anticipated further treatment, including type, frequency, and duration of treatment(s), |
28 | whether or not maximum medical improvement has been reached, and the anticipated date of |
29 | discharge; |
30 | (iii) Whether the employee can return to the former position of employment, or is capable |
31 | of other work, specifying work restrictions and work capabilities of the employee; |
32 | (2) The affidavit shall be admissible as an exhibit of the workers' compensation court |
33 | with or without the appearance of the affiant. |
34 | (d) "Itemized bill", as referred to in this section, means a completed statement of |
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1 | charges, on a form CMS HCFA 1500, UB 92/94 or other form suitable to the insurer, which that |
2 | includes, but is not limited to, an enumeration of specific types of care provided,; facilities or |
3 | equipment used,; services rendered,; and appliances or medicines prescribed, for purposes of |
4 | identifying the treatment given the employee with respect to his or her injury. |
5 | (e) (1) The treating physician shall furnish to the employee, or to his or her legal |
6 | representative, a copy of his or her medical report within ten (10) days of the examination date. |
7 | (2) The treating physician shall notify the employer, and the employee and his or her |
8 | attorney, immediately when an employee is able to return to full or modified work. |
9 | (3) There shall be no charge for a health record when that health record is necessary to |
10 | support any appeal or claim under the Workers' Compensation Act § 23-17-19.1(16). The treating |
11 | physician shall furnish to the employee, or to his or her legal representative, a medical report, |
12 | within ten (10) days of the request, stating the diagnosis, disability, loss of use, end result and/or |
13 | causal relationship of the employee's condition associated with the work related injury. The |
14 | physician shall be entitled to charge for these services only as enunciated in the State of Rhode |
15 | Island workers compensation medical fee schedule. |
16 | (f) (1) Compensation for medical expenses and other services under § 28-33-5, 28-33- |
17 | 7 or 28-33-8 is due and payable within twenty-one (21) days from the date a request is payment is |
18 | not made within twenty-one (21) days from the date a request is made for payment, the provider |
19 | of medical services may add, and the insurer or self-insurer shall pay, interest at the per annum |
20 | rate as provided in § 9-21-10 on the amount due. The employee or the medical provider may file |
21 | a petition with the administrator of the workers' compensation court which petition shall follow |
22 | the procedure as authorized in chapter 35 of this title. |
23 | (2) The twenty-one (21) day (21) period in subdivision (1) of this subsection and in § 28- |
24 | 35-12 shall begin on the date the insurer receives a request with appropriate documentation |
25 | required to determine whether the claim is compensable and the payment requested is due. |
26 | 28-33-17. Weekly compensation for total incapacity -- Permanent total disability -- |
27 | Dependents' allowances. -- (a) (1) While the incapacity for work resulting from the injury is |
28 | total, the employer shall pay the injured employee a weekly compensation equal to seventy-five |
29 | percent (75%) of his or her average weekly spendable base wages, earnings, or salary, as |
30 | computed pursuant to the provisions of § 28-33-20. The amount may not exceed more than sixty |
31 | percent (60%) of the state average weekly wage of individuals in covered employment under the |
32 | provisions of the Rhode Island Eemployment Ssecurity Aact as computed and established by the |
33 | Rhode Island department of labor and training, annually, on or before May 31 of each year, under |
34 | the provisions of § 28-44-6(a). Effective September 1, 1974, the maximum rate for weekly |
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1 | compensation for total disability shall not exceed sixty-six and two-thirds percent (662/3%) of the |
2 | state average weekly wage, as computed and established under the provisions of § 28-44-6(a). |
3 | Effective September 1, 1975, the maximum rate for weekly compensation for total disability shall |
4 | not exceed one hundred percent (100%) of the state average weekly wage, as computed and |
5 | established under the provisions of § 28-44-6(a). Effective September 1, 2007, the maximum rate |
6 | for weekly compensation for total disability shall not exceed one hundred fifteen percent (115%) |
7 | of the state average weekly wage, as computed and established under the provisions of § 28-44- |
8 | 6(a). Effective October 1, 2016, the maximum rate for weekly compensation for total disability |
9 | shall not exceed one hundred twenty percent (120%) of the state average weekly wage as |
10 | computed and established under the provisions of § 28-44-6(a), and effective October 1, 2017, the |
11 | maximum rate for weekly compensation for total disability shall not exceed one hundred twenty - |
12 | five percent (125%) of the state average weekly wage, as computed and established under the |
13 | provisions of § 28-44-6(a). If the maximum weekly benefit rate is not an exact multiple of one |
14 | dollar ($1.00), then the rate shall be raised to the next higher multiple of one dollar ($1.00). |
15 | (2) The average weekly wage computed and established under § 28-44-6(a) is applicable |
16 | to injured employees whose injury occurred on or after September 1, 2000, and shall be |
17 | applicable for the full period during which compensation is payable. |
18 | (3) (i) "Spendable earnings" means the employee's gross, average weekly wages, |
19 | earnings, or salary, including any gratuities reported as income, reduced by an amount determined |
20 | to reflect amounts which that would be withheld from the wages, earnings, or salary under federal |
21 | and state income tax laws, and under the Federal Insurance Contributions Act (FICA), 26 |
22 | U.S.C. 3101 et seq., relating to sSocial sSecurity and Medicare taxes. In all cases, it is to be |
23 | assumed that the amount withheld would be determined on the basis of expected liability of the |
24 | employee for tax for the taxable year in which the payments are made without regard to any |
25 | itemized deductions but taking into account the maximum number of personal exemptions |
26 | allowable. |
27 | (ii) Each year, the director shall publish tables of the average weekly wage and seventy- |
28 | five percent (75%) of spendable earnings that are to be in effect on May 10. These tables shall be |
29 | conclusive for the purposes of converting an average weekly wage into seventy-five percent |
30 | (75%) of spendable earnings. In calculating spendable earnings, the director shall have discretion |
31 | to exempt funds assigned to third parties by order of the family court pursuant to § 8-10-3 and |
32 | funds designated for payment of liens pursuant to § 28-33-27 upon submission of supporting |
33 | evidence. |
34 | (b) (1) In the following cases, it shall, for the purpose of this section, be that the injury |
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1 | resulted in permanent total disability: |
2 | (i) The total and irrecoverable loss of sight in both eyes or the reduction to one-tenth |
3 | (1/10th) or less of normal vision with glasses; |
4 | (ii) The loss of both feet at or above the ankle; |
5 | (iii) The loss of both hands at or above the wrist; |
6 | (iv) The loss of one hand and one foot; |
7 | (v) An injury to the spine resulting in permanent and complete paralysis of the legs or |
8 | arms; and |
9 | (vi) An injury to the skull resulting in incurable imbecility or insanity. |
10 | (2) In all other cases, total disability shall be determined only if, as a result of the injury, |
11 | the employee is physically unable to earn any wages in any employment; provided, that in cases |
12 | where manifest injustice would otherwise result, total disability shall be determined when an |
13 | employee proves, taking into account the employee's age, education, background, abilities, and |
14 | training, that he or she is unable, on account of his or her compensable injury, to perform his or |
15 | her regular job and is unable to perform any alternative employment. The court may deny total |
16 | disability under this subsection without requiring the employer to identify particular alternative |
17 | employment. |
18 | (c) (1) Where the employee has persons conclusively presumed to be dependent upon |
19 | him or her, or in fact so dependent, the sum of fifteen dollars ($15.00) shall be added to the |
20 | weekly compensation payable for total incapacity for each person wholly dependent on the |
21 | employee, except that the sum of forty dollars ($40.00) shall be added for those receiving benefits |
22 | under § 28-33-12, but in no case shall the aggregate of those amounts exceed eighty percent |
23 | (80%) of the average weekly wage of the employee, except that there shall be no limit for those |
24 | receiving benefits under § 28-33-12. |
25 | (2) The dependency allowance shall be in addition to the compensation benefits for total |
26 | disability otherwise payable under the provisions of this section. The dependency allowance shall |
27 | be increased if the number of persons dependent upon the employee increases during the time that |
28 | weekly compensation benefits are being received. |
29 | (3) For the purposes of this section, the following persons shall be conclusively presumed |
30 | to be wholly dependent for support upon an employee: |
31 | (i) A wife upon a husband with whom she is living at the time of his injury, but only |
32 | while she is not working for wages during her spouse's total disability. |
33 | (ii) A husband upon a wife with whom he is living at the time of her injury, but only |
34 | while he is not working for wages during his spouse's total disability. |
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1 | (iii) Children under the age of eighteen (18) years, or over that age but physically or |
2 | mentally incapacitated from earning, if living with the employee, or, if the employee is bound or |
3 | ordered by law, decree, or order of court, or by any other lawful requirement, to support the |
4 | children, although living apart from them. Provided, that the payment of dependency benefits to a |
5 | dependent child over the age of eighteen (18) years shall continue as long as that child is |
6 | satisfactorily enrolled as a full-time student in an educational institution or an educational facility |
7 | duly accredited or approved by the appropriate state educational authorities at the time of |
8 | enrollment. Those payments shall not be continued beyond the age of twenty-three (23) years. |
9 | "Children," within the meaning of this paragraph, also includes any children of the injured |
10 | employee conceived but not born at the time of the employee's injury, and the compensation |
11 | provided for in this section shall be payable on account of any such children from the date of their |
12 | birth. |
13 | (d) "Dependents," as provided in this section, does not include the spouse of the injured |
14 | employee except as provided in paragraphs (c)(3)(i) and (ii) of this section. In all other cases |
15 | questions of dependency shall be determined in accordance with the facts as the facts may be at |
16 | the time of the injury. |
17 | (e) The court, or any of its judges, may, in its or his or her discretion, order the insurer or |
18 | self-insurer to make payment of the nine dollars ($9.00) or fifteen dollars ($15.00) for those |
19 | receiving benefits under § 28-33-12 directly to the dependent. |
20 | (f) (1) Where any employee's incapacity is total and has extended beyond fifty-two (52) |
21 | weeks, regardless of the date of injury, payments made to all totally incapacitated employees shall |
22 | be increased as of May 10, 1991, and annually on the tenth of May after that as long as the |
23 | employee remains totally incapacitated. The increase shall be by an amount equal to the total |
24 | percentage increase in annual cConsumer pPrice iIndex, United States cCity aAverage for uUrban |
25 | wWage eEarners and cClerical wWorkers, as formulated and computed by the bBureau of lLabor |
26 | sStatistics of the United States Department of Labor for the period of March 1 to February 28 |
27 | each year. |
28 | (2) If the employee is subsequently found to be only partially incapacitated, the weekly |
29 | compensation benefit paid to the employee shall be equal to the payment in effect prior to his or |
30 | her most recent cost of living adjustment. |
31 | (3) "Index" as used in this section refers to the consumer price index, United States cCity |
32 | aAverage for uUrban wWage eEarners and cClerical wWorkers, as that index is formulated and |
33 | computed by the Bureau of Labor Statistics of the United States Department of Labor. |
34 | (4) The May 10, 1991, increase shall be based upon the total percentage increase, if any, |
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1 | in the annual consumer price index for the period of March 1, 1990 to February 28, 1991. |
2 | Thereafter, increases shall be made on May 10 annually, based upon the percentage increase, if |
3 | any, in the index for the period March 1 to February 28. |
4 | (5) The computations in this section shall be made by the director of labor and training |
5 | and promulgated to insurers and employers making payments required by this section. Increases |
6 | shall be paid by insurers and employers without further order of the court. If payment payable |
7 | under this section is not paid within fourteen (14) days after the employer or insurer has been |
8 | notified or it becomes due, whichever is later, there shall be added to the unpaid payment an |
9 | amount equal to twenty percent (20%) of that amount, which shall be paid at the same time as, |
10 | but in addition to, the payment. |
11 | (6) This section applies only to payment of weekly indemnity benefits to employees as |
12 | described in subdivision (1) of this subsection, and does not apply to specific compensation |
13 | payments for loss of use or disfigurement or payment of dependency benefits or any other |
14 | benefits payable under the Wworkers' Ccompensation Aact. |
15 | (7) Notwithstanding any other provision of the general law or public laws to the contrary, |
16 | any employee of the state of Rhode Island who is receiving workers' compensation benefits for |
17 | total incapacity, as a result of brain injury due to a violent assault, on or before July 19, 2005, |
18 | shall be entitled to receive the health insurance benefit he or she was entitled to at the time of the |
19 | injury for the duration of the total incapacity or until said employee and his or her spouse are both |
20 | eligible for Medicare. |
21 | 28-33-18.3. Continuation of benefits -- Partial incapacity. -- (a) (1) For all injuries |
22 | occurring on or after September 1, 1990, in those cases where the employee has received a notice |
23 | of intention to terminate partial incapacity benefits pursuant to § 28-33-18, the employee, or his |
24 | or her duly authorized representative, may file with the workers' compensation court a petition for |
25 | continuation of benefits on forms prescribed by the workers' compensation court. In any |
26 | proceeding before the workers' compensation court on a petition for continuation of partial |
27 | incapacity benefits, where the employee demonstrates by a fair preponderance of the evidence |
28 | that his or her partial incapacity poses a material hindrance to obtaining employment suitable to |
29 | his or her limitation, partial incapacity benefits shall continue. For injuries on and after July 1, |
30 | 2016 2018, "material hindrance" is defined to include only compensable injuries causing a greater |
31 | than sixty-five percent (65%) degree of functional impairment and/or disability. Any period of |
32 | time for which the employee has received benefits for total incapacity shall not be included in the |
33 | calculation of the three hundred and twelve- (312) week (312) period. |
34 | (2) The provisions of this subsection apply to all injuries from Sept. 1, 1990, to July 1, |
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1 | 2016 2018. |
2 | (b) (1) Where any employee's incapacity is partial and has extended for more than three |
3 | hundred and twelve (312) weeks and the employee has proved an entitlement to continued |
4 | benefits under subsection (a) of this section, payments made to these incapacitated employees |
5 | shall be increased annually on the tenth (10th) day of May thereafter so long as the employee |
6 | remains incapacitated. The increase shall be by an amount equal to the total percentage increase |
7 | in the annual cConsumer pPrice iIndex, United States cCity aAverage for uUrban wWage |
8 | eEarners and cClerical wWorkers, as formulated and computed by the Bureau of Labor Statistics |
9 | of the United States Department of Labor for the period of March 1 to February 28 each year. |
10 | (2) "Index" as used in this section refers to the cConsumer pPrice iIndex, United States |
11 | cCity aAverage for uUrban wWage eEarners and cClerical wWorkers, as that index was |
12 | formulated and computed by the Bureau of Labor Statistics of the United States Department of |
13 | Labor. |
14 | (3) The annual increase shall be based upon the percentage increase, if any, in the |
15 | cConsumer pPrice iIndex for the month of a given year, over the index for February, the previous |
16 | year. Thereafter, increases shall be made on May 10 annually, based upon the percentage |
17 | increase, if any, in the cConsumer pPrice iIndex for the period of March 1 to February 28. |
18 | (4) The computations in this section shall be made by the director of labor and training |
19 | and promulgated to insurers and employers making payments required by this section. Increases |
20 | shall be paid by insurers and employers without further order of the court. If payment payable |
21 | under this section is not mailed within fourteen (14) days after the employer or insurer has been |
22 | notified by publication in a newspaper of general circulation in the state it becomes due, there |
23 | shall be added to the unpaid payment an amount equal to twenty percent (20%) of it, to be paid at |
24 | the same time as, but in addition to, the payment. |
25 | (5) This section applies only to payment of weekly indemnity benefits to employees as |
26 | described in subdivision (1) of this subsection, and does not apply to specific compensation |
27 | payments for loss of use or disfigurement or payment of dependency benefits or any other |
28 | benefits payable under the Wworkers' Ccompensation Aact. |
29 | (c) No petitions for commutation shall be allowed or entertained in those cases where an |
30 | employee is receiving benefits pursuant to this section. |
31 | SECTION 3. Section 28-35-12 of the General Laws in Chapter 28-35 entitled "Workers' |
32 | Compensation - Procedure" is hereby amended to read as follows: |
33 | 28-35-12. Petition for determination of controversy -- Contents and filing. -- (a) In |
34 | all disputes between an employer and employee in regard to compensation or any other obligation |
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1 | established under chapters 29 - 38 of this title, and when death has resulted from the injury and |
2 | the dependents of the deceased employee entitled to compensation are, or its apportionment |
3 | among them is, in dispute, any person in interest, or his or her duly authorized representative, |
4 | may file with the administrator of the workers' compensation court a petition, prescribed by the |
5 | court, setting forth the names and residences of the parties,; the facts relating to employment at |
6 | the time of injury,; the cause, extent, and character of the injury,; the amount of wages, earnings, |
7 | or salary received at the time of the injury,; and the knowledge of the employer of notice of the |
8 | occurrence of the injury,; and any other facts that may be necessary and proper for the |
9 | information of the court,; and shall state the matter in dispute and the claims of the petitioner with |
10 | reference to it; provided, that no petition shall be filed within twenty-one (21) days of the date of |
11 | the injury and no petition regarding any other obligation established under chapters 29 - 38 of this |
12 | title shall be filed until twenty-one (21) days after written demand for payment upon the employer |
13 | or insurer or written notice to the employer or insurer of failure to fulfill the obligation, except |
14 | that any petition alleging the non-payment or late payment of weekly compensation benefits, |
15 | attorneys' fees, and costs, may be filed after fourteen (14) days from the date the payment is due |
16 | as set forth in §§ 28-35-42, 28-35-43, and 28-35-20(c). All demands seeking payment of bills for |
17 | medical services rendered shall include reference to a claim number or a legible copy of the |
18 | agreement, order, and/or decree, if appropriate, establishing liability. Medical bills for services |
19 | ordered paid by decree or pretrial order shall be paid within fourteen (14) days of the entry of the |
20 | decree or order. In the event that the bills are not paid within the fourteen- (14) day (14) period, a |
21 | petition may be filed to enforce said order or decree without any additional written notice to the |
22 | employer or insurer. |
23 | (b) (1) If one or more claims are filed for an injury and there are two (2) or more insurers, |
24 | any one of which may be held to be liable to pay compensation, and the judge determines that the |
25 | injured employee would be entitled to receive compensation but for the existence of a controversy |
26 | as to which one of the insurers is liable to pay compensation, one of the insurers shall be selected |
27 | by a judge of the workers' compensation court, to pay to the injured employee the compensation, |
28 | pending a final decision of the workers' compensation court as to the matter in controversy, and |
29 | that decision shall require that the amount of compensation paid shall be deducted from the award |
30 | if made against another insurer and shall be paid by that other insurer to the insurer selected by |
31 | the judge. |
32 | (2) The workers' compensation court shall award compensation, costs, and attorneys' fees |
33 | in its discretion if one of the insurers is held to be liable following the hearing. |
34 | (c) If any determination of the workers' compensation court entitles an employee to |
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1 | retroactive payment of weekly benefits, the court shall award to the employee interest at the rate |
2 | per annum provided in § 9-21-10 on that retroactive weekly payment from six (6) months |
3 | subsequent to the date that the employee first filed a petition for benefits to the time when that |
4 | retroactive payment is actually made. If the proceedings are unduly delayed by or at the request |
5 | of the employee or his or her attorney, the judge may reduce or eliminate interest on retroactive |
6 | payment; provided, that the provisions of this section as they relate to interest shall apply only to |
7 | petitions filed on or after July 1, 1984. |
8 | (d) Any fine, penalty, or interest expense incurred by an insurer under this section may |
9 | not be used as an expense for the purpose of seeking a rate increase before the department of |
10 | business regulation. |
11 | SECTION 4. Sections 28-53-2 and 28-53-7 of the General Laws in Chapter 28-53 |
12 | entitled "Rhode Island Uninsured Employers Fund" are hereby amended to read as follows: |
13 | 28-53-2. Establishment -- Sources -- Administration. -- (a) There shall be established |
14 | within the department of labor and training a special restricted receipt account to be known as the |
15 | Rhode Island uninsured employers fund. The fund shall be capitalized from excise taxes assessed |
16 | against uninsured employers pursuant to the provisions of § 28-53-9 of this chapter and from |
17 | general revenues appropriated by the legislature. Beginning in state fiscal year ending June 30, |
18 | 2015 2016, the legislature may appropriate up to two million dollars ($2,000,000) in general |
19 | revenue funds annually for deposit into the Rhode Island uninsured employers fund. |
20 | (b) All moneys in the fund shall be mingled and undivided. The fund shall be |
21 | administered by the director of the department of labor and training or his or her designee, but in |
22 | no case shall the director incur any liability beyond the amounts paid into and earned by the |
23 | fund. |
24 | (c) All amounts owed to the uninsured employers fund from illegally uninsured |
25 | employers are intended to be excise taxes and as such, all ambiguities and uncertainties are to be |
26 | resolved in favor of a determination that such assessments are excise taxes. |
27 | 28-53-7. Payments to employees of uninsured employers. -- (a) Where it is determined |
28 | that the employee was injured in the course of employment while working for an employer who |
29 | fails to maintain a policy of workers' compensation insurance as required by Rhode Island general |
30 | laws § 28-36-1, et seq., the uninsured employers fund shall pay the benefits to which the injured |
31 | employee would be entitled pursuant to chapters 29 to 38 of this title subject to the limitations set |
32 | forth herein. |
33 | (b) The workers' compensation court shall hear all petitions for payment from the fund |
34 | pursuant to Rhode Island general laws § 28-30-1, et seq., provided, however, that the uninsured |
| LC005819/SUB A - Page 11 of 14 |
1 | employers fund and the employer shall be named as parties to any petition seeking payment of |
2 | benefits from the fund. |
3 | (c) Where an employee is deemed to be entitled to benefits from the uninsured |
4 | employers fund, the fund shall pay benefits for disability and medical expenses as provided |
5 | pursuant to chapters 29 to 38 of this title except that the employee shall not be entitled to receive |
6 | benefits for loss of function and disfigurement pursuant to the provisions of Rhode Island general |
7 | laws § 28-33-19. |
8 | (d) The fund shall pay cost, counsel and witness fees as provided in Rhode Island |
9 | general laws § 28-35-32 to any employee who successfully prosecutes any petitions for |
10 | compensation, petitions for medical expenses, petitions to amend a pretrial order or memorandum |
11 | of agreement and all other employee petitions and to employees who successfully defend, in |
12 | whole or in part, proceedings seeking to reduce or terminate any and all workers' compensation |
13 | benefits; provided, however, that the attorney's fees awarded to counsel who represent the |
14 | employee in petitions for lump sum commutation filed pursuant to Rhode Island general laws |
15 | § 28-33-25 or in the settlement of disputed cases pursuant to Rhode Island general laws § 28-33- |
16 | 25.1 shall be limited to the maximum amount paid to counsel who serve as court appointed |
17 | attorneys in workers' compensation proceedings as established by rule or order of the Rhode |
18 | Island supreme court. |
19 | (e) In the event that the uninsured employer makes payment of any monies to the |
20 | employee to compensate the employee for lost wages or medical expenses, the fund shall be |
21 | entitled to a credit for all such monies received by or on behalf of the employee against any future |
22 | benefits payable directly to the employee. |
23 | (f) This section shall apply to injuries that occur on or after January 1, 2015 2016. |
24 | SECTION 5. Section 36-10-31 of the General Laws in Chapter 36-10 entitled |
25 | "Retirement System-Contributions and Benefits" is hereby amended to read as follows: |
26 | 36-10-31. Deduction of amounts received from workers' compensation or as |
27 | damages. -- Any amount paid or payable under the provisions of any workers' compensation law |
28 | exclusive of Medicare set-aside allocations, specific compensation benefits or any benefits |
29 | authorized by the terms of a collective bargaining agreement or as the result of any action for |
30 | damages for personal injuries against the state of Rhode Island on account of the death or |
31 | disability of a member shall be offset against and payable in lieu of any benefits payable out of |
32 | funds provided by the state under the provisions of this chapter on account of the death or |
33 | disability of the member. If the value of the total commuted benefits under any workers' |
34 | compensation law or action is less than the present value on an actuarial basis of the benefits |
| LC005819/SUB A - Page 12 of 14 |
1 | otherwise payable under this chapter, the value of the commuted payments shall be deducted |
2 | from the present value of the benefits and the balance thereof shall be payable under the |
3 | provisions of this chapter. |
4 | SECTION 6. This act shall take effect upon passage. |
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LC005819/SUB A | |
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| LC005819/SUB A - Page 13 of 14 |
EXPLANATION | |
BY THE LEGISLATIVE COUNCIL | |
OF | |
A N A C T | |
RELATING TO LABOR AND LABOR RELATIONS - WORKERS' COMPENSATION - | |
GENERAL PROVISIONS | |
*** | |
1 | This act would make various changes to the procedure, and administration of the Rhode |
2 | Island workers' compensation court. |
3 | This act would take effect upon passage. |
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LC005819/SUB A | |
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| LC005819/SUB A - Page 14 of 14 |