2018 -- S 2593

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LC004654

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     STATE OF RHODE ISLAND

IN GENERAL ASSEMBLY

JANUARY SESSION, A.D. 2018

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A N   A C T

RELATING TO LABOR AND LABOR RELATIONS -- WORKERS' COMPENSATION --

BENEFITS

     

     Introduced By: Senators Lombardi, McCaffrey, Lynch Prata, Jabour, and Nesselbush

     Date Introduced: March 01, 2018

     Referred To: Senate Judiciary

     It is enacted by the General Assembly as follows:

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     SECTION 1. Sections 28-33-2, 28-33-12, 28-33-19, 28-33-22 and 28-33-44 of the

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General Laws in Chapter 28-33 entitled "Workers' Compensation - Benefits" are hereby amended

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to read as follows:

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     28-33-2. Injuries occasioned by willful intent or intoxication.

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     No compensation shall be allowed for the injury or death of an employee occasioned by

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his or her willful intention to bring about the injury or death of himself or herself or another,

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where it is proved that his or her injury or death was occasioned by that conduct, or that the injury

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or death resulted from his or her intoxication or unlawful use of controlled substances as defined

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in chapter 28 of title 21. If the employer establishes that, at the time of the injury or death or

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immediately following the injury or death, the employee had positive blood test results reflecting

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the presence of alcohol, or another controlled substance as defined in chapter 28 of title 21, which

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was not prescribed by an authorized medical practitioner or was not used in accordance with the

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prescribed use of the drug, it shall be presumed that the employee was intoxicated at the time of

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the injury and that intoxication occasioned the injury. Once the employer has produced such

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positive test results, the burden of proof shall be on the employee, to overcome the presumptions,

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by establishing that the employee was not intoxicated at the time of the injury and that

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intoxication did not occasion the injury or death.

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     28-33-12. Death benefits payable to dependents.

 

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     (a) (1) If death results from the injury, the employer shall pay the dependents of the

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employee wholly dependent upon his or her earnings for support at the time of his or her injury or

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death, whichever is the greater in number, a weekly payment equal to the rate that would have

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been payable for total incapacity to the deceased employee under the provisions of § 28-33-17,

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except as provided in this section in case the dependent is the surviving spouse or child under the

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age of eighteen (18) of that employee.

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     (2) If the dependent is a surviving spouse, or surviving spouse upon whom there is

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dependent one or more children of the deceased employee including an adopted child or stepchild

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under the age of eighteen (18) years or over that age but physically or mentally incapacitated

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from earning, the employer shall pay the surviving spouse the weekly rate for total incapacity the

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deceased employee would have been entitled to receive under the provisions of § 28-33-17 plus

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forty dollars ($40.00) per week for each dependent child.

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     (3) "Child" within the meaning of this section also includes any child of the injured

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employee conceived but not born at the time of the employee's injury, and the compensation

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provided for in this section shall be payable on account of any child from the date of its birth.

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     (b) Upon the remarriage or death of the surviving spouse or if there is no surviving

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spouse then upon the death of the injured employee, the compensation payable under this chapter

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shall subsequently be paid to those dependent child or children of the injured employee, and if

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there is more than one child the compensation shall be divided equally among them and the

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compensation shall be not more than the weekly rate for total incapacity due the injured employee

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under the provisions of § 28-33-17 for the dependent child plus forty dollars ($40.00) for each

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additional dependent child.

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     (c) If the employee leaves dependents only partly dependent upon his or her earnings for

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support at the time of his or her injury or death, the employer shall pay that dependent from the

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date of the injury or death, whichever is greater in number, a weekly compensation equal to the

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amount of the average weekly contribution by the employee to the partial dependents, not

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exceeding the weekly payments provided in this section for the benefit of wholly dependent

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persons.

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     (d) When weekly payments have been made to an injured employee before his or her

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death, the compensation to dependents shall begin from the date of the last of those payments;

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and provided, that if the deceased leaves no dependents at the time of the injury or death, the

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employer shall not be liable to pay compensation under chapters 29 -- 38 of this title except as

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specifically provided in § 28-33-16.

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     (e) Except in the case of a dependent child physically or mentally incapacitated from

 

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earning, dependency benefits for each child shall terminate when that dependent child attains his

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or her eighteenth (18th) birthday; provided, that the payment of dependency benefits to a

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dependent child over the age of eighteen (18) years shall continue as long as that child is

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satisfactorily enrolled as a full-time student in an educational institution or an educational facility

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duly accredited or approved by the appropriate state educational authorities at the time of

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enrollment. Those payments shall not be continued beyond the age of twenty-three (23) years.

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     (f) When a surviving spouse without dependent children remarries, benefits payable

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under this section shall cease on the date of the remarriage.

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     (g) A surviving spouse entitled to benefits under this section shall receive an annual cost

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of living increase as referred to in § 28-33-17(f)(1) of four percent (4%) on every anniversary of

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the date of death for so long as he or she is eligible for benefits under this section.

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     28-33-19. Additional compensation for specific injuries.

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     (a) (1) In case of the following specified injuries there shall be paid in addition to all

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other compensation provided for in chapters 29 to 38 of this title a weekly payment equal to one-

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half (1/2) of the average weekly earnings of the injured employee, but in no case more than ninety

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dollars ($90.00) nor less than forty-five dollars ($45.00) per week. In case of the following

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specified injuries that occur on or after January 1, 2012, there shall be paid in addition to all other

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compensation provided for in chapters 29 to 38 of this title a weekly payment equal to one-half

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(1/2) of the average weekly earnings of the injured employee, but in no case more than one

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hundred eighty dollars ($180) nor less than ninety dollars ($90.00) per week. Payment made

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under this section shall be made in a one time payment unless the parties otherwise agree.

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Payment shall be mailed within fourteen (14) days of the entry of a decree, order, or agreement of

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the parties:

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     (i) For the loss by severance of both hands at or above the wrist, or for the loss of the arm

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at or above the elbow or for the loss of the leg at or above the knee, or both feet at or above the

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ankle, or of one hand and one foot, or the entire and irrecoverable loss of the sight of both eyes,

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or the reduction to one-tenth (1/10) or less of normal vision with glasses, for a period of three

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hundred twelve (312) weeks; provided, that for the purpose of this chapter the Snellen chart

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reading (20/200) shall equal one-tenth (1/10) of normal vision or a reduction of ninety percent

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(90%) of the vision. Additionally, any loss of visual performance including, but not limited to,

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loss of binocular vision, other than direct visual acuity may be considered in evaluating eye loss;

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     (ii) For the loss by severance of either arm at or above the elbow, or of either leg at or

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above the knee, for a period of three hundred twelve (312) weeks;

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     (iii) For the loss by severance of either hand at or above the wrist for a period of two

 

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hundred forty-four (244) weeks;

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     (iv) For the entire and irrecoverable loss of sight of either eye, or the reduction to one-

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tenth (1/10) or less of normal vision with glasses, or for loss of binocular vision for a period of

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one hundred sixty (160) weeks;

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     (v) For the loss by severance of either foot at or above the ankle, for a period of two

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hundred five (205) weeks;

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     (vi) For the loss by severance of the entire distal phalange of either thumb for a period of

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thirty-five (35) weeks; and for the loss by severance at or above the second joint of either thumb,

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for a period of seventy-five (75) weeks;

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     (vii) For the loss by severance of one phalange of either index finger, for a period of

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twenty-five (25) weeks; for the loss by severance of at least two (2) phalanges of either index

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finger, for a period of thirty-two (32) weeks; for the loss by severance of at least three (3)

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phalanges of either index finger, for a period of forty-six (46) weeks;

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     (viii) For the loss by severance of one phalange of the second finger of either hand, for a

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period of sixteen (16) weeks; for the loss by severance of two (2) phalanges of the second finger

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of either hand, for a period of twenty-two (22) weeks; for the loss by severance of three (3)

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phalanges of the second finger on either hand, for a period of thirty (30) weeks;

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     (ix) For the loss by severance of one phalange of the third finger of either hand, for a

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period of twelve (12) weeks; for the loss by severance of two (2) phalanges of the third finger of

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either hand, for a period of eighteen (18) weeks; for the loss by severance of three (3) phalanges

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of a third finger of either hand, for a period of twenty-five (25) weeks;

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     (x) For the loss by severance of one phalange of the fourth finger of either hand, for a

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period of ten (10) weeks; for the loss by severance of two (2) phalanges of the fourth finger of

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either hand, for a period of fourteen (14) weeks; for the loss by severance of three (3) phalanges

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of a fourth finger of either hand, for a period of twenty (20) weeks;

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     (xi) For the loss by severance of one phalange of the big toe on either foot, for a period of

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twenty (20) weeks; for the loss by severance of two (2) phalanges of the big toe of either foot, for

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a period of thirty-eight (38) weeks; for the loss by severance at or above the distal joint of any

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other toe than the big toe, for a period of ten (10) weeks for each such toe;

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     (xii) For partial loss by severance for any of the injuries specified in paragraphs (1)(i) --

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(1)(xi) of this subsection, proportionate benefits shall be paid for the period of time that the

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partial loss by severance bears to the total loss by severance.

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     (2) Where any bodily member or portion of it has been rendered permanently stiff or

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useless, compensation in accordance with the above schedule shall be paid as if the member or

 

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portion of it had been completely severed; provided, that if the stiffness or uselessness is less than

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total, then compensation shall be paid for that period of weeks in proportion to the applicable

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period where the member or portion of it has been completely severed as the instant percentage of

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stiffness or uselessness bears to the total stiffness or total uselessness of the bodily members or

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portion of them.

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     (3) In case of the following specified injuries there shall be paid in addition to all other

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compensation provided for in chapters 29 -- 38 under this title a weekly payment equal to one-

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half (1/2) of the average weekly earnings of the injured employee, but in no case more than ninety

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dollars ($90.00) nor less than forty-five dollars ($45.00) per week. Payment under this subsection

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shall be made in a one time payment unless the parties otherwise agree. Payment shall be mailed

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within fourteen (14) days of the entry of a decree, order, or agreement of the parties:

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     (i) For permanent disfigurement of the body the number of weeks may not exceed five

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hundred (500) weeks, which sum shall be payable in a one time payment within fourteen (14)

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days of the entry of a decree, order, or agreement of the parties in addition to all other sums under

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this section wherever it is applicable.

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     (4) (i) Loss of hearing due to industrial noise is recognized as an occupational disease for

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purposes of chapters 29 -- 38 of this title and occupational deafness is defined to be a loss of

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hearing in one or both ears due to prolonged exposure to harmful noise in employment. Harmful

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noise means sound capable of producing occupational deafness.

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     (ii) Hearing loss shall be evaluated pursuant to protocols established by the workers'

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compensation medical advisory board. All treatment consistent with this subsection shall be

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consistent with the protocols established by the workers' compensation medical advisory board

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subject to § 28-33-5.

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     (iii) If the employer has conducted baseline screenings within one (1) year of exposure to

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harmful noise to evaluate the extent of an employee's pre-existing hearing loss, the causative

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factor shall be apportioned based on the employee's pre-existing hearing loss and subsequent

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occupational hearing loss, and the compensation payable to the employee shall only be that

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portion of the compensation related to the present work-related exposure.

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     (iv) There shall be payable as permanent partial disability for total occupational deafness

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of one ear, seventy-five (75) weeks of compensation; for total occupational deafness of both ears,

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two hundred forty-four (244) weeks of compensation; for partial occupational deafness in one or

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both ears, compensation shall be paid for any periods that are proportionate to the relation which

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the hearing loss bears to the amount provided in this subdivision for total loss of hearing in one or

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both ears, as the case may be. For the complete loss of hearing for either ear due to external

 

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trauma or by other mechanism, acuity loss shall be paid pursuant to this subsection.

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     (v) No benefits shall be granted for tinnitus, psychogenic hearing loss, congenital hearing

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loss, recruitment or hearing loss above three thousand (3,000) hertz.

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     (vi) The provisions of this subsection and the amendments insofar as applicable to

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hearing loss shall be operative as to any occupational hearing loss that occurs on or after

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September 1, 2003, except for acuity hearing loss related to a single event which shall become

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effective upon passage.

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     (vii) If previous hearing loss, whether occupational or not, is established by an

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audiometric examination or other competent evidence, whether or not the employee was exposed

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to assessable noise exposure within one year preceding the test, the employer is not liable for the

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previous loss, nor is the employer liable for a loss for which compensation has previously been

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paid or awarded. The employer is liable only for the difference between the percent of

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occupational hearing loss determined as of the date of the audiometric examination conducted by

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a certified audiometric technician using an audiometer which meets the specifications established

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by the American National Standards Institute (ANSI 3.6-1969, ri973) used to determine

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occupational hearing loss and the percentage of loss established by the baseline audiometric

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examination. An amount paid to an employee for occupational hearing loss by any other

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employer shall be credited against compensation payable by the subject employer for the hearing

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loss. The employee shall not receive in the aggregate greater compensation from all employers

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for occupational hearing loss than that provided in this section for total occupational hearing loss.

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A payment shall not be paid to an employee unless the employee has worked in excessive noise

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exposure employment for a total period of at least one hundred eighty (180) days for the

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employer for whom compensation is claimed.

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     (viii) No claim for occupational deafness may be filed until six (6) months separation

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from the type of noisy work for the last employer in whose employment the employee was at any

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time during the employment exposed to harmful noise.

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     (ix) The total compensation due for hearing loss is recovered from the employer who last

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employed the employee in whose employment the employee was last exposed to harmful noise

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and the insurance carrier, if any, on the risk when the employee was last so exposed, and if the

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occupational hearing loss was contracted while the employee was in the employment of a prior

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employer, and there was no baseline testing by the last employer, the employer and insurance

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carrier which is made liable for the total compensation as provided by this section may petition

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the worker's compensation court for an apportionment of the compensation among the several

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employers which since the contraction of the hearing loss have employed the employee in a noisy

 

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environment.

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     (b) Where payments are required to be made under more than one clause of this section,

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payments shall be made in a one time payment unless the parties otherwise agree. Payment shall

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be mailed within fourteen (14) days of the entry of a decree, order, or agreement of the parties.

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     (c) Payments pursuant to this section, except paragraph (a)(3)(ii) of this section, shall be

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made only after an employee's condition as relates to loss of use has reached maximum medical

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improvement as defined in § 28-29-2(8) and as found pursuant to § 28-33-18(b).

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     (d) An employer or insurer shall be entitled to recover any overpayments made for

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indemnity benefits, by a set-off against payments due to an employee for loss of use or

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disfigurement paid pursuant to this section.

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     28-33-22. Minors employed in violation of law.

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     (a) If, at the time of the injury, the injured employee is a minor employed in violation of

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any law of this state or of the United States relating to the employment of minors, then the

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compensation payable shall be treble the amount which would have been payable if that minor

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had been legally employed; provided, however, notwithstanding any law to the contrary, such

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additional compensation shall be paid solely by the employer as a penalty and not by or through

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coverage under a policy of workers' compensation insurance, and no policy of workers'

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compensation insurance shall be deemed to provide coverage for such additional compensation.

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     (b) In fixing the amount of any compensation under chapters 29 -- 38 of this title due

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allowance shall be made for any sum which the employer may have paid to any injured minor

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employee or to his dependents on account of the injury, except those sums that the employer may

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have expended or directed to be expended for medical, surgical, or hospital service.

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     28-33-44. Continuation of health insurance benefits.

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     (a) No employer shall cancel but shall be obligated to continue to provide any employee's

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health insurance benefits for a period of two (2) years from the date of the employee's receiving

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weekly compensation benefits pursuant to a preliminary determination or a decision of the

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workers' compensation court, or the filing at the department of a memorandum of agreement or

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notice of direct payment for injuries occurring on or before February 28, 1986. The provisions of

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this section shall not apply if:

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     (1) The employee is no longer receiving compensation pursuant to a preliminary

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determination or a decision of the workers' compensation court;

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     (2) Has accepted suitable alternative employment;

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     (3) Fails to pay any contribution toward the health care benefits that he or she was

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required to pay prior to the injury;

 

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     (4) A petition for a commutation or a structured settlement, as defined in § 28-33-25, is

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granted;

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     (5) The employee is a beneficiary of an equivalent health insurance policy of his or her

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spouse; or

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     (6) The employee is employed in the construction industry and is a participant in a multi-

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employer welfare plan as defined in the Employee Retirement Income Security Act of 1974, 29

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U.S.C. § 1002 et seq., and which the Internal Revenue Service has determined under the Internal

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Revenue Code, 26 U.S.C. § 101 et seq., is tax exempt as to contributions received and as to

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benefits received by its participants.

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     (b) In the event any employer fails to comply with the provisions of this section, then the

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employer, and not its workers' compensation insurance carrier, shall be liable for hospital and

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medical costs that would have been paid by the hospital or medical insurance plan afforded the

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employee had he or she been covered by the plan.

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     (c) The provisions of this section shall only apply to claims for injuries sustained on or

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after July 1, 1984.

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     SECTION 2. Section 28-36-5 of the General Laws in Chapter 28-36 entitled "Workers'

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Compensation - Insurance" is hereby amended to read as follows:

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     28-36-5. Policy provisions as to liability of employer and insurer.

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     Every policy shall cover the entire liability of the employer under chapters 29 -- 38 of this

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title, except for appeals from an order of the retirement board filed pursuant to the provisions of

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Rhode Island General Law § 45-21.2-9, and for the penalty provisions retained in § 28-33-22 and

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the provisions of §§ 28-33-44 and 28-33-47, and shall contain an agreement by the insurer to the

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effect that the insurer shall be directly and primarily liable to the employee and, in the event of

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his death, to his or her dependents, to pay to him, her, or them the compensation, if any, for which

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the employer is liable.

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     SECTION 3. This act shall take effect upon passage.

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EXPLANATION

BY THE LEGISLATIVE COUNCIL

OF

A N   A C T

RELATING TO LABOR AND LABOR RELATIONS -- WORKERS' COMPENSATION --

BENEFITS

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     This act would allow for employers, in workers' compensation actions, to shift the legal

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burden to employees to prove they were not intoxicated at the time of injury or death, after a

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showing by the employer that the employee had a positive test for intoxicating substances at or

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immediately following the injury or death. It would also provide an annual cost of living increase

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for surviving spouses in workers' compensation actions based upon the Consumer Price Index and

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exclude any employee from receiving workers' compensation benefits during any period of their

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imprisonment, including home confinement. This act would also allow for employers or insurers

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to recover overpayment made for indemnity benefits by set-off payments due for loss of use or

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disfigurement. This act would also require that employers bear sole responsibility for treble

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damages, as a penalty, if the injured employee is a minor employed in violation of any law.

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     This act would take effect upon passage.

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