Dear Client,
A NUMBER OF NEW WORKERS'
COMPENSATION LAWS HAVE JUST BEEN SIGNED BY THE GOVERNOR THAT YOU NEED TO KNOW
ABOUT!
These
new laws significantly impact workers' compensation carriers and the handling
of workers' compensation claims. Below
please find a list of the significant workers' compensation bills that have
been signed into law by the Governor, including a link to the text of each
bill, the effective date and a summary of the new law.
HB10-1038
- Workers' Comp Claims Process Brochure - Effective May 26, 2010
The employer/insurance carrier MUST provide the claimant a brochure
describing the claims process and informing the claimant of his/her rights at
the same time the employer/insurance carrier files the required admission,
denial or notice of contest with the Division.
The brochure is only required in claims for compensation in excess of
three days lost time or a claim for permanent disability. Click here for a copy of the 2010 Required Brochure published by the Division. SB10-012 - Workers'
Comp Benefits Knowing Penalty -Effective August 11, 2010-
Increases penalties for violations of the act,
rules or orders up to $1,000 per day
(instead of $500).
-
Lowers the threshold from willfully to knowingly to obtain penalties for failure to pay
medical benefits within 30 days.
SB10-076- Unreasonable Insurance Claims Practices - Effective May 17, 2010 Provides that it is an unfair
method of competition and unfair or deceptive act or practice to base the
compensation of claims administrators on: - the number of policies canceled
- the number of times coverage is denied
- the use of a quota for the number of claims
- the use of an arbitrary quota or cap limiting or
- by restricting the amount of claims payments without
due consideration of the merits of the claim.
- Workers' Compensation Procedures - Effective March 31, 2010 A number of statutory changes were made to the Workers' Compensation Act in
2009. Originally, these provisions only
applied to claims filed on or after August 5, 2009. However,
the following
provisions now apply to all workers'
compensation claims, regardless of the date the claim was filed: -
Division IME
doctors can not contact treatment providers or doctors who have evaluated the claimant prior to
writing their report.
-
Division IME
doctors are prohibited from requiring
a claimant to perform repeat testing when the initial testing results were
valid.
-
Respondents must assert a claim for overpayment within one year after the existence
of the overpayment becomes known.
-
A party
seeking to modify an issue determined by a general or final admission, summary
order, or a full order must bear the burden of proof for any such
modification.
-
Any issue for which a hearing is pending at the time shall proceed to the hearing without the need for the
applicant to re-file the application for hearing on the issue.
-
An IME physician must complete a written report and provide
it to both parties simultaneously and record the IME.
In addition, the following new provisions now apply
to all new and pending workers' compensation claims: -
The Director of must establish a single life expectancy table
-
Respondents must pay any lump sum settlement
funds within 15 days after receiving the executed settlement order.
-
All
documents must be transmitted or served
in the same manner or by the same means to all required recipients.
SB10-011-
Workers' Comp Conflicts Of Interest - DIME Strike Provision applies to
requests for DIMEs made on or after July 1, 2010; Other provisions effective
May 27, 2010
-
Prior to striking a DIME doctor, the
striking party is entitled to obtain a summary disclosure of
business/financial/employment/advisory relationship information between the physician and
the respondents. No party is required to provide its determination to strike
the DIME until receipt and "reasonable opportunity" to review the summary
disclosure
-
No insurer, etc., shall pay or receive any
financial remuneration designed to encourage a claim to be denied. This constitutes bad faith and the person
paying/receiving remuneration shall be subject to penalties.
-
Prohibits
a treating doctor from communicating with the employer/insurer about an injured
worker unless the injured worker is present OR the authorized treatment
provider makes an accurate written record of the communication and provides it
to both parties.
SB10-013
- Workers' Compensation Accountability (Survey)- Effective July 1, 2010 - Requires
each insurer/employer to survey claimant regarding claimant's satisfaction with
the insurer for claims that are reported to the DWC.
- Requires insurer/employer to report the
survey results annually to the DWC.
SB 10-187- Concerning Workers'
Compensation- All provisions
apply to injuries occurring on or after July 1, 2010 except law regarding adjustment
of benefit caps goes into effect on January 1, 2011
-
"Wages"
DOES NOT include any other advantage or fringe benefit not specifically
mentioned in the statute (i.e. the cost to continue or replace health
insurance, tips, room & board and lodging received from the employer).
-
The cost of continuing or replacing Medicaid and
other indigent health care programs are not included in calculating the average
weekly wage.
- If a Respondent denies a request for ATP recommended post-MMI treatment by
filing an Application for Hearing but then subsequently agrees to pay the cost
of medical treatment fewer than 20 days before the hearing, Respondents will be required to pay
claimant the costs (not attorney fees) of obtaining medical maintenance
benefits.
-
Average weekly was is calculated as of the date
of the employee's accident (not as of "date of disablement" as suggested in
the Avalanche court case).
-
No
Social Security offset on permanent partial benefits (only temporary and
permanent total disability benefits).
- No requirement for an employee to file for
Social Security Disability Benefits upon request of the Respondents.
-
A modified offer of employment that would
either: (1) require claimant to travel a distance of greater than 50 miles
one way than claimant's pre-injury commute is not sufficient to terminate
TTD; (2) or would be impracticable for the claimant to accept considering the
totality of the claimant's circumstances is not sufficient to terminate TTD
benefits.
-
Requires the Division adjust the benefit caps
annually ($75,000/$150,000)
-
Proposes
that a claimant can get a lump sum of permanent partial benefits without
waiving a claim for permanent total benefits.
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