MINUTES OF MEETING
ASSEMBLY COMMITTEE ON LABOR AND MANAGEMENT
Sixty-seventh Session
April 15, 1993
The Assembly Committee on Labor and Management was called to order by Chairman Chris Giunchigliani at 3:39 p.m., Thursday, April 15, 1993, in Room 119 of the Legislative Building, Carson City, Nevada. Exhibit A is the Meeting Agenda, Exhibit B is the Attendance Roster.
COMMITTEE MEMBERS PRESENT:
Ms. Chris Giunchigliani, Chairman
Mr. Bernie Anderson, Vice Chairman
Mr. Douglas A. Bache
Mr. John C. Bonaventura
Mr. John Carpenter
Mr. Tom Collins, Jr.
Mr. Peter G. Ernaut
Mr. Lynn Hettrick
Mrs. Erin Kenny
Mr. John B. Regan
Mr. Michael A. Schneider
COMMITTEE MEMBERS ABSENT:
None
GUEST LEGISLATORS PRESENT:
None
STAFF MEMBERS PRESENT:
Mr. Don W. Williams, Principal Research Analyst (LCB)
Mr. Frank Krajewski, Senior Research Analyst (LCB)
OTHERS PRESENT:
Mr. Danny Thompson, AFL-CIO; Mr. Blackie Evans, AFL-CIO; Mr. Scott Young, SIIS; Mr. Jim Jeppson, DIIR; Mr. Jack Jeffrey, Southern Nevada Building Trades Council; Mr. Scott Craigie, Governor's Office; Mr. L. Mark Balen, Professional Fire Fighters of Nevada; Mr. O. C. Lee, Nevada Conference of Police and Sheriffs; Mr. Larry Zimmerman, CDS of Nevada; Mr. Phil Dahn, IW433 (Las Vegas); and Mr. Dave Owen, Clark County School District (Las Vegas).
SENATE BILL NO. 316: Makes various changes to provisions
governing industrial insurance.
First item on the agenda to be discussed was the average monthly wage, primarily Section 292, including Sections 87 and 200.
Mr. Carpenter requested verification of the procedure to be used to approve amendments. Ms. Giunchigliani stated the committee would deal with all amendments at one time rather than trying to do it piecemeal. There was further discussion regarding the technical amendments and language.
Mr. Danny Thompson, Nevada State AFL-CIO, spoke in opposition to Section 292 - reduction in benefits. He stated the AFL-CIO did not feel the SIIS problem needed to be solved in five years, and by instituting managed care and utilization and review of case management, there was no need to reduce benefits. Ms. Giunchigliani clarified the AFL-CIO was opposed to the freeze in Section 292.
Mr. Blackie Evans, Nevada State AFL-CIO, reminded the committee the reduction in the state average wage also affected the temporary total disability (TTD), permanent total disability (PTD), the survivors' benefits and all the benefits an injured worker would receive. Mr. Evans explained workers' benefits were calculated at 66 2/3's of the state average wage, not of their salary. Mr. Carpenter requested a further explanation of the percentage of the state average wage in Section 87. Mr. Evans answered every July 1st, the Employment Security Department (ESD) conducted a survey and calculated the state average wage, which was tied into the benefit structure of SIIS.
Ms. Giunchigliani stated payment structure was currently the lesser of the monthly wage actually received or deemed to have been received and was not subject to the Nevada Industrial Act or the Nevada OSHA Act. New language was added which stated the date of the accident or injury to the employee must be determined and did not include any amount paid by the employer for health insurance covering an employee or dependents.
Mr. Evans explained insurance premiums being part of the state average wage had never been advocated or applied. Organized labor had never attempted to have insurance premiums considered as part of the state average wage.
Scott Young, SIIS, addressed Mr. Carpenter's concern about how the state average wage was currently computed. He deferred answering because there were people who calculated the claims with more expertise than he. Mr. Young volunteered to have a sample put together and brought back to the committee. Jim Jeppson, Division of Industrial Insurance Regulation (DIIR), further explained each year the DIIR established what the state average monthly wage was for indemnifcation benefits for injured workers' wages. The information was based on data the DIIR received from the Employment Security Department (ESD). He noted NRS 616.027 stated the average monthly wage would be 66 2/3 percent of 150 percent of the state average monthly wage. The maximum was $1,880.12 currently. If gross monthly salary exceeded $2,820.19, the benefit would be limited to the maximum average monthly wage. Mr. Jeppson continued his explanation of the calculation to determine benefits with the actual computation of 66 2/3 percent of 150 percent of the weekly wage multiplied by 4.33.
Jack Jeffrey, Southern Nevada Building Trades Council, added the formula was a "Daykinism."
Scott Craigie, of the Governor's office, stated the money received was equal to the state average wage and was tax free, yet it would be a hardship to people in the higher income brackets. Mr. Craigie referred to Section 292 and pointed out the wage freeze applied only to the TTD and did not apply to survivor benefits and other benefits; also line 46 of page 140 reflected the purpose of calculating benefits for a temporary total disability was then limited to one benefit.
Ms. Giunchigliani questioned the rationale for this, Mr. Craigie responded when the wage freeze was first discussed, it was discussed in the terms Mr. Evans described earlier, as being across the board. However when other changes were made to the PPD formula, it was agreed to limit the average monthly wage freeze to this one area so benefit packages were not double or triple hit. He added the TTD area had shown a 46 percent increase in the payments in the last 10 years. Ms. Giunchigliani reiterated the first 5 days of TTD were not paid for; there was a recommendation to freeze the TTD for two years and to change how the wages were factored.
Scott Young was asked to come forward by Ms. Giunchigliani to discuss the intent of Section 87 to not include the health insurance, and possibly lead into Section 200. Mr. Young informed the committee the purpose of Section 87 was to make certain the cost of health care insurance an employer provided did not get included in the average monthly wage. Mr. Young spoke of a previous case where a claimant asserted the health care premium should be included but the case was overturned by the district court. Mr. Young felt the matter could come up again and be met with an adverse ruling. SIIS would be forced to do one of two things: raise rates due to the higher benefit cost; or further risk having unfunded liabilities due to paying out benefits to claimants without charging a corresponding premium. Professor Larson who wrote the treatise on Worker's Compensation indicated this had never been done in the history of worker's compensation. The professor expressed concerns some employers might drop their health insurance coverage so they would not have a premium income.
Mr. Collins suggested an employer who did not provide insurance for his employees would not have premiums figured into average wage. Mr. Young agreed and added the same would hold true for vacation pay. Mr. Collins wanted to verify if the intent was to keep employers from dropping insurance. Mr. Young said yes, and if it were included, SIIS would have to increase the premiums on the employees to secure the increase of benefits of the injured worker.
Mr. Anderson questioned how to balance the primary wage earner finding insurance on his own while receiving benefits. Mr. Young felt SIIS dealt with the worker's compensation and if the case had not been overturned, SIIS would have had to pay higher benefits. Their only recourse would have been to raise premiums. Mr. Young felt that would be detrimental to the economy of the entire state. Mr. Anderson responded a person looking for work took into consideration the wage and the included benefits, and he wondered why these same concerns were not taken into consideration with an injured worker. Mr. Young clarified four or five states did take these concerns into consideration, and the United States Supreme Court ruled not to include it. Again, Mr. Young said, if it became law, SIIS would have to raise premiums. Mr. Anderson queried whether premium rates would have to be raised anyway in order to keep up with the wage factor. Mr. Young indicated other factors would eventually dictate the need for premium rate increases. This would simply be a factor making the rates go up even higher and again might have the adverse effect of encouraging some employers to drop it so their premium would remain lower. This was a provision that came out of the consensus group and it also was unanimously supported by the SIIS board.
Mr. Evans illustrated how expensive health care insurance could be for a laid-up worker - $400 to $500 per month. After thirty days an employer stopped paying the insurance premium for an injured worker creating a very serious problem. Organized labor had not advocated the cost of health care be included in the state average wage. Ms. Giunchigliani clarified current law prohibited health care policies from covering a workplace injury.
Ms. Giunchigliani asked Mr. Young to briefly explain Section 200 with regard to the subsequent injury fund. Mr. Young addressed the Harrison decision from the Supreme Court which was a complicated issue. Under NRS 616.625 worker's compensation benefits were based on the wage earned on the date of injury. Mr. Young explained briefly the Harrison case; Mr. Harrison fell off a scaffold, driving rebar through his leg and his leg did not heal. Eight years later, an infection in the wound site caused the leg to be amputated. Prior to Mr. Harrison's court case, SIIS analyzed wage rates according to the wage earned on the date of the injury. The Supreme Court decided to treat Mr. Harrison's amputation as a "new" injury, not resulting from the original fall. Mr. Harrison had not worked during the eight year period and did not have a current wage. The Supreme Court calculated a current wage for him. The Supreme Court stated in a footnote to the Harrison case it would only increase the wage rate in very rare instances. Over time the Harrison rule had been expanded and there were a significant number of cases receiving a much higher rate of benefit when the case was reopened and the employee went to permanently and totally disabled. There was no way of knowing today if an injured worker was a candidate for the application of the Harrison rule nor what their wage rate would be in the future. In effect, Mr. Young continued, what happened was a claim was reserved and premiums collected based on the given injury and the given wage, yet wound up paying benefits on a much higher wage. Mr. Young then introduced EXHIBIT C, a memo prepared for the Senate hearings on SIIS. Mr. Young defined significant numbers as three or four cases a month, which over time, amounted to a significant amount of money.
Ms. Giunchigliani wondered about a cost of living adjustment for individuals with rare cases. Mr. Young stated all persons receiving permanent total disability benefits prior to July 1, 1975 received a minimum $400 month payment. Mr. Young referred to EXHIBIT C and reviewed with the committee the vast differences in payments due to the Harrison rule. SIIS was now seeing an increasing trend toward more and more of these cases. In the past, SIIS used NRS 616.625 for the original wage base. Mr. Young agreed there was a reason why a person injured 10 or 15 years ago would want to try to apply the Harrison rule to themselves. He also stated the difficulty was in the area of fairness and how to adequately fund a case today when there was lifetime reopening. Ms. Giunchigliani asked if a person went back to work and had a new wage, would the new wage be taken into consideration. Mr. Young answered if an employee had a new injury he would be eligible for benefits under his current wage rate. If the injury was several years ago and the condition gradually deteriorated, under present law, an injured worker would have to live with the wage rate from the original injury date. Mr. Young added SIIS has new language proposed for the bill. He explained there was a doctrine named the "Last Injurious Exposure Rule." This rule decided which employer should be responsible when there has been a prior industrial injury and now there was a subsequent injury. Under law, if the second accident qualified as a true accident and met all the tests of the definition of an accident or injury, and there had been some significant addition to the underlying disability, the current employer would be responsible for that injury claim and the employee would get the higher wage rate. Section 200 currently undermined the "Last Injurious Exposure Rule," yet SIIS was not critical of the bill drafter. All of the attorneys at SIIS worked together and created a version that would eliminate the worst abuses of the Harrison rule, yet still preserve the "Last Injurious Exposure Rule" while making it clear a new injury on the job today, would warrant today's wage, not the old wage.
Ms. Giunchigliani reiterated in a re-injury to the original injury, the Subsequent Injury Fund would come in as long as there was a rating over six percent and the previous employer would not be liable. The most recent employer was the one who would have the impact on the premium rate or mod factor.
Mr. Anderson mentioned a scenario about a high-paying employee making over the state average wage, involved in an industrial accident, who was put back to work in a lower paying position but as a result of those injuries decided he could no longer work. He asked how the wage determination was made -- from the original higher wage position when the injury occurred or the lower wage position when the employee left employment. Mr. Young answered the employee would receive the higher wage from the first job. Mr. Young also mentioned another Supreme Court case, the Anderson case, in which the individual had an industrial injury, could not return to the same job, took another job at a lower rate of pay, and experienced a re-injury. SIIS took the stand under NRS 616.625, the injured worker had to take the lower pay rate of the second job because of the new injury. The Supreme Court decided to overturn the SIIS decision allowing the employee to go to the higher wage because it was not fair and penalized the employee who went back to work and got hurt again. Mr. Scott said Section 200, (the new language proposed), could potentially impose some changes on the Anderson case. The new language might still have an impact on the Supreme Court's decision on Anderson. Ms. Giunchigliani requested Mr. Young to remember the incentive was to get the injured worker back to work.
Mr. Schneider questioned Mr. Young on the benefits paid for life on a partial or permanent disability and the Supreme Court. Mr. Young responded a life payment was not a Supreme Court ruling. If a person could not return to any type of gainful employment he was reasonably suited for, he become PT (permanent and total) or a pensioner. He would then receive a monthly check for the rest of his life based on his wage on the date of injury, based on 66 2/3 of that wage. Mr. Schneider wondered if a partial disability would be paid until retirement age. Mr. Young stated permanent partial disability (PPD) was calculated through age 70, but could be taken in a lump sum. Mr. Young added if someone was permanently and totally disabled and he improved enough to be able to return to work, he would then be taken off benefits and expected to go to back to work. It had happened in some instances, injured workers had recovered from a severe injury, been able to work and their pension was stopped.
Lynn Grandlund, GWC, offered testimony as shown in EXHIBIT D with no further comment.
The next section discussed was Section 187, Re-opening of Claims. Mark Balen, Professional Fire Fighters of Nevada, stated their recommendation was to offer an amendment to Section 187 by removing all new language in the bracketed areas and returning to the current language in the bill. Ms. Giunchigliani clarified Mr. Balen referred to all new language inclusive in Section 187. Ms. Giunchigliani asked if this area affected the heart and lung. Mr. Balen said yes, and allowed for re-opening of heart and lung injuries.
Mr. Carpenter agreed the new language was confusing and suggested a rewrite. Mr. Balen concurred and stated the new language required extra hoops for fire fighters to jump through to re-open a case.
O. C. Lee represented the police officers of the state of Nevada and he stated he and his organization concured with Mr. Balen's testimony on Section 187.
Ms. Kenny expressed an interest in the rationale the Senate used to put in this new language after Mr. Balen and Mr. Lee had expressed their concerns. Mr. Balen told the committee they were not allowed to voice their concerns, simply not given the opportunity.
Ms. Giunchigliani summed up Section 187 dealt with the re-opening rights, but this section also had an effect on the heart and lung. She stated what the consensus legislation did in the interim committee was to retain the re-opening but have specific areas which eliminated the abuses and some language. She noted the bill did not come back that way but she would see if something could be worked out and brought back to the committee.
Mr. Young addressed Mr. Balen's and Mr. Lee's concern. The consensus group tryed to straighten out the problems of the re-opening aspects of Section 187, although the group was not specifically thinking about the re-opening provision dealing with heart and lung. Mr. Young stated what would meet Mr. Balen's and Mr. Lee's needs was to delete Section 233. That, in effect, would leave Section 8 in NRS 617.457 which would mean the new re-opening provisions would not apply to the heart and lung statutes. SIIS had no intent to change that. SIIS was looking at, in Section 187, lifetime re-opening rights. Employers and insurers felt lifetime re-opening rights were somehow excessive. There were many instances where an injured worker would need lifetime re-opening rights, with the best example being hip replacement. Hip replacements do wear out and need replacement over time and if it was the result of a work injury, the employee should have it replaced for the rest of their life. SIIS had a problem with re-opening with claimants closing their claim and getting their PPD award without being completely healed. Sometimes within a short period of time these same claimants would come in and re-open their claim because they had not been completely recovered at the time of their closure and award. The current law states if a claim was closed and a worker wanted to re-open it, they had to show they had worsened medically, the worsening was related to the industrial injury, and they had a doctor's certificate indicating some kind of treatment. He explained the change being proposed stated if a worker tried to re-open during the first year after the claim was closed, they would have to show by "clear and convincing evidence" treatment was now needed and was related to the industrial injury. After one year a claim could be re-opened by "preponderance of evidence" the condition was the result of an industrial injury. SIIS felt this law would take care of the abuses as well as some of the confusion. Mr. Young felt the language in Section 187 was clearly understood and would take care of legal problems surrounding lifetime re-opening without abolishing lifetime re-opening.
Mr. Lee expanded on what Mr. Young had stated. He addressed Section 233, in reference to heart and lung. Larry Zimmerman suggested deleting the entire section to address the heart and lung issue Mr. Lee referred to.
Mr. Collins verified the deletion of Section 233 with Ms. Giunchigliani.
Mr. Zimmerman asked for questions from the committee. Ms. Giunchigliani asked for clarification of the "clear and convincing" language and how it was interpreted. Mr. Young replied the consensus group used the "clear and convincing" language. The normal burden of proof was a "preponderance" and was roughly 51 percent, while "clear and convincing" was somewhere in the neighborhood of 90 percent, a much higher evidentiary standard. The reason for that language, "clear and convincing," was if an injured worker was going to try and re-open within the first year, the treatment would have to be clearly established and a result of the industrial injury. The language was agreed upon by everyone within the consensus group, including the trial lawyers.
There was a brief discussion regarding the adoption of the new language in reference to re-opening claims. Mr. Young stated a worker would need a doctor stating their medical condition was worse than it was when the claim closed and the worsening was related to the industrial injury. Mr. Anderson wondered how to handle a claimant with a prosthesis that no longer functioned properly. Mr. Young answered a doctor would have to verify a worsening of condition. Mr. Zimmerman explained the worker received forms stating the closure of their claim. If there was no change, the claim stayed closed. Mr. Anderson asked who made the final determination if a claim should be closed. Mr. Zimmerman responded the injured worker always had the right to appeal the determination of the insured through the hearing officer.
Ms. Giunchigliani read from NRS 616.545, and noted the issue was this language would eliminate most of the abuses of the right to re-open identified by insurers and would retain lifetime re-opening. It would impose a one year waiting period before a claim could be re-opened unless there were exceptional circumstances. In order to re-open within one year of claim closure, the injured employee would have to demonstrate there had been objective change in medical condition, and the primary cause of the change was due to the industrial injury. The injured worker would have to prove this by "clear and convincing" medical evidence and in all other cases the injured worker would have to wait one year from the claim closure before the claim would be eligible for re-opening.
Mr. Lee expressed a problem with understanding why there was a price-tag savings allocated to this particular section of the bill, yet there was no access of those numbers. This implied to Mr. Lee someone would not get a benefit. Mr. Lee called attention to earlier testimony a workmen's compensation claim could not be paid by the medical insurance program. Mr. Lee questioned who would pay the medical bills if a worker was injured, his pain increased, there was no medical evidence to prove his pain, his medical insurance would not pay it, and workmen's compensation would not pay it.
Mr. Zimmerman rebutted Mr. Lee stating there was no prohibition in re-opening the claim; there were, however, certain standards to be met to re-open. If the appeals process denied the re-opening request, there was a one-year waiting period. Ms. Giunchigliani asked about the issue of pain. Mr. Young justified Mr. Lee's statements. If a worker experienced pain without medical evidence of a structural change to the injured area, this case would fall under palliative care, which made a person feel better but did not actually improve the condition. Historically, most jurisdictions did not allow an injured worker to keep a claim open to receive palliative care. Once a worker was declared to be stable (healthy as medicine could make one), his claim was closed. Pain alone was not enough.
Mr. Thompson declared the AFL-CIO did not participate in the consensus group and the AFL-CIO did not support this section.
Ms. Kenny mentioned the concern with soft tissue injuries which were non-documentable. She further stated there were many studies indicating in workmen's compensation claims nationwide 80 percent of claims were not where most of the money was spent. It was the remaining 15 to 20 percent of the problem claims of which the majority were back injuries. Ms. Kenny questioned how SIIS was handling the pain aspect for the worker when most pain increased several weeks after the injury. Mr. Young responded under current law, pain was not addressed in the fashion Ms. Kenny was talking about. He also stated pain was subjective with no way to verify it and subject to abuse.
Ms. Kenny recognized the primary goal was to get the worker back to work and there was certainly a financial incentive for a worker to return to work as soon as possible. She raised the issue of the worker, who due to financial reasons, asked his doctor for early release back to work, then re-injured the same injury. How many people put in a financial quandary made a bad decision to return early to work and were further hurt by SIIS's rulings. Mr. Zimmerman acknowledged many workers returned to work while continuing SIIS benefits. Ms. Kenny restated the scenario of an employee who wanted to get out of the system and get back to work due to financial stress. Mr. Zimmerman reiterated the statute did not prohibit re-opening, there was just a certain standard to meet. He assured Ms. Kenny a new injury to the old injury, an aggravation, would be considered a new claim.
Ms. Giunchigliani pointed out pain currently is considered in the AMA Guides as a factor.
Mr. Craigie returning to Section 233, stated that language is in the present statute NRS 617.457. He felt total elimination would create a devastating impact on volunteer firemen. He emphasized the governor's position all along has been Subsection 8 should remain in this language and no changes should be made in the area of re-openers or in other areas relating to the stress language, and there should be no changes which could in any way impact the benefits given to policemen and firemen. He further asked that Subsection 8 remain in Section 233. Ms. Giunchigliani restated when SB 316 is passed in whatever format, the committee would not reduplicate what is currently in statute.
Mr. Regan asked Mr. Craigie if brackets from line 46 to line 2 could be removed or the language removed. Mr. Craigie requested the brackets be removed and the language in Subsection 8 remain in the law.
Mr. Carpenter felt the language needed to be rewritten so the ordinary person would not have to get a lawyer to understand it. Mr. Young informed Mr. Carpenter SIIS would be happy to work with the bill drafters to simplify the language. The difficulty came when lawyers picked each word apart and Mr. Young agreed to work with LCB to come up with more comprehensible language.
Mr. Young followed up on Mr. Thompson's remark regarding Section 187 and felt labor organizations might have a different understanding about the section due to his possible poor explanation or something had changed. SIIS had the understanding everyone agreed to the language and approach. Mr. Young volunteered to speak with the labor representatives to correct any misunderstandings or changes. Ms. Giunchigliani expressed appreciation to Mr. Young for discussing any potential problems with labor. Mr. Young agreed with Mr. Thompson and expressed his concern with the term consensus group not being the best term. What the group did resulted in a consensus but there were not many groups represented. Ms. Giunchigliani stated the interim committee weighed and adopted the language to be worked on this session, but the language was not necessarily the same. She asked Don Williams to work with Larry Zimmerman and various members to point out what language from SB 316 might not be accurate or might be different.
Mr. Thompson wished to clarify for Mr. Young the AFL-CIO position. He said any negotiations he had been involved in had been a give-and-take situation, but if everything he had agreed to was put into a bill and everything he disagreed to was put in the same bill, there was nowhere to go. Basically that was where the AFL-CIO felt they were now - with nowhere to go.
Mr. Ernaut stated Section 97 addressed the needs test and those abuses in the first year and raises the standard regardless of whether it was in the first year or beyond. In either the test of clear and convincing or preponderance, a worker must show primary cause in both and that was the change in current law, Mr. Young replied. Mr. Ernaut asked how should the committee address the abuses, the subjective things such as pain. Mr. Ernaut referred to Ms. Kenny's earlier statements regarding being released to work before being ready and wondered if there was the potential for malpractice. Mr. Thompson, while not having the answers to Mr. Ernaut's questions, again restated his position on negotiation as a give-and-take situation. He felt the benefit reduction had not been a give-and-take situation. Mr. Ernaut wanted to know exactly what the AFL-CIO wanted, and Mr. Thompson replied every time the AFL-CIO had agreed to something, they had to give something up. Mr. Ernaut asked Mr. Thompson for some ideas to mull over and talk about. Ms. Giunchigliani said overall the committee needed to find out from business, labor, doctors, attorneys, injured workers, everybody that was affected in this realm, what language the committee could react to, something to work with.
Ms. Kenny responded to Mr. Ernaut's statement about malpractice. She stated there were two ways patients could leave care; one was to ask to be removed and the doctor could agree; and two was the patient did not show up and was automatically relieved from care. It had nothing to do with malpractice.
Mr. Zimmerman directed the committee's attention to Subsection 9, line 24 which refered to a claim automatically closed pursuant to Subsection 2 of NRS 616.567 which might not be re-opened pursuant to this section. The claims to be closed automatically were those claims that had not reached the threshold of $200. If the claimant was insured by the system and did not receive medical treatment for his injury for at least six months, the claimant could not appeal the closing of that claim. Mr. Zimmerman explained the statute provided any claim not reaching $200 would close automatically after a six month period where there was no further treatment assuming all treatment needed was given. He believed if there would be a new standard, and an injured worker could not open a claim costing less than $200, there was no need to limit it to the State Industrial Insurance System but should also apply to self-insured employers. Mr. Zimmerman also responded to Mr. Lee's statement on re-opening. The consensus group was formed a year ago March and many hours were spent working on the consensus language. They did not have in mind putting any price tags on any deduction in benefits. The price was not a factor in the consensus group's deliberations.
Ms. Giunchigliani moved the meeting on to the Benefit Decisions, Sections 12 through 19 of the primary sections. She related this section was the attempt to streamline the form process. Instead of using C3 (EXHIBIT E) and C4 (EXHIBIT F), there would be one form. Mr. Zimmerman stated the present statute, NRS 616.500, had been faulty for the past 50 years. Essentially how it would work was if an employee was injured on the job, he would report the injury or accident to the appropriate person and fill out a form in duplicate. One copy was for the employer, the other for the employee. The worker had a receipt stating he had reported it to his employer within 30 days. The injured worker would then have 90 days to seek medical treatment. Within three days of treating the injured worker, the doctor had to send a form to the employer and to the administrator or insurer handling the claim. The form currently used was the C4 form, and Mr. Zimmerman briefly explained what information should be included in each section.
Mr. Carpenter, in referring to Section 14, understood it to say an employer, within six days after being notified of a claim for compensation from a medical doctor, or the employee sought medical treatment, needed to complete the report. Mr. Carpenter asked if NRS 616.500 would remain and if an employer had only six days to fill out the form. Mr. Zimmerman explained the form discussed was the C3 form and it must be sent in within six days of the incident whether the employee went to the doctor or not. With this change, the report would only have to be sent to SIIS if the employer knew the worker sought medical care. The employee had to notify his employer he had been injured within 30 days of the incident. There was a brief discussion on form C3 with Mr. Carpenter suggesting there was confusion with the form. Mr. Zimmerman explained the form was basically documentation for the employer verifying the worker reported the injury within the 30 day time frame. Ms. Giunchigliani suggested Section 166 should preclude Section 14. Mr. Zimmerman agreed with Ms. Giunchigliani the bill drafters did not have the steps in line. She stated the intent was to streamline the process. Ms. Giunchigliani discussed with Mr. Zimmerman the forms required to be submitted to SIIS for claim notification. Mr. Zimmerman reported the forms were required by DIR for SIIS and self-insured employers. Ms. Giunchigliani said DIR would be the proper authority to create the forms regardless if it only impacted SIIS. She asked, in Subsection 4, would it make better sense to say, "if medical treatment occurs" instead of "a $200 deductible" an employer insured by the system was not required to report. Mr. Zimmerman agreed it would be cleaner rather than to tie it to a dollar figure.
Mr. Carpenter wondered how an employer would handle the deductible. Mr. Zimmerman deferred an answer to Mr. Carpenter's query because it was not his territory but agreed with Mr. Carpenter the way it was written was fraught with problems and needed a lot of work.
Ms. Giunchigliani summed up Section 15 as just dealing with the acceptance or denial of a claim within 14 working days. She suggested reposting Sections 16, 17, 18 and 19 due to the late hour.
Philip Dahn, a probono injured employee advocate, referred to Section 15. Mr. Dahn asked what recourse an injured worker had if the insurer denied and did not want to accept responsibility. Did the employee have to wait 135 days as proposed in the new bill and what was the procedure an injured worker should follow. Mr. Zimmerman responded with every denial, an appeal form was sent. Ms. Giunchigliani reiterated nothing changed from current statute with the exception of extending the time from 14 days to 30 working days for a determination from SIIS. Mr. Dahn was concerned about the injured worker who had to wait six months to get a final determination on his case. Ms. Giunchigliani said she would make note of the determination time during the hearings and appeals meetings scheduled for next week.
Dave Owen, Director of Risk Management for Clark County School District, stated the district has approximately 800 compensable claims yearly. He briefly discussed the reports required for SIIS and DIR and expressed the Clark County School District's support of the form changes and determination times review. Ms. Giunchigliani asked Mr. Owen if a school district employee could use his sick leave currently for workmen's compensation. Mr. Owen referred to NRS 281.390 which allowed all public employees to augment statutory benefits with available sick leave balances and said he had testified to the Senate on this subject. Ms. Giunchigliani verified a public employee could use his sick leave during the five day waiting period prior to SIIS benefits commencing only if they had days to use. Mr. Owen stated many private employers in the Las Vegas area have their own methods of augmenting the statutory benefit on a voluntary basis.
Mr. Lee asked the committee members if they were finished with the heart and lung areas. Ms. Giunchigliani responded no and wanted the committee to note two sections should be listed under benefit decisions, Section 233 and Section 234, and those wwould be reposted.
There being no further business to come before committee, the meeting was adjourned at 5:53 p.m.
RESPECTFULLY SUBMITTED:
JUDY HANNA
Committee Secretary
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Assembly Committee on Labor and Management
April 15, 1993
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