Assembly Bill No. 326–Committee on Commerce and Labor
February 25, 1999
____________
Referred to Committee on Commerce and Labor
SUMMARY—Makes various changes concerning industrial insurance. (BDR 53-105)
FISCAL NOTE: Effect on Local Government: Yes.
Effect on the State or on Industrial Insurance: Yes.
~
EXPLANATION – Matter in
bolded italics is new; matter between brackets
THE PEOPLE OF THE STATE OF NEVADA, REPRESENTED IN SENATE AND ASSEMBLY, DO ENACT AS FOLLOWS:
1-1
Section 1. NRS 616A.070 is hereby amended to read as follows: 616A.070 "Benefit penalty" means an additional amount of money1-3
that , except as otherwise provided in NRS 616D.120 and section 14 of1-4
this act, is payable to a claimant if the administrator has determined that a1-5
violation of any of the provisions of paragraphs (a) to (d), inclusive, of1-6
subsection 1 of NRS 616D.120 has occurred.1-7
Sec. 2. NRS 616A.465 is hereby amended to read as follows: 616A.465 1. Except as otherwise provided in this section, the1-9
division shall:1-10
(a) Regulate insurers pursuant to chapters 616A to 617, inclusive, of1-11
NRS; and2-1
(b) Investigate insurers regarding compliance with statutes and the2-2
division’s regulations.2-3
2. The commissioner is responsible for reviewing rates, investigating2-4
the solvency of insurers, authorizing private carriers pursuant to chapter2-5
680A of NRS and certifying:2-6
(a) Self-insured employers pursuant to NRS 616B.300 to 616B.330,2-7
inclusive, and 616B.336;2-8
(b) Associations of self-insured public or private employers pursuant to2-9
NRS 616B.350 to 616B.446, inclusive; and2-10
(c) Third-party administrators pursuant to chapter 683A of NRS.2-11
3. The department of administration is responsible for contested claims2-12
relating to industrial insurance pursuant to NRS 616C.310 to 616C.385,2-13
inclusive. The administrator is responsible for administrative appeals2-14
pursuant to NRS 616B.215.2-15
4. The Nevada attorney for injured workers is responsible for legal2-16
representation of claimants pursuant to NRS 616A.435 to 616A.460,2-17
inclusive, and 616D.120.2-18
5. The division is responsible for the investigation of complaints.2-19
Except as otherwise provided in subsection 3 of section 14, if a complaint2-20
is filed with the division, the administrator shall cause to be conducted an2-21
investigation which includes a review of relevant records and interviews of2-22
affected persons. If the administrator determines that a violation may have2-23
occurred, the administrator shall proceed in accordance with the provisions2-24
of NRS 616D.120 and 616D.130.2-25
Sec. 3. Chapter 616C of NRS is hereby amended by adding thereto a2-26
new section to read as follows:2-27
1. An injured employee who wishes to participate in the selection of2-28
the rating physician or chiropractor who will determine the percentage of2-29
his disabilities pursuant to NRS 616C.490 must notify the insurer of his2-30
employer within 30 days after that insurer notifies him of his option to2-31
participate in such selection. The insurer shall, within 10 days after2-32
receiving such notice from an injured employee, notify the administrator.2-33
The administrator shall, within 10 days after receiving such notice from2-34
an insurer, provide to the injured employee and the insurer a list with the2-35
names of five physicians or chiropractors who are on the list of qualified2-36
physicians and chiropractors designated by the administrator pursuant to2-37
NRS 616C.490. The administrator shall select the five names of2-38
physicians or chiropractors in rotation from the list according to their2-39
area of specialization and the order in which their names appear on the2-40
list.2-41
2. Within 15 days after the administrator deposits in the mail or2-42
otherwise delivers the list of names of physicians or chiropractors to the2-43
injured employee and the insurer, the administrator shall hold a3-1
conference to allow the injured employee and insurer to challenge the3-2
selection of physicians or chiropractors. If the injured employee or the3-3
insurer demonstrates good cause why he cannot attend the scheduled3-4
conference, the administrator may continue the conference once, for not3-5
more than 7 days. At the conference:3-6
(a) The injured employee and the insurer are each entitled to exercise3-7
two peremptory challenges.3-8
(b) After the injured employee and insurer have exercised their3-9
challenges, if more than one name remains on the list, the administrator3-10
shall select the rating physician or chiropractor who will determine the3-11
extent of the injured employee’s disabilities.3-12
The insurer shall schedule an appointment with the physician or3-13
chiropractor selected by the administrator.3-14
Sec. 4. NRS 616C.100 is hereby amended to read as follows: 616C.100 1. If an injured employee disagrees with the percentage of3-16
disability determined by a physician or chiropractor, the injured employee3-17
may obtain a second determination of the percentage of disability. If the3-18
employee wishes to obtain such a determination, he must select the next3-19
physician or chiropractor in rotation from the list of qualified physicians or3-20
chiropractors maintained by the administrator pursuant to section 3 of this3-21
act and subsection 2 of NRS 616C.490. If a second determination is3-22
obtained, the injured employee shall pay for the determination. If the3-23
physician or chiropractor selected to make the second determination3-24
finds a higher percentage of disability than the first physician or3-25
chiropractor, the insurer shall pay to the employee an amount equal to3-26
the maximum allowable fee established by the administrator pursuant to3-27
NRS 616C.260 for the type of service performed, or the usual fee of that3-28
physician or chiropractor for such service, whichever is less.3-29
2. The results of a second determination made pursuant to subsection 13-30
may be offered at any hearing or settlement conference.3-31
Sec. 5. NRS 616C.175 is hereby amended to read as follows: 616C.175 1.3-33
3-34
3-35
(a) Has a preexisting condition from a cause or origin that did not arise3-36
out of or in the course of his current or past employment; and3-37
(b)3-38
arising out of and in the course of his employment which aggravates,3-39
precipitates or accelerates his preexisting condition,3-40
shall be deemed to be an injury by accident that is compensable pursuant3-41
to the provisions of chapters 616A to 616D, inclusive, of NRS, unless3-42
3-43
4-1
4-2
resulting condition.4-3
2.4-4
4-5
4-6
(a) Sustains an injury by accident arising out of and in the course of his4-7
employment; and4-8
(b)4-9
accelerates the injury in a manner that does not arise out of and in the4-10
course of his employment,4-11
shall be deemed to be an injury by accident that is compensable pursuant4-12
to the provisions of chapters 616A to 616D, inclusive, of NRS, unless the4-13
insurer can prove by clear and convincing evidence that the injury4-14
described in paragraph4-15
condition.4-16
Sec. 6. NRS 616C.330 is hereby amended to read as follows: 616C.330 1. The hearing officer shall:4-18
(a) Within 5 days after receiving a request for a hearing, set the hearing4-19
for a date and time within 30 days after his receipt of the request;4-20
(b) Give notice by mail or by personal service to all interested parties to4-21
the hearing at least 15 days before the date and time scheduled; and4-22
(c) Conduct hearings expeditiously and informally.4-23
2. The notice must include a statement that the injured employee may4-24
be represented by a private attorney or seek assistance and advice from the4-25
Nevada attorney for injured workers.4-26
3. If necessary to resolve a medical question concerning an injured4-27
employee’s condition, the hearing officer may refer the employee to a4-28
physician or chiropractor chosen by the hearing officer. If the medical4-29
question concerns the rating of a permanent disability, the hearing officer4-30
may refer the employee to a rating physician or chiropractor. The rating4-31
physician or chiropractor must be selected in rotation from the list of4-32
qualified physicians and chiropractors maintained by the administrator4-33
pursuant to section 3 of this act and subsection 2 of NRS 616C.490, unless4-34
the insurer and injured employee otherwise agree to a rating physician or4-35
chiropractor. The insurer shall pay the costs of any medical examination4-36
requested by the hearing officer.4-37
4. The hearing officer may allow or forbid the presence of a court4-38
reporter and the use of a tape recorder in a hearing.4-39
5. The hearing officer shall render his decision within 15 days after:4-40
(a) The hearing; or4-41
(b) He receives a copy of the report from the medical examination he4-42
requested.5-1
6. The hearing officer shall render his decision in the most efficient5-2
format developed by the chief of the hearings division of the department of5-3
administration.5-4
7. The hearing officer shall give notice of his decision to each party by5-5
mail. He shall include with the notice of his decision the necessary forms5-6
for appealing from the decision.5-7
8. Except as otherwise provided in NRS 616C.380, the decision of the5-8
hearing officer is not stayed if an appeal from that decision is taken unless5-9
an application for a stay is submitted by a party. If such an application is5-10
submitted, the decision is automatically stayed until a determination is5-11
made on the application. A determination on the application must be made5-12
within 30 days after the filing of the application. If, after reviewing the5-13
application, a stay is not granted by the hearing officer or an appeals5-14
officer, the decision must be complied with within 10 days after the refusal5-15
to grant a stay.5-16
Sec. 7. NRS 616C.360 is hereby amended to read as follows: 616C.360 1. A stenographic or electronic record must be kept of the5-18
hearing before the appeals officer and the rules of evidence applicable to5-19
contested cases under chapter 233B of NRS apply to the hearing.5-20
2. The appeals officer must hear any matter raised before him on its5-21
merits, including new evidence bearing on the matter.5-22
3. If necessary to resolve a medical question concerning an injured5-23
employee’s condition, the appeals officer may refer the employee to a5-24
physician or chiropractor chosen by the appeals officer. If the medical5-25
question concerns the rating of a permanent disability, the appeals officer5-26
may refer the employee to a rating physician or chiropractor. The rating5-27
physician or chiropractor must be selected in rotation from the list of5-28
qualified physicians or chiropractors maintained by the administrator5-29
pursuant to section 3 of this act and subsection 2 of NRS 616C.490, unless5-30
the insurer and the injured employee otherwise agree to a rating physician5-31
or chiropractor. The insurer shall pay the costs of any examination5-32
requested by the appeals officer.5-33
4. Any party to the appeal or the appeals officer may order a transcript5-34
of the record of the hearing at any time before the seventh day after the5-35
hearing. The transcript must be filed within 30 days after the date of the5-36
order unless the appeals officer otherwise orders.5-37
5. The appeals officer shall render his decision:5-38
(a) If a transcript is ordered within 7 days after the hearing, within 305-39
days after the transcript is filed; or5-40
(b) If a transcript has not been ordered, within 30 days after the date of5-41
the hearing.6-1
6. The appeals officer may affirm, modify or reverse any decision6-2
made by the hearing officer and issue any necessary and proper order to6-3
give effect to his decision.6-4
Sec. 8. NRS 616C.440 is hereby amended to read as follows: 616C.440 1. Except as otherwise provided in this section and NRS6-6
616C.175, every employee in the employ of an employer, within the6-7
provisions of chapters 616A to 616D, inclusive, of NRS, who is injured by6-8
accident arising out of and in the course of employment, or his dependents6-9
as defined in chapters 616A to 616D, inclusive, of NRS, is entitled to6-10
receive the following compensation for permanent total disability:6-11
(a) In cases of total disability adjudged to be permanent, compensation6-12
per month of 66 2/3 percent of the average monthly wage.6-13
(b) If there is a previous disability, as the loss of one eye, one hand, one6-14
foot or any other previous permanent disability, the percentage of6-15
disability for a subsequent injury must be determined by computing the6-16
percentage of the entire disability and deducting therefrom the percentage6-17
of the previous disability as it existed at the time of the subsequent injury,6-18
but such a deduction for a previous award for permanent partial disability6-19
must be made in a reasonable manner and must not be more than the total6-20
amount which was paid for the previous award for permanent partial6-21
disability.6-22
(c) If the character of the injury is such as to render the employee so6-23
physically helpless as to require the service of a constant attendant, an6-24
additional allowance may be made so long as such requirements continue,6-25
but the allowance may not be made while the employee is receiving6-26
benefits for care in a hospital or facility for intermediate care pursuant to6-27
the provisions of NRS6-28
2. Except as otherwise provided in NRS 616B.185 and 616B.186, an6-29
injured employee or his dependents are not entitled to accrue or be paid6-30
any benefits for a permanent total disability during the time the injured6-31
employee is incarcerated. The injured employee or his dependents are6-32
entitled to receive such benefits when the injured employee is released6-33
from incarceration if he is certified as permanently totally disabled by a6-34
physician or chiropractor.6-35
3. An employee is entitled to receive compensation for a permanent6-36
total disability only so long as the permanent total disability continues to6-37
exist. The insurer has the burden of proving that the permanent total6-38
disability no longer exists.6-39
4. If an employee who has received compensation in a lump sum for a6-40
permanent partial disability pursuant to NRS 616C.495 is subsequently6-41
determined to be permanently and totally disabled, the compensation for6-42
the permanent total disability must be reduced as follows:7-1
(a) If the employee has not received a minimum lump sum, the7-2
7-3
compensation for the permanent total disability an amount equal to the7-4
monthly installment rate for awards for permanent partial disability until7-5
the7-6
insurer has deducted an amount that equals the amount it has already7-7
paid out as a lump sum; or7-8
(b) If the employee received a minimum lump sum, the7-9
insurer of the employee’s employer shall deduct from the compensation for7-10
the permanent total disability an amount of not more than 10 percent of the7-11
rate of compensation for a permanent total disability until the lump sum is7-12
recovered.7-13
The provisions of this subsection are retroactive for all claims for7-14
compensation for a permanent total disability remaining open on7-15
7-16
Sec. 9. NRS 616C.475 is hereby amended to read as follows: 616C.475 1. Except as otherwise provided in this section, NRS7-18
616C.175 and 616C.390, every employee in the employ of an employer,7-19
within the provisions of chapters 616A to 616D, inclusive, of NRS, who is7-20
injured by accident arising out of and in the course of employment, or his7-21
dependents, is entitled to receive for the period of temporary total7-22
disability, 66 2/3 percent of the average monthly wage.7-23
2. Except as otherwise provided in NRS 616B.185 and 616B.186, an7-24
injured employee or his dependents are not entitled to accrue or be paid7-25
any benefits for a temporary total disability during the time the injured7-26
employee is incarcerated. The injured employee or his dependents are7-27
entitled to receive such benefits when the injured employee is released7-28
from incarceration if he is certified as temporarily totally disabled by a7-29
physician or chiropractor.7-30
3. If a claim for the period of temporary total disability is allowed, the7-31
first payment pursuant to this section must be issued by the insurer within7-32
14 working days after receipt of the initial certification of disability and7-33
regularly thereafter.7-34
4. Any increase in compensation and benefits effected by the7-35
amendment of subsection 1 is not retroactive.7-36
5. Payments for a temporary total disability must cease when:7-37
(a) A physician or chiropractor determines that the employee is7-38
physically capable of any gainful employment for which the employee is7-39
suited, after giving consideration to the employee’s education, training and7-40
experience;7-41
(b) The employer offers the employee light-duty employment or7-42
employment that is modified according to the limitations or restrictions7-43
imposed by a physician or chiropractor pursuant to subsection 7; or8-1
(c) Except as otherwise provided in NRS 616B.185 and 616B.186, the8-2
employee is incarcerated.8-3
6. Each insurer may, with each check that it issues to an injured8-4
employee for a temporary total disability, include a form approved by the8-5
division for the injured employee to request continued compensation for8-6
the temporary total disability.8-7
7. A certification of disability issued by a physician or chiropractor8-8
must:8-9
(a) Include the period of disability and a description of any physical8-10
limitations or restrictions imposed upon the work of the employee;8-11
(b) Specify whether the limitations or restrictions are permanent or8-12
temporary; and8-13
(c) Be signed by the treating physician or chiropractor authorized8-14
pursuant to NRS 616B.515 or 616B.527.8-15
8. If certification of disability specifies that the physical limitations or8-16
restrictions are temporary, the employer of the employee at the time of his8-17
accident is not required to comply with NRS 616C.545 to 616C.575,8-18
inclusive, and 616C.590 or the regulations adopted by the division8-19
governing vocational rehabilitation services if the employer offers the8-20
employee a position that8-21
(a) Is substantially similar to the employee’s position at the time of his8-22
injury in relation to the location of the employment8-23
required to work ; and8-24
(b) Provides a gross wage that is equal to or greater than the gross8-25
wage the employee was earning at the time of his injury.8-26
Sec. 10. NRS 616C.490 is hereby amended to read as follows: 616C.490 1. Except as otherwise provided in NRS 616C.175, every8-28
employee, in the employ of an employer within the provisions of chapters8-29
616A to 616D, inclusive, of NRS, who is injured by an accident arising out8-30
of and in the course of employment is entitled to receive the compensation8-31
provided for permanent partial disability. As used in this section,8-32
"disability" and "impairment of the whole man" are equivalent terms.8-33
2. Within 30 days after receiving from a physician or chiropractor a8-34
report indicating that the injured employee may have suffered a permanent8-35
disability and is stable and ratable, the insurer shall provide the injured8-36
employee with written notification that he may participate, pursuant to8-37
the provisions of section 3 of this act, in the selection of a rating8-38
physician or chiropractor who will determine the percentage of the8-39
injured employee’s disability. Unless the injured employee notifies the8-40
insurer that he will participate in the selection of the rating physician or8-41
chiropractor within 30 days after receiving the written notification that8-42
the employee may participate, the insurer shall schedule an appointment8-43
with a rating physician or chiropractor .9-1
9-2
chiropractor from a group of rating physicians and chiropractors9-3
designated by the administrator, to determine the percentage of disability9-4
in accordance with the American Medical Association’s Guides to the9-5
Evaluation of Permanent Impairment as adopted and supplemented by the9-6
division pursuant to NRS 616C.110. Rating physicians and chiropractors9-7
must be selected in rotation from the list of qualified physicians and9-8
chiropractors designated by the administrator, according to their area of9-9
specialization and the order in which their names appear on the list.9-10
3. At the request of the insurer, the injured employee shall, before an9-11
evaluation by a rating physician or chiropractor is performed, notify the9-12
insurer of:9-13
(a) Any previous evaluations performed to determine the extent of any9-14
of the employee’s disabilities; and9-15
(b) Any previous injury, disease or condition sustained by the employee9-16
which is relevant to the evaluation performed pursuant to this section.9-17
The notice must be on a form approved by the administrator and provided9-18
to the injured employee by the insurer at the time of the insurer’s request.9-19
4. Unless the regulations adopted pursuant to NRS 616C.110 provide9-20
otherwise, a rating evaluation must include an evaluation of the loss of9-21
motion, sensation and strength of an injured employee if the injury is of a9-22
type that might have caused such a loss. No factors other than the degree of9-23
physical impairment of the whole man may be considered in calculating9-24
the entitlement to compensation for a permanent partial disability. A rating9-25
evaluation of the spinal region must determine the percentage of9-26
disability as it existed before any surgical procedures were performed on9-27
the spinal region, unless the physician or chiropractor determines that9-28
the injured employee experienced major complications from the surgical9-29
procedure. If the physician or chiropractor determines that an injured9-30
employee experienced major complications from a surgical procedure9-31
performed on the spinal region, he shall include the effect of the9-32
complications when determining the percentage of disability of that9-33
injured employee.9-34
5. The rating physician or chiropractor shall provide the insurer with9-35
his evaluation of the injured employee. After receiving the evaluation, the9-36
insurer shall, within 14 days, provide the employee with a copy of the9-37
evaluation and notify the employee:9-38
(a) Of the compensation to which he is entitled pursuant to this section;9-39
or9-40
(b) That he is not entitled to benefits for permanent partial disability.9-41
6. Each 1 percent of impairment of the whole man must be9-42
compensated by a monthly payment:10-1
(a) Of 0.5 percent of the claimant’s average monthly wage for injuries10-2
sustained before July 1, 1981;10-3
(b) Of 0.6 percent of the claimant’s average monthly wage for injuries10-4
sustained on or after July 1, 1981, and before June 18, 1993;10-5
(c) Of 0.54 percent of the claimant’s average monthly wage for injuries10-6
sustained on or after June 18, 199310-7
(d) Of 0.6 percent of the claimant’s average monthly wage for injuries10-8
sustained on or after October 1, 1999.10-9
Compensation must commence on the date of the injury or the day10-10
following the termination of temporary disability compensation, if any,10-11
whichever is later, and must continue on a monthly basis for 5 years or10-12
until the claimant is 70 years of age, whichever is later.10-13
7. Compensation benefits may be paid annually to claimants who will10-14
be receiving less than $100 a month.10-15
8. Where there is a previous disability, as the loss of one eye, one10-16
hand, one foot, or any other previous permanent disability, the percentage10-17
of disability for a subsequent injury must be determined by computing the10-18
percentage of the entire disability and deducting therefrom the percentage10-19
of the previous disability as it existed at the time of the subsequent injury.10-20
9. The division may adopt schedules for rating permanent disabilities10-21
resulting from injuries sustained before July 1, 1973, and reasonable10-22
regulations to carry out the provisions of this section.10-23
10. The increase in compensation and benefits effected by the10-24
amendment of this section is not retroactive for accidents which occurred10-25
before July 1, 1973.10-26
11. This section does not entitle any person to double payments for the10-27
death of an employee and a continuation of payments for a permanent10-28
partial disability, or to a greater sum in the aggregate than if the injury had10-29
been fatal.10-30
Sec. 11. NRS 616C.555 is hereby amended to read as follows: 616C.555 1. A vocational rehabilitation counselor shall develop a10-32
plan for a program of vocational rehabilitation for each injured employee10-33
who is eligible for vocational rehabilitation services pursuant to NRS10-34
616C.590. The counselor shall work with the insurer and the injured10-35
employee to develop a program that is compatible with the injured10-36
employee’s age, sex and physical condition.10-37
2. If the counselor determined in the written assessment developed10-38
pursuant to NRS 616C.550 that the injured employee has existing10-39
marketable skills, the plan must consist of job placement assistance only.10-40
When practicable, the goal of job placement assistance must be to aid the10-41
employee in finding a position which pays a gross wage that is equal to or10-42
greater than 80 percent of the gross wage that he was earning at the time of10-43
his injury. An injured employee must not receive job placement assistance11-1
for more than 90 days after the date on which he was notified that he is11-2
eligible only for job placement assistance because:11-3
(a) He was physically capable of returning to work; or11-4
(b) It was determined that he had existing marketable skills.11-5
3. If the counselor determined in the written assessment developed11-6
pursuant to NRS 616C.550 that the injured employee does not have11-7
existing marketable skills, the plan must consist of a program which trains11-8
or educates the injured employee and provides job placement assistance.11-9
Except as otherwise provided in NRS 616C.560, such a program must not11-10
exceed11-11
11-12
11-13
11-14
11-15
11-16
11-17
11-18
11-19
4. A plan for a program of vocational rehabilitation must comply with11-20
the requirements set forth in NRS 616C.585.11-21
5. A program of vocational rehabilitation must not commence before11-22
the treating physician or chiropractor, or an examining physician or11-23
chiropractor determines that the injured employee is capable of safely11-24
participating in the program.11-25
6. If, based upon the opinion of a treating or an examining physician11-26
or chiropractor, the counselor determines that an injured employee is not11-27
eligible for vocational rehabilitation services, the counselor shall provide a11-28
copy of the opinion to the injured employee, the injured employee’s11-29
employer and the insurer.11-30
7. A plan for a program of vocational rehabilitation must be signed by11-31
a certified vocational rehabilitation counselor.11-32
8. If an initial program of vocational rehabilitation pursuant to this11-33
section is unsuccessful, an injured employee may submit a written request11-34
for the development of a second program of vocational rehabilitation11-35
which relates to the same injury. An insurer shall authorize a second11-36
program for an injured employee upon good cause shown.11-37
9. If a second program of vocational rehabilitation pursuant to11-38
subsection 8 is unsuccessful, an injured employee may submit a written11-39
request for the development of a third program of vocational rehabilitation11-40
which relates to the same injury. The insurer, with the approval of the11-41
employer who was the injured employee’s employer at the time of his11-42
injury, may authorize a third program for the injured employee. If such an11-43
employer has terminated operations, his approval is not required for12-1
authorization of a third program. An insurer’s determination to authorize12-2
or deny a third program of vocational rehabilitation may not be appealed.12-3
10. The division shall adopt regulations to carry out the provisions of12-4
this section. The regulations must specify the contents of a plan for a12-5
program of vocational rehabilitation.12-6
Sec. 12. NRS 616C.560 is hereby amended to read as follows: 616C.560 1. A program for vocational rehabilitation developed12-8
pursuant to subsection 3 of NRS 616C.555 may be extended:12-9
(a) Without condition or limitation, by the insurer at his sole discretion;12-10
or12-11
(b) In accordance with this section if:12-12
(1) The injured employee makes a written request to extend the12-13
program within 30 days after he receives written notification that he is12-14
eligible for vocational rehabilitation services; and12-15
(2) There are exceptional circumstances which make it unlikely that12-16
the injured employee will obtain suitable gainful employment as a result of12-17
vocational rehabilitation which is limited to the period for which he is12-18
eligible.12-19
An insurer’s determination to grant or deny an extension pursuant to12-20
paragraph (a) may not be appealed.12-21
2. If an injured employee has incurred a permanent physical12-22
impairment of less than 11 percent:12-23
(a) The total length of the program, including any extension, must not12-24
exceed12-25
(b) "Exceptional circumstances" shall be deemed to exist for the12-26
purposes of paragraph (b) of subsection 1, if:12-27
(1) The injured employee lacks work experience, training, education12-28
or other transferable skills for an occupation which he is physically capable12-29
of performing; or12-30
(2) Severe physical restrictions as a result of the industrial injury12-31
have been imposed by a physician which significantly limit the employee’s12-32
occupational opportunities.12-33
3. If an injured employee has incurred a permanent physical12-34
impairment of 11 percent or more:12-35
(a) The total length of the program, including any extension, must not12-36
exceed12-37
(b) "Exceptional circumstances" shall be deemed to exist for the12-38
purposes of paragraph (b) of subsection 1, if the injured employee has12-39
suffered:12-40
(1) The total and permanent loss of sight of both eyes;12-41
(2) The loss by separation of a leg at or above the knee;12-42
(3) The loss by separation of a hand at or above the wrist;13-1
(4) An injury to the head or spine which results in permanent and13-2
complete paralysis of both legs, both arms or a leg and an arm;13-3
(5) An injury to the head which results in a severe cognitive13-4
functional impairment which may be established by a nationally13-5
recognized form of objective psychological testing;13-6
(6) The loss by separation of an arm at or above the elbow and the13-7
loss by separation of a leg at or above the knee;13-8
(7) An injury consisting of second or third degree burns on 5013-9
percent or more of the body, both hands or the face;13-10
(8) A total bilateral loss of hearing;13-11
(9) The total loss or significant and permanent impairment of speech;13-12
or13-13
(10) A permanent physical impairment of 50 percent or more13-14
determined pursuant to NRS 616C.490, if the severity of the impairment13-15
limits the injured employee’s gainful employment to vocations that are13-16
primarily intellectual and require a longer program of education.13-17
4. The insurer shall deliver a copy of its decision granting or denying13-18
an extension to the injured employee and the employer. Except as13-19
otherwise provided in this section, the decision shall be deemed to be a13-20
final determination of the insurer for the purposes of NRS 616C.315.13-21
Sec. 13. NRS 616C.580 is hereby amended to read as follows: 616C.580 1.13-23
section, vocational rehabilitation services must not be provided outside of13-24
this state. If an injured employee lives within 50 miles from any border of13-25
this state on the date of injury, he may receive vocational rehabilitation13-26
services at a location within 50 miles from any border of this state and13-27
within 50 miles from his residence if such services are available at such13-28
location.13-29
2. An injured employee, who:13-30
(a) Is eligible for vocational rehabilitation services pursuant to NRS13-31
616C.590; and13-32
(b) Resides outside of this state13-33
vocational rehabilitation services outside of this state pursuant to13-34
subsection 1,13-35
may execute a written agreement with the insurer which provides for the13-36
payment of compensation in a lump sum in lieu of the provision of13-37
vocational rehabilitation services pursuant to NRS 616C.595. The amount13-38
of the lump sum must not exceed $15,000.13-39
3. An injured employee who resides outside of this state but does not13-40
qualify to receive vocational rehabilitation services outside of this state13-41
pursuant to subsection 1 may receive the vocational rehabilitation services13-42
to which he is entitled pursuant to NRS 616C.545 to 616C.575, inclusive,13-43
and 616C.590 if he relocates to14-1
(a) This state ; or15-1
(b) A location within 50 miles from any border of this state,15-2
at his own expense15-3
Sec. 14. Chapter 616D of NRS is hereby amended by adding thereto a15-4
new section to read as follows:15-5
1. A cause of action may be brought and maintained against an15-6
insurer or a third-party administrator who violates any provision of this15-7
chapter or chapter 616A, 616B, 616C or 617 of NRS by a claimant who15-8
has not accepted a benefit penalty pursuant to NRS 616D.120.15-9
2. A claimant may pursue a cause of action against an insurer or15-10
third-party administrator and file a complaint with the administrator15-11
alleging a violation of any of the provisions of paragraphs (a) to (d),15-12
inclusive, of subsection 1 of NRS 616D.120 but may not accept a benefit15-13
penalty from that insurer or third-party administrator unless he first15-14
waives, in writing, all rights to:15-15
(a) Proceed in the previously instituted action; and15-16
(b) Bring any future action against the insurer or third-party15-17
administrator.15-18
Such a claimant must deliver to the insurer or third-party administrator15-19
the written waiver within 5 days after the insurer or third-party15-20
administrator attempts to deliver the benefit penalty to the claimant.15-21
3. If a claimant who has brought a cause of action against an15-22
insurer or third-party administrator does not wish to participate in an15-23
investigation conducted by the administrator pursuant to NRS 616D.13015-24
against that insurer or third-party administrator, the claimant may notify15-25
the administrator that he is pursuing a cause of action against that15-26
insurer or third-party administrator and is waiving his right to receive a15-27
benefit penalty from that insurer or third-party administrator. If a15-28
claimant notifies the administrator that he is pursuing a cause of action15-29
against an insurer or third-party administrator, the administrator shall15-30
not require the claimant to participate in the investigation concerning15-31
that insurer or third-party administrator and shall not impose a benefit15-32
penalty on that insurer or third-party administrator.15-33
4. A claimant who:15-34
(a) Wishes to preserve his right to bring or maintain a cause of action15-35
against an insurer or third-party administrator; and15-36
(b) Is offered a benefit penalty by that insurer or third-party15-37
administrator pursuant to an order of the administrator issued pursuant15-38
to subsection 3 of NRS 616D.120,15-39
must refuse to accept the benefit penalty and must deliver to the insurer15-40
or third-party administrator a written refusal to accept the benefit penalty15-41
within 5 days after the insurer or third-party administrator attempts to15-42
deliver the benefit penalty.16-1
Sec. 15. NRS 616D.010 is hereby amended to read as follows: 616D.010 Except as otherwise provided in NRS 616A.020, 616B.60016-3
and 616C.190, and section 14 of this act, no penalty or remedy provided16-4
in this chapter or chapter 616A, 616B or 616C of NRS is exclusive of any16-5
other penalty or remedy, but is cumulative and in addition to every other16-6
penalty or remedy and may be exercised without exhausting and without16-7
regard to any other penalty or remedy provided by those chapters or any16-8
other statute.16-9
Sec. 16. NRS 616D.030 is hereby amended to read as follows: 616D.030 1.16-11
act, no cause of action may be brought or maintained against an insurer or16-12
a third-party administrator who violates any provision of this chapter or16-13
chapter 616A, 616B, 616C or 617 of NRS.16-14
2.16-15
administrative fines provided for in NRS 616B.318 and 616D.120 are the16-16
exclusive remedies for any violation of this chapter or chapter 616A,16-17
616B, 616C or 617 of NRS committed by an insurer or a third-party16-18
administrator.16-19
Sec. 17. NRS 616D.050 is hereby amended to read as follows: 616D.050 1. Appeals officers, the administrator, the manager and16-21
the manager’s designee, in conducting hearings or other proceedings16-22
pursuant to the provisions of chapters 616A to 616D, inclusive, of NRS or16-23
regulations adopted pursuant to those chapters may:16-24
(a)16-25
of this act, issue subpoenas requiring the attendance of any witness or the16-26
production of books, accounts, papers, records and documents.16-27
(b) Administer oaths.16-28
(c) Certify to official acts.16-29
(d)16-30
this act, call and examine under oath any witness or party to a claim.16-31
(e) Maintain order.16-32
(f) Rule upon all questions arising during the course of a hearing or16-33
proceeding.16-34
(g) Permit discovery by deposition or interrogatories.16-35
(h) Initiate and hold conferences for the settlement or simplification of16-36
issues.16-37
(i) Dispose of procedural requests or similar matters.16-38
(j) Generally regulate and guide the course of a pending hearing or16-39
proceeding.16-40
2. Hearing officers, in conducting hearings or other proceedings16-41
pursuant to the provisions of chapters 616A to 616D, inclusive, of NRS or16-42
regulations adopted pursuant to those chapters, may:17-1
(a) Issue subpoenas requiring the attendance of any witness or the17-2
production of books, accounts, papers, records and documents that are17-3
relevant to the dispute for which the hearing or other proceeding is being17-4
held.17-5
(b) Maintain order.17-6
(c) Permit discovery by deposition or interrogatories.17-7
(d) Initiate and hold conferences for the settlement or simplification of17-8
issues.17-9
(e) Dispose of procedural requests or similar matters.17-10
(f) Generally regulate and guide the course of a pending hearing or17-11
proceeding.17-12
Sec. 18. NRS 616D.120 is hereby amended to read as follows: 616D.120 1. Except as otherwise provided in this section, if the17-14
administrator determines that an insurer, organization for managed care,17-15
health care provider, third-party administrator or employer has:17-16
(a) Through fraud, coercion, duress or undue influence:17-17
(1) Induced a claimant to fail to report an accidental injury or17-18
occupational disease;17-19
(2) Persuaded a claimant to settle for an amount which is less than17-20
reasonable;17-21
(3) Persuaded a claimant to settle for an amount which is less than17-22
reasonable while a hearing or an appeal is pending; or17-23
(4) Persuaded a claimant to accept less than the compensation found17-24
to be due him by a hearing officer, appeals officer, court of competent17-25
jurisdiction, written settlement agreement, written stipulation or the17-26
division when carrying out its duties pursuant to chapters 616A to 617,17-27
inclusive, of NRS;17-28
(b) Refused to pay or unreasonably delayed payment to a claimant of17-29
compensation found to be due him by a hearing officer, appeals officer,17-30
court of competent jurisdiction, written settlement agreement, written17-31
stipulation or the division when carrying out its duties pursuant to chapters17-32
616A to 616D, inclusive, or chapter 617 of NRS, if the refusal or delay17-33
occurs:17-34
(1) Later than 10 days after the date of the settlement agreement or17-35
stipulation;17-36
(2) Later than 30 days after the date of the decision of a court,17-37
hearing officer, appeals officer or division, unless a stay has been granted;17-38
or17-39
(3) Later than 10 days after a stay of the decision of a court, hearing17-40
officer, appeals officer or division has been lifted;17-41
(c) Refused to process a claim for compensation pursuant to chapters17-42
616A to 616D, inclusive, or chapter 617 of NRS;18-1
(d) Made it necessary for a claimant to initiate proceedings pursuant to18-2
chapters 616A to 616D, inclusive, or chapter 617 of NRS for18-3
compensation found to be due him by a hearing officer, appeals officer,18-4
court of competent jurisdiction, written settlement agreement, written18-5
stipulation or the division when carrying out its duties pursuant to chapters18-6
616A to 616D, inclusive, or chapter 617 of NRS;18-7
(e) Failed to comply with the division’s regulations covering the18-8
payment of an assessment relating to the funding of costs of administration18-9
of chapters 616A to 617, inclusive, of NRS;18-10
(f) Failed to provide or unreasonably delayed payment to an injured18-11
employee or reimbursement to an insurer pursuant to NRS 616C.165; or18-12
(g) Intentionally failed to comply with any provision of, or regulation18-13
adopted pursuant to, this chapter or chapter 616A, 616B, 616C or 617 of18-14
NRS,18-15
the administrator shall impose an administrative fine of $1,000 for each18-16
initial violation, or a fine of $10,000 for a second or subsequent violation.18-17
2. Except as otherwise provided in chapters 616A to 616D, inclusive,18-18
or chapter 617 of NRS, if the administrator determines that an insurer,18-19
organization for managed care, health care provider, third-party18-20
administrator or employer has failed to comply with any provision of this18-21
chapter or chapter 616A, 616B, 616C or 617 of NRS, or any regulation18-22
adopted pursuant thereto, the administrator may take any of the following18-23
actions:18-24
(a) Issue a notice of correction for:18-25
(1) A minor violation, as defined by regulations adopted by the18-26
division; or18-27
(2) A violation involving the payment of compensation in an amount18-28
which is greater than that required by any provision of this chapter or18-29
chapter 616A, 616B, 616C or 617 of NRS, or any regulation adopted18-30
pursuant thereto.18-31
The notice of correction must set forth with particularity the violation18-32
committed and the manner in which the violation may be corrected.18-33
18-34
the administrator to modify or negate in any manner a determination or any18-35
portion of a determination made by a hearing officer, appeals officer or18-36
court of competent jurisdiction or a provision contained in a written18-37
settlement agreement or written stipulation.18-38
(b) Impose an administrative fine for:18-39
(1) A second or subsequent violation for which a notice of correction18-40
has been issued pursuant to paragraph (a); or18-41
(2) Any other violation of this chapter or chapter 616A, 616B, 616C18-42
or 617 of NRS, or any regulation adopted pursuant thereto, for which a18-43
notice of correction may not be issued pursuant to paragraph (a).19-1
The fine imposed may not be greater than $250 for an initial violation, or19-2
more than $1,000 for any second or subsequent violation.19-3
(c) Order a plan of corrective action to be submitted to the administrator19-4
within 30 days after the date of the order.19-5
3.19-6
pursuant to subsection 3 of section 14 of this act, he is pursuing a cause19-7
of action against an insurer or third-party administrator and waiving his19-8
right to receive a benefit penalty, if the administrator determines that a19-9
violation of any of the provisions of paragraphs (a) to (d), inclusive, of19-10
subsection 1 has occurred, the administrator shall order the insurer,19-11
organization for managed care, health care provider, third-party19-12
administrator or employer to pay to the claimant a benefit penalty in an19-13
amount equal to 50 percent of the compensation due or $10,000,19-14
whichever is less. In no event may a benefit penalty be less than $500. The19-15
benefit penalty is for the benefit of the claimant and , except as otherwise19-16
provided in this subsection, must be paid directly to him within 10 days19-17
after the date of the administrator’s determination. If the claimant has,19-18
pursuant to section 14 of this act, brought an action against an insurer or19-19
third-party administrator who is subject to an order of the administrator19-20
pursuant to this section, the insurer or third-party administrator is not19-21
required to pay the penalty to the claimant if the claimant:19-22
(a) Refuses to deliver a written waiver pursuant to subsection 2 of19-23
section 14 of this act; or19-24
(b) Delivers to the insurer or third-party administrator a written19-25
refusal to accept the benefit penalty pursuant to subsection 4 of section19-26
14 of this act.19-27
Proof of the payment of the benefit penalty , the claimant’s refusal to19-28
deliver a written waiver or the claimant’s refusal to accept the benefit19-29
penalty must be submitted to the administrator within 10 days after the19-30
date of his determination unless an appeal is filed pursuant to NRS19-31
616D.140. Any compensation to which the claimant may otherwise be19-32
entitled pursuant to chapters 616A to 616D, inclusive, or chapter 617 of19-33
NRS must not be reduced by the amount of any benefit penalty received19-34
pursuant to this subsection.19-35
4. In addition to any fine or benefit penalty imposed pursuant to this19-36
section, the administrator may assess against an insurer who violates any19-37
regulation concerning the reporting of claims expenditures used to19-38
calculate an assessment an administrative penalty of up to twice the19-39
amount of any underpaid assessment.19-40
5. If:19-41
(a) The administrator determines that a person has violated any of the19-42
provisions of NRS 616D.200, 616D.220, 616D.240, 616D.300, 616D.31019-43
or 616D.350 to 616D.440, inclusive; and20-1
(b) The fraud control unit for industrial insurance established pursuant20-2
to NRS 228.420 notifies the administrator that the unit will not prosecute20-3
the person for that violation,20-4
the administrator shall impose an administrative fine of not more than20-5
$10,000.20-6
6. Two or more fines of $1,000 or more imposed in 1 year for acts20-7
enumerated in subsection 1 must be considered by the commissioner as20-8
evidence for the withdrawal of:20-9
(a) A certificate to act as a self-insured employer.20-10
(b) A certificate to act as an association of self-insured public or private20-11
employers.20-12
(c) A certificate of registration as a third-party administrator.20-13
7. The commissioner may, without complying with the provisions of20-14
NRS 616B.327 or 616B.431, withdraw the certification of a self-insured20-15
employer, association of self-insured public or private employers or third-20-16
party administrator if, after a hearing, it is shown that the self-insured20-17
employer, association of self-insured public or private employers or third-20-18
party administrator violated any provision of subsection 1.20-19
Sec. 19. NRS 616D.140 is hereby amended to read as follows: 616D.140 1. If a person wishes to contest a decision of the20-21
administrator to impose an administrative fine or benefit penalty pursuant20-22
to this chapter or chapter 616A, 616B, 616C or 617 of NRS, he must file a20-23
notice of appeal with the division within 10 days after receipt of the20-24
administrator’s decision, showing why the proposed fine or benefit penalty20-25
should not be imposed.20-26
2. If a notice of appeal is filed as required by subsection 1, the20-27
administrator shall, in accordance with the provisions of NRS 233B.121,20-28
issue a notice of hearing that must include a date for a hearing on the20-29
matter, which must be no sooner than 30 days after the notice of appeal is20-30
filed. The administrator may grant a continuance of the hearing upon a20-31
showing of good cause.20-32
3.20-33
appeal is not filed as required by this section, the imposition of the fine or20-34
benefit penalty shall be deemed a final order and is not subject to review20-35
by any court or agency. If the claimant on whose behalf a benefit penalty20-36
is imposed:20-37
(a) Refused to deliver to an insurer or third-party administrator a20-38
written waiver pursuant to subsection 2 of section 14 of this act; or20-39
(b) Delivered a written refusal to accept the benefit penalty pursuant20-40
to subsection 4 of section 14 of this act,20-41
the imposition of a benefit penalty against the insurer or third-party20-42
administrator shall not be deemed a final order pursuant to this20-43
subsection.21-1
4. Except as otherwise provided in NRS 616B.086, a hearing held21-2
pursuant to this section must be conducted by the administrator or a person21-3
designated by him. A record of the hearing must be kept but it need not be21-4
transcribed unless it is requested by the person against whom the order or21-5
notice of violation has been issued and that person pays the cost of21-6
transcription. The administrator shall render a written decision on the21-7
appeal.21-8
5. An administrative fine imposed pursuant to this chapter or chapter21-9
616A, 616B, 616C or 617 of NRS must be paid to the division. If the21-10
violation for which the fine is levied was committed by a person while21-11
acting within the course and scope of his agency or employment, the fine21-12
must be paid by his principal or employer. The fine may be recovered in a21-13
civil action brought in the name of the division in a court of competent21-14
jurisdiction in the county in which the violation occurred or in which the21-15
person against whom the fine is levied has his principal place of business.21-16
6.21-17
616D.120, a benefit penalty imposed pursuant to NRS 616D.120 must be21-18
paid to the claimant on whose behalf it is imposed. If such payment is not21-19
made within the period required by NRS 616D.12021-20
third-party administrator cannot demonstrate that the claimant refused to21-21
deliver a written waiver or delivered a written refusal to accept the benefit21-22
penalty pursuant to subsection 2 or 4 of section 14 of this act, the benefit21-23
penalty may be recovered in a civil action brought by the administrator on21-24
behalf of the claimant in a court of competent jurisdiction in the county in21-25
which the claimant resides, in which the violation occurred or in which the21-26
person who is required to pay the benefit penalty has his principal place of21-27
business.21-28
7. Any party aggrieved by a decision of the administrator rendered21-29
pursuant to this section may appeal the decision directly to the district21-30
court.21-31
Sec. 20. NRS 617.366 is hereby amended to read as follows: 617.366 1.21-33
21-34
21-35
(a) Has a preexisting condition from a cause or origin that did not arise21-36
out of and in the course of his current or past employment; and21-37
(b)21-38
which aggravates, precipitates or accelerates his preexisting condition,21-39
shall be deemed to be an injury by accident that is compensable pursuant21-40
to the provisions of chapters 616A to 616D, inclusive, of NRS, unless21-41
21-42
22-1
22-2
resulting condition.22-3
2.22-4
22-5
22-6
(a) Contracts an occupational disease; and22-7
(b)22-8
accelerates the occupational disease in a manner that does not arise out of22-9
and in the course of his employment,22-10
shall be deemed to be an injury by accident that is compensable pursuant22-11
to the provisions of chapters 616A to 616D, inclusive, of NRS, unless the22-12
22-13
evidence that the effect described in paragraph (b) is the primary cause of22-14
the resulting condition.22-15
Sec. 21. NRS 617.510 is hereby amended to read as follows: 617.510 Except as otherwise provided in NRS 617.017, and section22-17
14 of this act, no penalty or remedy provided in this chapter is exclusive of22-18
any other penalty or remedy, but is cumulative and in addition to every22-19
other penalty or remedy and may be exercised without exhausting and22-20
without regard to any other penalty or remedy provided by this chapter or22-21
any other statute.~