Senate Bill No. 42–Committee on Commerce and Labor

Prefiled January 27, 1999

(On Behalf of Legislative Committee on Workers’ Compensation)

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Referred to Committee on Commerce and Labor

 

SUMMARY—Revises provisions governing payment of workers’ compensation for subsequent injuries from subsequent injury funds. (BDR 53-389)

FISCAL NOTE: Effect on Local Government: No.

Effect on the State or on Industrial Insurance: No.

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EXPLANATION – Matter in bolded italics is new; matter between brackets [omitted material] is material to be omitted. Green numbers along left margin indicate location on the printed bill (e.g., 5-15 indicates page 5, line 15).

 

AN ACT relating to industrial insurance; revising the provisions regarding those subsequent injuries for which the account of an employer who is insured by the state industrial insurance system will be charged; limiting the subsequent injuries for which workers’ compensation is payable from the subsequent injury fund for self-insured employers and the subsequent injury fund for associations of self-insured public or private employers; repealing the provisions creating and governing a subsequent injury fund for private carriers of industrial insurance; and providing other matters properly relating thereto.

 

THE PEOPLE OF THE STATE OF NEVADA, REPRESENTED IN SENATE AND ASSEMBLY, DO ENACT AS FOLLOWS:

1-1 Section 1. NRS 616B.540 is hereby amended to read as follows:

1-2 616B.540 1. If an employee of an employer who is insured by the

1-3 system has a permanent physical impairment from any cause or origin and ,

1-4 before July 1, 1999, incurs a subsequent disability by injury arising out of

1-5 and in the course of his employment which entitles him to compensation for

1-6 a disability that is substantially greater by reason of the combined effects of

1-7 the preexisting impairment and the subsequent injury than that which would

1-8 have resulted from the subsequent injury alone, the compensation due must

1-9 not be charged to the employer’s account if:

1-10 (a) The employee knowingly made a false representation as to his

1-11 physical condition at the time he was hired by the employer;

1-12 (b) The employer relied upon the false representation and this reliance

1-13 formed a substantial basis of the employment; and

2-1 (c) A causal connection existed between the false representation and the

2-2 subsequent disability.

2-3 2. If the subsequent injury of the employee that occurred before July 1,

2-4 1999, results in his death and it is determined that the death would not have

2-5 occurred except for the preexisting permanent physical impairment, the

2-6 compensation due must not be charged to the employer’s account.

2-7 3. To qualify for the removal of a charge from his account pursuant to

2-8 this section, the employer must establish by written records that he had

2-9 knowledge of the permanent physical impairment at the time the employee

2-10 was hired or that the employee was retained in employment after the

2-11 employer acquired that knowledge.

2-12 4. The employer shall notify the manager of any possible claim

2-13 pursuant to this section as soon as practicable, but not later than [100] 50

2-14 weeks after the subsequent injury or death. A claim pursuant to this section

2-15 must be submitted to the chief before July 1, 2000.

2-16 5. The manager shall take such actions as are necessary to carry out the

2-17 requirements of this section.

2-18 6. An appeal of any decision made concerning a charge or removal of a

2-19 charge pursuant to this section must be submitted directly to an appeals

2-20 officer. The appeals officer shall hear the appeal within 45 days after the

2-21 appeal is submitted to him.

2-22 7. As used in this section [, "permanent] :

2-23 (a) "Chief" means the chief administrative officer of the industrial

2-24 insurance regulation section of the division.

2-25 (b) "Permanent physical impairment" means any permanent condition,

2-26 whether congenital or caused by injury or disease, of such seriousness as to

2-27 constitute a hindrance or obstacle to obtaining employment or to obtaining

2-28 reemployment if the employee is unemployed. For the purposes of this

2-29 section, a condition is not a "permanent physical impairment" unless it

2-30 would support a rating of permanent impairment of 6 percent or more of the

2-31 whole man if evaluated according to the American Medical Association’s

2-32 Guides to the Evaluation of Permanent Impairment as adopted and

2-33 supplemented pursuant to NRS 616C.110.

2-34 Sec. 2. NRS 616B.557 is hereby amended to read as follows:

2-35 616B.557 Except as otherwise provided in NRS 616B.560:

2-36 1. If an employee of a self-insured employer has a permanent physical

2-37 impairment from any cause or origin and before July 1, 1999, incurs a

2-38 subsequent disability by injury arising out of and in the course of his

2-39 employment which entitles him to compensation for disability that is

2-40 substantially greater by reason of the combined effects of the preexisting

2-41 impairment and the subsequent injury than that which would have resulted

2-42 from the subsequent injury alone, the compensation due must be charged to

3-1 the subsequent injury fund for self-insured employers in accordance with

3-2 regulations adopted by the board.

3-3 2. If the subsequent injury of [such an] the employee that occurred

3-4 before July 1, 1999, results in his death and it is determined that the death

3-5 would not have occurred except for the preexisting permanent physical

3-6 impairment, the compensation due must be charged to the subsequent injury

3-7 fund for self-insured employers in accordance with regulations adopted by

3-8 the board.

3-9 3. As used in this section, "permanent physical impairment" means any

3-10 permanent condition, whether congenital or caused by injury or disease, of

3-11 such seriousness as to constitute a hindrance or obstacle to obtaining

3-12 employment or to obtaining reemployment if the employee is unemployed.

3-13 For the purposes of this section, a condition is not a "permanent physical

3-14 impairment" unless it would support a rating of permanent impairment of 6

3-15 percent or more of the whole man if evaluated according to the American

3-16 Medical Association’s Guides to the Evaluation of Permanent Impairment

3-17 as adopted and supplemented by the division pursuant to NRS 616C.110.

3-18 4. To qualify under this section for reimbursement from the subsequent

3-19 injury fund for self-insured employers, the self-insured employer must

3-20 establish by written records that the self-insured employer had knowledge of

3-21 the "permanent physical impairment" at the time the employee was hired or

3-22 that the employee was retained in employment after the self-insured

3-23 employer acquired such knowledge.

3-24 5. A self-insured employer shall notify the board of any possible claim

3-25 against the subsequent injury fund for self-insured employers as soon as

3-26 practicable, but not later than [100] 50 weeks after the injury or death. A

3-27 claim against the subsequent injury fund for self-insured employers

3-28 pursuant to this section must be submitted to the administrator before

3-29 July 1, 2000.

3-30 6. The board shall adopt regulations establishing procedures for

3-31 submitting claims against the subsequent injury fund for self-insured

3-32 employers. The board shall notify the self-insured employer of [his] its

3-33 decision on [such a] the claim within 90 days after the claim is received.

3-34 7. An appeal of any decision made concerning a claim against the

3-35 subsequent injury fund for self-insured employers must be submitted

3-36 directly to the district court.

3-37 Sec. 3. NRS 616B.560 is hereby amended to read as follows:

3-38 616B.560 1. A self-insured employer who pays compensation due to

3-39 an employee who has a permanent physical impairment from any cause or

3-40 origin and who, before July 1, 1999, incurs a subsequent disability by

3-41 injury arising out of and in the course of his employment which entitles him

3-42 to compensation for disability that is substantially greater by reason of the

3-43 combined effects of the preexisting impairment and the subsequent injury

4-1 than that which would have resulted from the subsequent injury alone is

4-2 entitled to be reimbursed from the subsequent injury fund for self-insured

4-3 employers if:

4-4 (a) The employee knowingly made a false representation as to his

4-5 physical condition at the time he was hired by the self-insured employer;

4-6 (b) The self-insured employer relied upon the false representation and

4-7 this reliance formed a substantial basis of the employment; and

4-8 (c) A causal connection existed between the false representation and the

4-9 subsequent disability.

4-10 If the subsequent injury of the employee that occurred before July 1, 1999,

4-11 results in his death and it is determined that the death would not have

4-12 occurred except for the preexisting permanent physical impairment, any

4-13 compensation paid is entitled to be reimbursed from the subsequent injury

4-14 fund for self-insured employers.

4-15 2. A self-insured employer shall notify the board of any possible claim

4-16 against the subsequent injury fund for self-insured employers pursuant to

4-17 this section [no] not later than 60 days after the date of the subsequent

4-18 injury or the date the self-insured employer learns of the employee’s false

4-19 representation, whichever is later.

4-20 3. A claim against the subsequent injury fund for self-insured

4-21 employers pursuant to this section must be submitted to the administrator

4-22 before July 1, 2000.

4-23 Sec. 4. NRS 616B.578 is hereby amended to read as follows:

4-24 616B.578 Except as otherwise provided in NRS 616B.581:

4-25 1. If an employee of a member of an association of self-insured public

4-26 or private employers has a permanent physical impairment from any cause

4-27 or origin and before July 1, 1999, incurs a subsequent disability by injury

4-28 arising out of and in the course of his employment which entitles him to

4-29 compensation for disability that is substantially greater by reason of the

4-30 combined effects of the preexisting impairment and the subsequent injury

4-31 than that which would have resulted from the subsequent injury alone, the

4-32 compensation due must be charged to the subsequent injury fund for

4-33 associations of self-insured public or private employers in accordance with

4-34 regulations adopted by the board.

4-35 2. If the subsequent injury of [such an] the employee that occurred

4-36 before July 1, 1999, results in his death and it is determined that the death

4-37 would not have occurred except for the preexisting permanent physical

4-38 impairment, the compensation due must be charged to the subsequent injury

4-39 fund for associations of self-insured public or private employers in

4-40 accordance with regulations adopted by the board.

4-41 3. As used in this section, "permanent physical impairment" means any

4-42 permanent condition, whether congenital or caused by injury or disease, of

4-43 such seriousness as to constitute a hindrance or obstacle to obtaining

5-1 employment or to obtaining reemployment if the employee is unemployed.

5-2 For the purposes of this section, a condition is not a "permanent physical

5-3 impairment" unless it would support a rating of permanent impairment of 6

5-4 percent or more of the whole man if evaluated according to the American

5-5 Medical Association’s Guides to the Evaluation of Permanent Impairment

5-6 as adopted and supplemented by the division pursuant to NRS 616C.110.

5-7 4. To qualify under this section for reimbursement from the subsequent

5-8 injury fund for associations of self-insured public or private employers, the

5-9 association of self-insured public or private employers must establish by

5-10 written records that the employer had knowledge of the "permanent physical

5-11 impairment" at the time the employee was hired or that the employee was

5-12 retained in employment after the employer acquired such knowledge.

5-13 5. An association of self-insured public or private employers shall

5-14 notify the board of any possible claim against the subsequent injury fund for

5-15 associations of self-insured public or private employers as soon as

5-16 practicable, but not later than [100] 50 weeks after the injury or death. A

5-17 claim against the subsequent injury fund for associations of self-insured

5-18 public or private employers pursuant to this section must be submitted to

5-19 the board before July 1, 2000.

5-20 6. The board shall adopt regulations establishing procedures for

5-21 submitting claims against the subsequent injury fund for associations of self-

5-22 insured public or private employers. The board shall notify the association

5-23 of self-insured public or private employers of its decision on [such a] the

5-24 claim within 90 days after the claim is received.

5-25 7. An appeal of any decision made concerning a claim against the

5-26 subsequent injury fund for associations of self-insured public or private

5-27 employers must be submitted directly to the district court.

5-28 Sec. 5. NRS 616B.581 is hereby amended to read as follows:

5-29 616B.581 1. An association of self-insured public or private

5-30 employers that pays compensation due to an employee who has a permanent

5-31 physical impairment from any cause or origin and who, before July 1, 1999,

5-32 incurs a subsequent disability by injury arising out of and in the course of

5-33 his employment which entitles him to compensation for disability that is

5-34 substantially greater by reason of the combined effects of the preexisting

5-35 impairment and the subsequent injury than that which would have resulted

5-36 from the subsequent injury alone is entitled to be reimbursed from the

5-37 subsequent injury fund for associations of self-insured public or private

5-38 employers if:

5-39 (a) The employee knowingly made a false representation as to his

5-40 physical condition at the time he was hired by the member of the association

5-41 of self-insured public or private employers;

5-42 (b) The employer relied upon the false representation and this reliance

5-43 formed a substantial basis of the employment; and

6-1 (c) A causal connection existed between the false representation and the

6-2 subsequent disability.

6-3 If the subsequent injury of the employee that occurred before July 1, 1999,

6-4 results in his death and it is determined that the death would not have

6-5 occurred except for the preexisting permanent physical impairment, any

6-6 compensation paid is entitled to be reimbursed from the subsequent injury

6-7 fund for associations of self-insured public or private employers.

6-8 2. An association of self-insured public or private employers shall

6-9 notify the board of any possible claim against the subsequent injury fund for

6-10 associations of self-insured public or private employers pursuant to this

6-11 section [no] not later than 60 days after the date of the subsequent injury or

6-12 the date the employer learns of the employee’s false representation,

6-13 whichever is later.

6-14 3. A claim against the subsequent injury fund for associations of self-

6-15 insured public or private employers pursuant to this section must be

6-16 submitted to the board before July 1, 2000.

6-17 Sec. 6. NRS 616B.584, 616B.587 and 616B.590 are hereby repealed.

6-18 Sec. 7. 1. This section and sections 1 to 5, inclusive, of this act

6-19 become effective on July 1, 1999.

6-20 2. Section 6 of this act becomes effective upon passage and approval.

 

6-21 TEXT OF REPEALED SECTIONS

 

6-22 616B.584 Subsequent injury fund for private carriers established;

6-23 purpose; disbursements; investments; assessment rates, payments and

6-24 penalties. [Effective July 1, 1999.]

6-25 1. There is hereby established as a special revenue fund in the state

6-26 treasury the subsequent injury fund for private carriers, which may be used

6-27 only to make payments in accordance with the provisions of NRS 616B.587

6-28 and 616B.590. The administrator shall administer the fund.

6-29 2. All assessments, penalties, bonds, securities and all other properties

6-30 received, collected or acquired by the administrator for the subsequent

6-31 injury fund for private carriers must be delivered to the custody of the state

6-32 treasurer.

6-33 3. All money and securities in the fund must be held by the state

6-34 treasurer as custodian thereof to be used solely for workers’ compensation

6-35 for employees whose employers are insured by private carriers.

6-36 4. The state treasurer may disburse money from the fund only upon

6-37 written order of the state controller.

6-38 5. The state treasurer shall invest money of the fund in the same manner

6-39 and in the same securities in which he is authorized to invest state general

7-1 funds which are in his custody. Income realized from the investment of the

7-2 assets of the fund must be credited to the fund.

7-3 6. The administrator shall adopt regulations for the establishment and

7-4 administration of assessment rates, payments and penalties. Assessment

7-5 rates must reflect the relative hazard of the employments covered by private

7-6 carriers and must be based upon expected annual expenditures for claims for

7-7 payments from the subsequent injury fund for private carriers. The system

7-8 must not be required to pay any assessments, payments or penalties into the

7-9 subsequent injury fund for private carriers, or any costs associated with the

7-10 fund.

7-11 7. The commissioner shall assign an actuary to review the establishment

7-12 of assessment rates. The rates must be filed with the commissioner 30 days

7-13 before their effective date. Any private carrier who wishes to appeal the rate

7-14 so filed must do so pursuant to NRS 679B.310.

7-15 616B.587 Payment of cost of additional compensation resulting

7-16 from subsequent injury of employee of employer insured by private

7-17 carrier. [Effective July 1, 1999.] Except as otherwise provided in NRS

7-18 616B.590:

7-19 1. If an employee of an employer who is insured by a private carrier has

7-20 a permanent physical impairment from any cause or origin and incurs a

7-21 subsequent disability by injury arising out of and in the course of his

7-22 employment which entitles him to compensation for disability that is

7-23 substantially greater by reason of the combined effects of the preexisting

7-24 impairment and the subsequent injury than that which would have resulted

7-25 from the subsequent injury alone, the compensation due must be charged to

7-26 the subsequent injury fund for private carriers in accordance with

7-27 regulations adopted by the administrator.

7-28 2. If the subsequent injury of such an employee results in his death and

7-29 it is determined that the death would not have occurred except for the

7-30 preexisting permanent physical impairment, the compensation due must be

7-31 charged to the subsequent injury fund for private carriers in accordance with

7-32 regulations adopted by the administrator.

7-33 3. As used in this section, "permanent physical impairment" means any

7-34 permanent condition, whether congenital or caused by injury or disease, of

7-35 such seriousness as to constitute a hindrance or obstacle to obtaining

7-36 employment or to obtaining reemployment if the employee is unemployed.

7-37 For the purposes of this section, a condition is not a "permanent physical

7-38 impairment" unless it would support a rating of permanent impairment of 6

7-39 percent or more of the whole man if evaluated according to the American

7-40 Medical Association’s Guides to the Evaluation of Permanent Impairment

7-41 as adopted and supplemented by the division pursuant to NRS 616C.110.

7-42 4. To qualify under this section for reimbursement from the subsequent

7-43 injury fund for private carriers, the private carrier must establish by written

8-1 records that the employer had knowledge of the "permanent physical

8-2 impairment" at the time the employee was hired or that the employee was

8-3 retained in employment after the employer acquired such knowledge.

8-4 5. A private carrier shall notify the administrator of any possible claim

8-5 against the subsequent injury fund for private carriers as soon as practicable,

8-6 but not later than 100 weeks after the injury or death.

8-7 6. The administrator shall adopt regulations establishing procedures for

8-8 submitting claims against the subsequent injury fund for private carriers.

8-9 The administrator shall notify the private carrier of his decision on such a

8-10 claim within 90 days after the claim is received.

8-11 7. An appeal of any decision made concerning a claim against the

8-12 subsequent injury fund for private carriers must be submitted directly to the

8-13 appeals officer. The appeals officer shall hear such an appeal within 45 days

8-14 after the appeal is submitted to him.

8-15 616B.590 Reimbursement of private carrier for cost of additional

8-16 compensation resulting from subsequent injury. [Effective July 1,

8-17 1999.]

8-18 1. A private carrier who pays compensation due to an employee who

8-19 has a permanent physical impairment from any cause or origin and incurs a

8-20 subsequent disability by injury arising out of and in the course of his

8-21 employment which entitles him to compensation for disability that is

8-22 substantially greater by reason of the combined effects of the preexisting

8-23 impairment and the subsequent injury than that which would have resulted

8-24 from the subsequent injury alone is entitled to be reimbursed from the

8-25 subsequent injury fund for private carriers if:

8-26 (a) The employee knowingly made a false representation as to his

8-27 physical condition at the time he was hired by the employer insured by a

8-28 private carrier;

8-29 (b) The employer relied upon the false representation and this reliance

8-30 formed a substantial basis of the employment; and

8-31 (c) A causal connection existed between the false representation and the

8-32 subsequent disability.

8-33 If the subsequent injury of the employee results in his death and it is

8-34 determined that the death would not have occurred except for the

8-35 preexisting permanent physical impairment, any compensation paid is

8-36 entitled to be reimbursed from the subsequent injury fund for private

8-37 carriers.

8-38 2. A private carrier shall notify the administrator of any possible claim

8-39 against the subsequent injury fund for private carriers pursuant to this

8-40 section no later than 60 days after the date of the subsequent injury or the

8-41 date the employer learns of the employee’s false representation, whichever

8-42 is later.

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