Senate Bill No. 55–Committee on Commerce and Labor
Prefiled January 28, 1999
(On Behalf of Legislative Committee on Workers’ Compensation)
____________
Referred to Committee on Commerce and Labor
SUMMARY—Makes various changes regarding industrial insurance. (BDR 53-387)
FISCAL NOTE: Effect on Local Government: No.
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. Chapter 616C of NRS is hereby amended by adding thereto1-2
the provisions set forth as sections 2 to 5, inclusive, of this act.1-3
Sec. 2. Insofar as practicable, a hearing officer or an appeals officer1-4
shall, with respect to each appeal or contested claim for compensation,1-5
author and explain fully the decision he renders, including, without1-6
limitation, an explanation of the reasons for the decision.2-1
Sec. 3. The senior appeals officer shall:2-2
1. At least twice each year, conduct an evaluation of the performance2-3
of each of the other appeals officers employed by the hearings division of2-4
the department of administration. In conducting an evaluation pursuant2-5
to this section, the senior appeals officer shall determine whether the2-6
appeals officer being evaluated has:2-7
(a) Met the standards for performance prescribed by the chief of the2-8
hearings division pursuant to NRS 616C.295; and2-9
(b) Rendered decisions in contested claims for compensation in a2-10
timely manner as required pursuant to subsection 5 of NRS 616C.360.2-11
2. Within 15 days after completing an evaluation pursuant to2-12
subsection 1, prepare a written report of the evaluation and transmit a2-13
copy to the chief of the hearings division of the department of2-14
administration for compilation pursuant to NRS 616C.295.2-15
3. In accordance with the requirements for training and continuing2-16
education, standards and procedures prescribed by the chief of the2-17
hearings division of the department of administration pursuant to NRS2-18
616C.295, provide training to each of the other appeals officers employed2-19
by the hearings division.2-20
Sec. 4. 1. The commission to recommend appeals officers,2-21
consisting of five members, is hereby created. The membership of the2-22
commission consists of:2-23
(a) One member appointed by the governor to represent the interests2-24
of:2-25
(1) Self-insured employers;2-26
(2) Associations of self-insured public or private employers; and2-27
(3) Private carriers.2-28
(b) One member appointed by the governor to represent the interests2-29
of the system.2-30
(c) Two members appointed by the governor to represent the interests2-31
of employees, one of whom must represent the interests of employees who2-32
are members of organized labor.2-33
(d) One member appointed by the board of governors of the State Bar2-34
of Nevada or its successor organization.2-35
2. After the initial appointments, members of the commission serve2-36
terms of 4 years, except when appointed to fill unexpired terms.2-37
3. The commission shall elect a chairman from among its members.2-38
4. A vacancy occurring in the membership of the commission must2-39
be filled in the same manner as the original appointment.2-40
5. The commission shall meet at the call of the chairman or at the2-41
request of a majority of the members of the commission.3-1
6. Whenever practicable, the commission shall hold its meetings3-2
through the use of electronic communication, unless doing so would3-3
violate the provisions of chapter 241 of NRS.3-4
7. The members of the commission serve without compensation,3-5
except that while engaged in the business of the commission, each3-6
member is entitled to receive the per diem allowance and travel expenses3-7
provided for state officers and employees generally.3-8
Sec. 5. 1. If the governor determines that:3-9
(a) The term of an appeals officer is about to expire; or3-10
(b) The appointment of one or more additional appeals officers or3-11
special appeals officers is necessary or desirable to conduct hearings in3-12
contested claims for compensation pursuant to NRS 616C.360,3-13
the governor shall notify the commission to recommend appeals officers3-14
at least 45 days before the date on which the term of the appeals officer3-15
will expire or on which the additional appeals officer or special appeals3-16
officer will be appointed. If the governor intends to reappoint an appeals3-17
officer whose term is about to expire, the governor shall notify the3-18
commission to recommend appeals officers of that fact.3-19
2. Except as otherwise provided in this subsection, within 30 days3-20
after the receipt of the notice described in subsection 1, the commission3-21
to recommend appeals officers shall provide to the governor a list of3-22
three nominees for appointment to the position of appeals officer or3-23
special appeals officer, as appropriate. If the governor has provided3-24
notice of intent to reappoint an appeals officer pursuant to subsection 1,3-25
the commission to recommend appeals officers shall:3-26
(a) Conduct an evaluation of the performance of the appeals officer3-27
during the immediately preceding term, including, without limitation, an3-28
evaluation of the performance of the appeals officer with respect to the3-29
standards adopted pursuant to NRS 616C.295; and3-30
(b) Provide to the governor a recommendation regarding whether the3-31
appeals officer should be reappointed.3-32
3. In appointing an appeals officer or special appeals officer3-33
pursuant to NRS 616C.340, the governor shall consider, but is not bound3-34
by, a list of nominees provided or a recommendation made by the3-35
commission to recommend appeals officers pursuant to this section.3-36
Sec. 6. NRS 616C.295 is hereby amended to read as follows: 616C.295 The chief of the hearings division of the department of3-38
administration shall:3-39
1. Prescribe by regulation3-40
(a) The qualifications and training required before a person may,3-41
pursuant to chapters 616A to 616D, inclusive, or chapter 617 of NRS, serve3-42
as a hearing officer. Training for a hearing officer must include techniques3-43
of mediation.4-1
(b) The training and continuing education required of each person4-2
employed by the hearings division as an appeals officer.4-3
(c) Standards for the performance of appeals officers in handling4-4
appeals and contested claims for compensation, including, without4-5
limitation, standards that require an appeals officer to render a decision4-6
in each appeal and contested claim in a manner that is consistent with:4-7
(1) Legal authority; and4-8
(2) Other decisions, if any, rendered by that appeals officer with4-9
respect to appeals and contested claims in which the facts and issues4-10
were substantially similar.4-11
(d) Procedures to improve the performance of an appeals officer4-12
whom the senior appeals officer determines by evaluation pursuant to4-13
section 3 of this act to be performing in a substandard manner.4-14
2. Provide for the expediting of the hearing of cases that involve the4-15
termination or denial of compensation.4-16
3. At least once each year, compile the following information with4-17
respect to each appeals officer employed by the hearings division of the4-18
department of administration:4-19
(a) The number of hearings on the merits in contested claims for4-20
compensation that the appeals officer has conducted in each month4-21
during his term of office;4-22
(b) The number of final decisions of the appeals officer for which4-23
judicial review is sought pursuant to NRS 616C.370, including notations4-24
that identify specifically for each such decision:4-25
(1) The court in which judicial review is sought; and4-26
(2) The action taken by the court in which judicial review is sought,4-27
including, without limitation, whether the matter is still pending or4-28
whether the court affirmed, modified or reversed the decision of the4-29
appeals officer; and4-30
(c) The evaluations pertaining to the appeals officer that have been4-31
conducted by the senior appeals officer pursuant to section 3 of this act.4-32
Sec. 7. NRS 616C.325 is hereby amended to read as follows: 616C.325 1. It is unlawful for any person to represent an employee4-34
before a4-35
hearings or other meetings with an insurer concerning the employee’s claim4-36
or possible claim, unless he is:4-37
(a) Employed full time by the employee’s labor organization;4-38
(b) Admitted to practice law in this state;4-39
(c) Employed full time by and under the supervision of an attorney4-40
admitted to practice law in this state; or4-41
(d) Appearing without compensation on behalf of the employee.4-42
It is unlawful for any person who is not admitted to practice law in this state4-43
to represent the employee before an appeals officer.5-1
2. It is unlawful for any person to represent an employer at hearings of5-2
contested cases unless that person is:5-3
(a) Employed full time by the employer or a trade association to which5-4
the employer belongs that is not formed solely for the purpose of providing5-5
representation at hearings of contested cases;5-6
(b) An employer’s representative licensed pursuant to subsection 3 who5-7
is not licensed as a third-party administrator;5-8
(c) Admitted to practice law in this state; or5-9
(d) A licensed third-party administrator.5-10
3. The director of the department of administration shall adopt5-11
regulations which include the:5-12
(a) Requirements for licensure of employers’ representatives, including:5-13
(1) The registration of each representative; and5-14
(2) The filing of a copy of each written agreement for the5-15
compensation of a representative;5-16
(b) Procedure for such licensure; and5-17
(c) Causes for revocation of such a license, including any applicable5-18
action listed in NRS 616D.120 or a violation of this section.5-19
4. Any person who is employed by or contracts with an employer to5-20
represent the employer at hearings regarding contested claims is an agent of5-21
the employer. If the employer’s representative violates any provision of this5-22
chapter or chapter 616A, 616B or 616D of NRS, the employer is liable for5-23
any penalty assessed because of that violation.5-24
5. An employer shall not make the compensation of any person5-25
representing him contingent in any manner upon the outcome of any5-26
contested claim.5-27
6. The director of the department of administration shall collect in5-28
advance and deposit with the state treasurer for credit to the state general5-29
fund the following fees for licensure as an employer’s representative:5-30
(a) Application and license $785-31
(b) Triennial renewal of each license 785-32
Sec. 8. NRS 616C.340 is hereby amended to read as follows: 616C.340 1. The governor shall , in accordance with section 5 of5-34
this act, appoint one or more appeals officers to conduct hearings in5-35
contested claims for compensation pursuant to NRS 616C.360. Each5-36
appeals officer5-37
his appointment and until his successor is appointed and has qualified. Each5-38
appeals officer is entitled to receive an annual salary in an amount provided5-39
by law and is in the unclassified service of the state.5-40
2. Each appeals officer must be an attorney who has been licensed to5-41
practice law before all the courts of this state for at least 2 years5-42
who has at least 2 years of experience practicing law in actions related to5-43
claims for compensation or similar experience. Except as otherwise6-1
provided in NRS 7.065, an appeals officer shall not engage in the private6-2
practice of law.6-3
3. An appeals officer shall comply with the provisions of the Nevada6-4
Code of Judicial Conduct.6-5
4. If an appeals officer determines that he has a personal interest or a6-6
conflict of interest, directly or indirectly, in any case which is before him,6-7
he shall disqualify himself from hearing the case.6-8
6-9
appoint one or more special appeals officers to conduct hearings in6-10
contested claims for compensation pursuant to NRS 616C.360. The6-11
governor shall not appoint an attorney who represents persons in actions6-12
related to claims for compensation to serve as a special appeals officer.6-13
6-14
must possess the same qualifications as a regular appeals officer and is6-15
vested with the same powers as a regular appeals officer. A special appeals6-16
officer may hear any case in which a regular appeals officer has a conflict,6-17
or any case assigned to him by the senior appeals officer to assist with a6-18
backlog of cases. A special appeals officer is entitled to be paid at an6-19
hourly rate, as determined by the department of administration.6-20
6-21
administrative determination of a claim for compensation under chapters6-22
616A to 616D, inclusive, or chapter 617 of NRS, and the whole record6-23
consists of all evidence taken at the hearing before the appeals officer and6-24
any findings of fact and conclusions of law based thereon.6-25
Sec. 9. NRS 616C.360 is hereby amended to read as follows: 616C.360 1. A stenographic or electronic record must be kept of the6-27
hearing before the appeals officer and the rules of evidence applicable to6-28
contested cases under chapter 233B of NRS apply to the hearing.6-29
2. The appeals officer must hear any matter raised before him on its6-30
merits, including new evidence bearing on the matter.6-31
3. If necessary to resolve a medical question concerning an injured6-32
employee’s condition, the appeals officer may refer the employee to a6-33
physician or chiropractor chosen by the appeals officer. If the medical6-34
question concerns the rating of a permanent disability, the appeals officer6-35
may refer the employee to a rating physician or chiropractor. The rating6-36
physician or chiropractor must be selected in rotation from the list of6-37
qualified physicians or chiropractors maintained by the administrator6-38
pursuant to subsection 2 of NRS 616C.490, unless the insurer and the6-39
injured employee otherwise agree to a rating physician or chiropractor. The6-40
insurer shall pay the costs of any examination requested by the appeals6-41
officer.6-42
4. Any party to the appeal or the appeals officer may order a transcript6-43
of the record of the hearing at any time before the seventh day after the7-1
hearing. The transcript must be filed within 30 days after the date of the7-2
order unless the appeals officer otherwise orders.7-3
5. The appeals officer shall render his decision:7-4
(a) If a transcript is ordered within 7 days after the hearing, within 307-5
days after the transcript is filed; or7-6
(b) If a transcript has not been ordered, within 30 days after the date of7-7
the hearing.7-8
6. The appeals officer may affirm, modify or reverse any decision7-9
made by the hearing officer and issue any necessary and proper order to7-10
give effect to his decision.7-11
7. The appeals officer shall give notice of his decision to each party7-12
by mail or by personal delivery.7-13
Sec. 10. Chapter 232 of NRS is hereby amended by adding thereto a7-14
new section to read as follows:7-15
The director, in his capacity as the chief of the hearings division, shall7-16
adopt regulations governing the conduct of the hearing and appeals7-17
officers. The regulations must include:7-18
1. A procedure for a person who believes that a hearing or appeals7-19
officer has violated the standards for conduct to make a complaint to the7-20
director or his designee.7-21
2. Rules of practice pursuant to which the director or his designee7-22
will hear complaints made pursuant to subsection 1.7-23
3. The penalties that may be imposed against a hearing or appeals7-24
officer if the director or his designee determines, pursuant to the rules of7-25
practice adopted pursuant to subsection 2, that a hearing or appeals7-26
officer has violated a standard for conduct.7-27
Sec. 11. NRS 232.212 is hereby amended to read as follows: 232.212 As used in NRS 232.212 to 232.2195, inclusive, and section7-29
10 of this act, unless the context requires otherwise:7-30
1. "Department" means the department of administration.7-31
2. "Director" means the director of the department.7-32
Sec. 12. NRS 232.215 is hereby amended to read as follows: 232.215 The director:7-34
1. Shall appoint a chief of the:7-35
(a) Risk management division;7-36
(b) Buildings and grounds division;7-37
(c) Purchasing division;7-38
(d) State printing division;7-39
(e) Administrative services division; and7-40
(f) Motor pool division if separately established.7-41
2. Shall appoint a chief of the budget division, or may serve in this7-42
position if he has the qualifications required by NRS 353.175.8-1
3. Shall serve as chief of the hearings division and8-2
hearing officers and compensation officers. The director may designate one8-3
of the appeals officers in the division8-4
The senior appeals officer shall supervise the administrative, technical and8-5
procedural activities of the division. The senior appeals officer shall8-6
perform such additional duties as the director, serving as chief of the8-7
hearings division, may require.8-8
4. Shall serve as chairman of the state public works board.8-9
5. Is responsible for the administration, through the divisions of the8-10
department, of the provisions of chapters 331, 333, 336 and 344 of NRS,8-11
NRS 353.150 to 353.246, inclusive, and all other provisions of law relating8-12
to the functions of the divisions of the department.8-13
6. Is responsible for the administration of the laws of this state relating8-14
to the negotiation and procurement of medical services and other benefits8-15
for state agencies.8-16
7. Has such other powers and duties as are provided by law.8-17
Sec. 13. NRS 232.680 is hereby amended to read as follows: 232.680 1. The cost of carrying out the provisions of NRS 232.5508-19
to 232.700, inclusive, and of supporting the division, a full-time employee8-20
of the legislative counsel bureau, the fraud control unit for industrial8-21
insurance established pursuant to NRS 228.420 and the legislative8-22
committee on workers’ compensation created pursuant to NRS 218.5375,8-23
must be paid from assessments payable by each:8-24
(a) Insurer based upon expected annual premiums to be received; and8-25
(b) Employer who provides accident benefits for injured employees8-26
pursuant to NRS 616C.265, based upon his expected annual expenses of8-27
providing those benefits.8-28
For the purposes of this subsection, the "premiums to be received" by a8-29
self-insured employer or an association of self-insured public or private8-30
employers shall be deemed to be the same fraction of the premiums to be8-31
received by the state industrial insurance system that his expected annual8-32
expenditure for claims is of the expected annual expenditure of the system8-33
for claims. The division shall adopt regulations which establish formulas of8-34
assessment which result in an equitable distribution of costs among the8-35
insurers and employers who provide accident benefits for injured8-36
employees. The formulas may utilize actual expenditures for claims.8-37
2. Federal grants may partially defray the costs of the division.8-38
3. Assessments made against insurers by the division after the adoption8-39
of regulations must be used to defray all costs and expenses of8-40
administering the program of workers’ compensation, including the8-41
payment of:8-42
(a) All salaries and other expenses in administering the division,8-43
including the costs of the office and staff of the administrator.9-1
(b) All salaries and other expenses of administering NRS 616A.435 to9-2
616A.460, inclusive, the offices of the hearings division of the department9-3
of administration and the programs of self-insurance and review of9-4
premium rates by the commissioner of insurance.9-5
(c) The salary and other expenses of a full-time employee of the9-6
legislative counsel bureau whose principal duties are limited to conducting9-7
research and reviewing and evaluating data related to industrial insurance.9-8
(d) All salaries and other expenses of the fraud control unit for industrial9-9
insurance established pursuant to NRS 228.420.9-10
(e) Claims against uninsured employers arising from compliance with9-11
NRS 616C.220 and 617.401.9-12
(f) All salaries and expenses of the members of the legislative committee9-13
on workers’ compensation and any other expenses incurred by the9-14
committee in carrying out its duties pursuant to NRS 218.5375 to9-15
218.5378, inclusive.9-16
(g) All the per diem allowances and travel expenses authorized for the9-17
members of the commission to recommend appeals officers pursuant to9-18
subsection 7 of section 4 of this act.9-19
Sec. 14. As soon as is practicable after July 1, 1999:9-20
1. The governor shall appoint to the commission to recommend9-21
appeals officers, created pursuant to section 4 of this act:9-22
(a) One person pursuant to paragraph (a) of subsection 1 of section 4 of9-23
this act to a term that expires on June 30, 2003.9-24
(b) One person pursuant to paragraph (b) of subsection 1 of section 4 of9-25
this act to a term that expires on June 30, 2001.9-26
(c) One person pursuant to paragraph (c) of subsection 1 of section 4 of9-27
this act to a term that expires on June 30, 2003.9-28
(d) One person pursuant to paragraph (c) of subsection 1 of section 4 of9-29
this act to a term that expires on June 30, 2001.9-30
2. The board of governors of the State Bar of Nevada shall appoint to9-31
the commission to recommend appeals officers, created pursuant to section9-32
4 of this act, one person pursuant to paragraph (d) of subsection 1 of9-33
section 4 of this act to a term that expires on June 30, 2003.9-34
Sec. 15. 1. This section and sections 1 to 12, inclusive, and 14 of9-35
this act become effective on July 1, 1999.9-36
2. Section 13 of this act becomes effective at 12:01 a.m. on July 1,9-37
1999.~