(REPRINTED WITH ADOPTED AMENDMENTS)
SECOND REPRINT A.B. 338
Assembly Bill No. 338–Assemblyman Bache
March 13, 2001
____________
Referred to Committee on Commerce and Labor
SUMMARY—Makes various changes concerning workers’ compensation. (BDR 53‑711)
FISCAL NOTE: Effect on Local Government: Yes.
Effect on the State: No.
~
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).
THE PEOPLE OF THE STATE OF NEVADA, REPRESENTED IN
SENATE AND ASSEMBLY, DO ENACT AS FOLLOWS:
1-1 Secs. 1-3. (Deleted by amendment.)
1-2 Sec. 4. NRS 616B.527 is hereby amended to read as follows:
1-3 616B.527 1. A self-insured employer, an association of self-insured
1-4 public or private employers or a private carrier may:
1-5 [1.] (a) Enter into a contract or contracts with one or more
1-6 organizations for managed care to provide comprehensive medical and
1-7 health care services to employees for injuries and diseases that are
1-8 compensable pursuant to chapters 616A to 617, inclusive, of NRS.
1-9 [2.] (b) Enter into a contract or contracts with providers of health care,
1-10 including, without limitation, physicians who provide primary care,
1-11 specialists, pharmacies, physical therapists, radiologists, nurses, diagnostic
1-12 facilities, laboratories, hospitals and facilities that provide treatment to
1-13 outpatients, to provide medical and health care services to employees for
2-1 injuries and diseases that are compensable pursuant to chapters 616A to
2-2 617, inclusive, of NRS.
2-3 [3.] (c) Require employees to obtain medical and health care services
2-4 for their industrial injuries from those organizations and persons with
2-5 whom the self-insured employer, association or private carrier has
2-6 contracted pursuant to [subsections 1 and 2,] paragraphs (a) and (b), or as
2-7 the self-insured employer, association or private carrier otherwise
2-8 prescribes.
2-9 [4. Require]
2-10 (d) Except as otherwise provided in subsection 3 of NRS 616C.090,
2-11 require employees to obtain the approval of the self-insured employer,
2-12 association or private carrier before obtaining medical and health care
2-13 services for their industrial injuries from a provider of health care who has
2-14 not been previously approved by the self-insured employer, association or
2-15 private carrier.
2-16 [5.] 2. An organization for managed care with whom a self-insured
2-17 employer, association of self-insured public or private employers or a
2-18 private carrier has contracted pursuant to this section shall comply with the
2-19 provisions of NRS 616B.528, 616B.5285 and 616B.529.
2-20 Sec. 5. Chapter 616C of NRS is hereby amended by adding thereto a
2-21 new section to read as follows:
2-22 If:
2-23 1. An insurer, an organization for managed care, a third-party
2-24 administrator or an employer who provides accident benefits for injured
2-25 employees pursuant to NRS 616C.265 denies authorization or
2-26 responsibility for payment for treatment or other services provided by a
2-27 provider of health care that the injured employee alleges are related to an
2-28 industrial injury or occupational disease;
2-29 2. The injured employee pays in protest for the treatment or other
2-30 services; and
2-31 3. A hearing officer or appeals officer ultimately determines that the
2-32 treatment or other services should have been covered, or the insurer,
2-33 organization for managed care, third-party administrator or employer
2-34 who provides accident benefits subsequently accepts responsibility for
2-35 payment,
2-36 the hearing officer or appeals officer shall order the insurer,
2-37 organization for managed care, third-party administrator or employer
2-38 who provides accident benefits to pay to the provider of health care the
2-39 amount which is allowed for the treatment or other services set forth in
2-40 the schedule of fees and charges established pursuant to NRS 616C.260
2-41 or, if the insurer has contracted with an organization for managed care
2-42 or with providers of health care pursuant to NRS 616B.527, the amount
2-43 that is allowed for the treatment or other services under that contract.
2-44 Within 30 days after receiving the payment, the provider of health care
2-45 shall reimburse the injured employee for the amount paid in protest by
2-46 him.
2-47 Sec. 6. NRS 616C.050 is hereby amended to read as follows:
2-48 616C.050 1. An insurer shall provide to each claimant:
3-1 (a) Upon written request, one copy of any medical information
3-2 concerning his injury or illness.
3-3 (b) A statement which contains information concerning the claimant’s
3-4 right to:
3-5 (1) Receive the information and forms necessary to file a claim;
3-6 (2) Select a treating physician or chiropractor and an alternative
3-7 treating physician or chiropractor in accordance with the provisions of
3-8 NRS 616C.090;
3-9 (3) Request the appointment of the Nevada attorney for injured
3-10 workers to represent him before the appeals officer;
3-11 (4) File a complaint with the administrator;
3-12 (5) When applicable, receive compensation for:
3-13 (I) Permanent total disability;
3-14 (II) Temporary total disability;
3-15 (III) Permanent partial disability;
3-16 (IV) Temporary partial disability; or
3-17 (V) All medical costs related to his injury or disease;
3-18 (6) Receive services for rehabilitation if his injury prevents him from
3-19 returning to gainful employment;
3-20 (7) Review by a hearing officer of any determination or rejection of a
3-21 claim by the insurer within the time specified by statute; and
3-22 (8) Judicial review of any final decision within the time specified by
3-23 statute.
3-24 2. The insurer’s statement must include a copy of the form designed
3-25 by the administrator pursuant to subsection 7 of NRS 616C.090 that
3-26 notifies injured employees of their right to select an alternative treating
3-27 physician or chiropractor. The administrator shall adopt regulations for
3-28 the manner of compliance by an insurer with the other provisions of
3-29 subsection 1.
3-30 Sec. 7. NRS 616C.090 is hereby amended to read as follows:
3-31 616C.090 1. The administrator shall establish a panel of physicians
3-32 and chiropractors who have demonstrated special competence and interest
3-33 in industrial health to treat injured employees under chapters 616A to
3-34 616D, inclusive, or chapter 617 of NRS. Every employer whose insurer has
3-35 not entered into a contract with an organization for managed care or with
3-36 providers of health care services pursuant to NRS 616B.527 shall maintain
3-37 a list of those physicians and chiropractors on the panel who are reasonably
3-38 accessible to his employees.
3-39 2. An injured employee whose employer’s insurer has not entered into
3-40 a contract with an organization for managed care or with providers of
3-41 health care services pursuant to NRS 616B.527 may choose his treating
3-42 physician or chiropractor from the panel of physicians and chiropractors. If
3-43 the injured employee is not satisfied with the first physician or chiropractor
3-44 he so chooses, he may make an alternative choice of physician or
3-45 chiropractor from the panel if the choice is made within 90 days after his
3-46 injury. The insurer shall notify the first physician or chiropractor in
3-47 writing. The notice must be postmarked within 3 working days after the
3-48 insurer receives knowledge of the change. The first physician or
3-49 chiropractor must be reimbursed only for the services he rendered to the
4-1 injured employee up to and including the date of notification. [Any] Except
4-2 as otherwise provided in this subsection, any further change is subject to
4-3 the approval of the insurer, which must be granted or denied within 10 days
4-4 after a written request for such a change is received from the injured
4-5 employee. If no action is taken on the request within 10 days, the request
4-6 shall be deemed granted. Any request for a change of physician or
4-7 chiropractor must include the name of the new physician or chiropractor
4-8 chosen by the injured employee. If the treating physician or chiropractor
4-9 refers the injured employee to a specialist for treatment, the treating
4-10 physician or chiropractor shall provide to the injured employee a list that
4-11 includes the name of each physician or chiropractor with that
4-12 specialization who is on the panel. After receiving the list, the injured
4-13 employee shall, at the time the referral is made, select a physician or
4-14 chiropractor from the list.
4-15 3. An injured employee whose employer’s insurer has entered into a
4-16 contract with an organization for managed care or with providers of health
4-17 care services pursuant to NRS 616B.527 must choose his treating physician
4-18 or chiropractor pursuant to the terms of that contract. If the injured
4-19 employee is not satisfied with the first physician or chiropractor he so
4-20 chooses, he may make an alternative choice of physician or chiropractor
4-21 pursuant to the terms of the contract if the choice is made within 90 days
4-22 after his injury. If the injured employee, after choosing his treating
4-23 physician or chiropractor, moves to a county which is not served by the
4-24 organization for managed care or providers of health care services named
4-25 in the contract and the insurer determines that it is impractical for the
4-26 injured employee to continue treatment with the physician or chiropractor,
4-27 the injured employee must choose a treating physician or chiropractor who
4-28 has agreed to the terms of that contract unless the insurer authorizes the
4-29 injured employee to choose another physician or chiropractor. If the
4-30 treating physician or chiropractor refers the injured employee to a
4-31 specialist for treatment, the treating physician or chiropractor shall
4-32 provide to the injured employee a list that includes the name of each
4-33 physician or chiropractor with that specialization who is available
4-34 pursuant to the terms of the contract with the organization for managed
4-35 care or with providers of health care services pursuant to NRS 616B.527,
4-36 as appropriate. After receiving the list, the injured employee shall, at the
4-37 time the referral is made, select a physician or chiropractor from the list.
4-38 If the employee fails to select a physician or chiropractor, the insurer
4-39 may select a physician or chiropractor with that specialization. If a
4-40 physician or chiropractor with that specialization is not available
4-41 pursuant to the terms of the contract, the organization for managed care
4-42 or the provider of health care services may select a physician or
4-43 chiropractor with that specialization.
4-44 4. Except when emergency medical care is required and except as
4-45 otherwise provided in NRS 616C.055, the insurer is not responsible for any
4-46 charges for medical treatment or other accident benefits furnished or
4-47 ordered by any physician, chiropractor or other person selected by the
4-48 injured employee in disregard of the provisions of this section or for any
4-49 compensation for any aggravation of the injured employee’s injury
5-1 attributable to improper treatments by such physician, chiropractor or other
5-2 person.
5-3 5. The administrator may order necessary changes in a panel of
5-4 physicians and chiropractors and shall suspend or remove any physician or
5-5 chiropractor from a panel for good cause shown.
5-6 6. An injured employee may receive treatment by more than one
5-7 physician or chiropractor if the insurer provides written authorization for
5-8 such treatment.
5-9 7. The administrator shall design a form that notifies injured
5-10 employees of their right pursuant to subsections 2 and 3 to select an
5-11 alternative treating physician or chiropractor and make the form
5-12 available to insurers for distribution pursuant to subsection 2 of NRS
5-13 616C.050.
5-14 Secs. 8 and 9. (Deleted by amendment.)
5-15 Sec. 10. NRS 616C.135 is hereby amended to read as follows:
5-16 616C.135 1. A provider of health care who accepts a patient as a
5-17 referral for the treatment of an industrial injury or an occupational disease
5-18 may not charge the patient for any treatment related to the industrial injury
5-19 or occupational disease, but must charge the insurer. The provider of health
5-20 care may charge the patient for any other unrelated services which are
5-21 requested in writing by the patient.
5-22 2. The insurer is liable for the charges for approved services if the
5-23 charges do not exceed:
5-24 (a) The fees established in accordance with NRS 616C.260 or the usual
5-25 fee charged by that person or institution, whichever is less; and
5-26 (b) The charges provided for by the contract between the provider of
5-27 health care and the insurer or the contract between the provider of health
5-28 care and the organization for managed care.
5-29 3. A provider of health care may accept payment from an injured
5-30 employee who is paying in protest pursuant to section 5 of this act for
5-31 treatment or other services that the injured employee alleges are related
5-32 to the industrial injury or occupational disease.
5-33 4. If a provider of health care, an organization for managed care, an
5-34 insurer or an employer violates the provisions of this section, the
5-35 administrator shall impose an administrative fine of not more than $250 for
5-36 each violation.
5-37 Sec. 11. NRS 616C.330 is hereby amended to read as follows:
5-38 616C.330 1. The hearing officer shall:
5-39 (a) Within 5 days after receiving a request for a hearing, set the hearing
5-40 for a date and time within 30 days after his receipt of the request;
5-41 (b) Give notice by mail or by personal service to all interested parties to
5-42 the hearing at least 15 days before the date and time scheduled; and
5-43 (c) Conduct hearings expeditiously and informally.
5-44 2. The notice must include a statement that the injured employee may
5-45 be represented by a private attorney or seek assistance and advice from the
5-46 Nevada attorney for injured workers.
5-47 3. If necessary to resolve a medical question concerning an injured
5-48 employee’s condition or to determine the necessity of treatment for which
5-49 authorization for payment has been denied, the hearing officer may refer
6-1 the employee to a physician or chiropractor of his choice who has
6-2 demonstrated special competence to treat the particular medical condition
6-3 of the employee. If the medical question concerns the rating of a permanent
6-4 disability, the hearing officer may refer the employee to a rating physician
6-5 or chiropractor. The rating physician or chiropractor must be selected in
6-6 rotation from the list of qualified physicians and chiropractors maintained
6-7 by the administrator pursuant to subsection 2 of NRS 616C.490, unless the
6-8 insurer and injured employee otherwise agree to a rating physician or
6-9 chiropractor. The insurer shall pay the costs of any medical examination
6-10 requested by the hearing officer.
6-11 4. If an injured employee has requested payment for the cost of
6-12 obtaining a second determination of his percentage of disability pursuant to
6-13 NRS 616C.100, the hearing officer shall decide whether the determination
6-14 of the higher percentage of disability made pursuant to NRS 616C.100 is
6-15 appropriate and, if so, may order the insurer to pay to the employee an
6-16 amount equal to the maximum allowable fee established by the
6-17 administrator pursuant to NRS 616C.260 for the type of service performed,
6-18 or the usual fee of that physician or chiropractor for such service,
6-19 whichever is less.
6-20 5. The hearing officer shall order an insurer, organization for
6-21 managed care or employer who provides accident benefits for injured
6-22 employees pursuant to NRS 616C.265 to pay the charges of a provider of
6-23 health care if the conditions of section 5 of this act are satisfied.
6-24 6. The hearing officer may allow or forbid the presence of a court
6-25 reporter and the use of a tape recorder in a hearing.
6-26 [6.] 7. The hearing officer shall render his decision within 15 days
6-27 after:
6-28 (a) The hearing; or
6-29 (b) He receives a copy of the report from the medical examination he
6-30 requested.
6-31 [7.] 8. The hearing officer shall render his decision in the most
6-32 efficient format developed by the chief of the hearings division of the
6-33 department of administration.
6-34 [8.] 9. The hearing officer shall give notice of his decision to each
6-35 party by mail. He shall include with the notice of his decision the necessary
6-36 forms for appealing from the decision.
6-37 [9.] 10. Except as otherwise provided in NRS 616C.380, the decision
6-38 of the hearing officer is not stayed if an appeal from that decision is taken
6-39 unless an application for a stay is submitted by a party. If such an
6-40 application is submitted, the decision is automatically stayed until a
6-41 determination is made on the application. A determination on the
6-42 application must be made within 30 days after the filing of the application.
6-43 If, after reviewing the application, a stay is not granted by the hearing
6-44 officer or an appeals officer, the decision must be complied with within 10
6-45 days after the refusal to grant a stay.
6-46 Sec. 12. NRS 616C.360 is hereby amended to read as follows:
6-47 616C.360 1. A stenographic or electronic record must be kept of the
6-48 hearing before the appeals officer and the rules of evidence applicable to
6-49 contested cases under chapter 233B of NRS apply to the hearing.
7-1 2. The appeals officer must hear any matter raised before him on its
7-2 merits, including new evidence bearing on the matter.
7-3 3. If necessary to resolve a medical question concerning an injured
7-4 employee’s condition or to determine the necessity of treatment for which
7-5 authorization for payment has been denied, the appeals officer may refer
7-6 the employee to a physician or chiropractor of his choice who has
7-7 demonstrated special competence to treat the particular medical condition
7-8 of the employee. If the medical question concerns the rating of a permanent
7-9 disability, the appeals officer may refer the employee to a rating physician
7-10 or chiropractor. The rating physician or chiropractor must be selected in
7-11 rotation from the list of qualified physicians or chiropractors maintained by
7-12 the administrator pursuant to subsection 2 of NRS 616C.490, unless the
7-13 insurer and the injured employee otherwise agree to a rating physician or
7-14 chiropractor. The insurer shall pay the costs of any examination requested
7-15 by the appeals officer.
7-16 4. If an injured employee has requested payment for the cost of
7-17 obtaining a second determination of his percentage of disability pursuant to
7-18 NRS 616C.100, the appeals officer shall decide whether the determination
7-19 of the higher percentage of disability made pursuant to NRS 616C.100 is
7-20 appropriate and, if so, may order the insurer to pay to the employee an
7-21 amount equal to the maximum allowable fee established by the
7-22 administrator pursuant to NRS 616C.260 for the type of service performed,
7-23 or the usual fee of that physician or chiropractor for such service,
7-24 whichever is less.
7-25 5. The appeals officer shall order an insurer, organization for
7-26 managed care or employer who provides accident benefits for injured
7-27 employees pursuant to NRS 616C.265 to pay the charges of a provider of
7-28 health care if the conditions of section 5 of this act are satisfied.
7-29 6. Any party to the appeal or the appeals officer may order a transcript
7-30 of the record of the hearing at any time before the seventh day after the
7-31 hearing. The transcript must be filed within 30 days after the date of the
7-32 order unless the appeals officer otherwise orders.
7-33 [6.] 7. The appeals officer shall render his decision:
7-34 (a) If a transcript is ordered within 7 days after the hearing, within 30
7-35 days after the transcript is filed; or
7-36 (b) If a transcript has not been ordered, within 30 days after the date of
7-37 the hearing.
7-38 [7.] 8. The appeals officer may affirm, modify or reverse any decision
7-39 made by the hearing officer and issue any necessary and proper order to
7-40 give effect to his decision.
7-41 Sec. 13. (Deleted by amendment.)
7-42 Sec. 14. NRS 616C.475 is hereby amended to read as follows:
7-43 616C.475 1. Except as otherwise provided in this section, NRS
7-44 616C.175 and 616C.390, every employee in the employ of an employer,
7-45 within the provisions of chapters 616A to 616D, inclusive, of NRS, who is
7-46 injured by accident arising out of and in the course of employment, or his
7-47 dependents, is entitled to receive for the period of temporary total
7-48 disability, 66 2/3 percent of the average monthly wage.
8-1 2. Except as otherwise provided in NRS 616B.028 and 616B.029, an
8-2 injured employee or his dependents are not entitled to accrue or be paid
8-3 any benefits for a temporary total disability during the time the injured
8-4 employee is incarcerated. The injured employee or his dependents are
8-5 entitled to receive such benefits when the injured employee is released
8-6 from incarceration if he is certified as temporarily totally disabled by a
8-7 physician or chiropractor.
8-8 3. If a claim for the period of temporary total disability is allowed, the
8-9 first payment pursuant to this section must be issued by the insurer within
8-10 14 working days after receipt of the initial certification of disability and
8-11 regularly thereafter.
8-12 4. Any increase in compensation and benefits effected by the
8-13 amendment of subsection 1 is not retroactive.
8-14 5. Payments for a temporary total disability must cease when:
8-15 (a) A physician or chiropractor determines that the employee is
8-16 physically capable of any gainful employment for which the employee is
8-17 suited, after giving consideration to the employee’s education, training and
8-18 experience;
8-19 (b) The employer offers the employee light-duty employment or
8-20 employment that is modified according to the limitations or restrictions
8-21 imposed by a physician or chiropractor pursuant to subsection 7; or
8-22 (c) Except as otherwise provided in NRS 616B.028 and 616B.029, the
8-23 employee is incarcerated.
8-24 6. Each insurer may, with each check that it issues to an injured
8-25 employee for a temporary total disability, include a form approved by the
8-26 division for the injured employee to request continued compensation for
8-27 the temporary total disability.
8-28 7. A certification of disability issued by a physician or chiropractor
8-29 must:
8-30 (a) Include the period of disability and a description of any physical
8-31 limitations or restrictions imposed upon the work of the employee;
8-32 (b) Specify whether the limitations or restrictions are permanent or
8-33 temporary; and
8-34 (c) Be signed by the treating physician or chiropractor authorized
8-35 pursuant to NRS 616B.527[.] or appropriately chosen pursuant to
8-36 subsection 3 of NRS 616C.090.
8-37 8. If the certification of disability specifies that the physical limitations
8-38 or restrictions are temporary, the employer of the employee at the time of
8-39 his accident is not required to comply with NRS 616C.545 to 616C.575,
8-40 inclusive, and 616C.590 or the regulations adopted by the division
8-41 governing vocational rehabilitation services if the employer offers the
8-42 employee temporary, light-duty employment. Any offer of temporary,
8-43 light-duty employment made by the employer must specify a position that:
8-44 (a) Is substantially similar to the employee’s position at the time of his
8-45 injury in relation to the location of the employment and the hours he is
8-46 required to work; and
8-47 (b) Provides a gross wage that is:
8-48 (1) If the position is in the same classification of employment, equal
8-49 to the gross wage the employee was earning at the time of his injury; or
9-1 (2) If the position is not in the same classification of employment,
9-2 substantially similar to the gross wage the employee was earning at the
9-3 time of his injury.
9-4 Sec. 15. NRS 616C.490 is hereby amended to read as follows:
9-5 616C.490 1. Except as otherwise provided in NRS 616C.175, every
9-6 employee, in the employ of an employer within the provisions of chapters
9-7 616A to 616D, inclusive, of NRS, who is injured by an accident arising out
9-8 of and in the course of employment is entitled to receive the compensation
9-9 provided for permanent partial disability. As used in this section,
9-10 “disability” and “impairment of the whole man” are equivalent terms.
9-11 2. Within 30 days after receiving from a physician or chiropractor a
9-12 report indicating that the injured employee may have suffered a permanent
9-13 disability and is stable and ratable, the insurer shall schedule an
9-14 appointment with the rating physician or chiropractor selected pursuant to
9-15 this subsection to determine the extent of the employee’s disability. Unless
9-16 the insurer and the injured employee otherwise agree to a rating physician
9-17 or chiropractor:
9-18 (a) The insurer shall select the rating physician or chiropractor from the
9-19 list of qualified rating physicians and chiropractors designated by the
9-20 administrator, to determine the percentage of disability in accordance with
9-21 the American Medical Association’s Guides to the Evaluation of
9-22 Permanent Impairment as adopted and supplemented by the division
9-23 pursuant to NRS 616C.110.
9-24 (b) Rating physicians and chiropractors must be selected in rotation
9-25 from the list of qualified physicians and chiropractors designated by the
9-26 administrator, according to their area of specialization and the order in
9-27 which their names appear on the list[.] unless the next physician or
9-28 chiropractor is currently an employee of the insurer making the
9-29 selection, in which case the insurer must select the physician or
9-30 chiropractor who is next on the list and who is not currently an employee
9-31 of the insurer.
9-32 3. If an insurer contacts the treating physician or chiropractor to
9-33 determine whether an injured employee has suffered a permanent
9-34 disability, the insurer shall deliver to the treating physician or
9-35 chiropractor that portion or a summary of that portion of the American
9-36 Medical Association’s Guides to the Evaluation of Permanent
9-37 Impairment as adopted by the division pursuant to NRS 616C.110 that is
9-38 relevant to the type of injury incurred by the employee.
9-39 4. At the request of the insurer, the injured employee shall, before an
9-40 evaluation by a rating physician or chiropractor is performed, notify the
9-41 insurer of:
9-42 (a) Any previous evaluations performed to determine the extent of any
9-43 of the employee’s disabilities; and
9-44 (b) Any previous injury, disease or condition sustained by the employee
9-45 which is relevant to the evaluation performed pursuant to this
9-46 section.
9-47 The notice must be on a form approved by the administrator and provided
9-48 to the injured employee by the insurer at the time of the insurer’s request.
10-1 [4.] 5. Unless the regulations adopted pursuant to NRS 616C.110
10-2 provide otherwise, a rating evaluation must include an evaluation of the
10-3 loss of motion, sensation and strength of an injured employee if the injury
10-4 is of a type that might have caused such a loss. No factors other than the
10-5 degree of physical impairment of the whole man may be considered in
10-6 calculating the entitlement to compensation for a permanent partial
10-7 disability.
10-8 [5.] 6. The rating physician or chiropractor shall provide the insurer
10-9 with his evaluation of the injured employee. After receiving the evaluation,
10-10 the insurer shall, within 14 days, provide the employee with a copy of the
10-11 evaluation and notify the employee:
10-12 (a) Of the compensation to which he is entitled pursuant to this
10-13 section; or
10-14 (b) That he is not entitled to benefits for permanent partial disability.
10-15 [6.] 7. Each 1 percent of impairment of the whole man must be
10-16 compensated by a monthly payment:
10-17 (a) Of 0.5 percent of the claimant’s average monthly wage for injuries
10-18 sustained before July 1, 1981;
10-19 (b) Of 0.6 percent of the claimant’s average monthly wage for injuries
10-20 sustained on or after July 1, 1981, and before June 18, 1993;
10-21 (c) Of 0.54 percent of the claimant’s average monthly wage for injuries
10-22 sustained on or after June 18, 1993, and before January 1, 2000; and
10-23 (d) Of 0.6 percent of the claimant’s average monthly wage for injuries
10-24 sustained on or after January 1, 2000.
10-25 Compensation must commence on the date of the injury or the day
10-26 following the termination of temporary disability compensation, if any,
10-27 whichever is later, and must continue on a monthly basis for 5 years or
10-28 until the claimant is 70 years of age, whichever is later.
10-29 [7.] 8. Compensation benefits may be paid annually to claimants who
10-30 will be receiving less than $100 a month.
10-31 [8.] 9. Where there is a previous disability, as the loss of one eye, one
10-32 hand, one foot, or any other previous permanent disability, the percentage
10-33 of disability for a subsequent injury must be determined by computing the
10-34 percentage of the entire disability and deducting therefrom the percentage
10-35 of the previous disability as it existed at the time of the subsequent injury.
10-36 [9.] 10. The division may adopt schedules for rating permanent
10-37 disabilities resulting from injuries sustained before July 1, 1973, and
10-38 reasonable regulations to carry out the provisions of this section.
10-39 [10.] 11. The increase in compensation and benefits effected by the
10-40 amendment of this section is not retroactive for accidents which occurred
10-41 before July 1, 1973.
10-42 [11.] 12. This section does not entitle any person to double payments
10-43 for the death of an employee and a continuation of payments for a
10-44 permanent partial disability, or to a greater sum in the aggregate than if the
10-45 injury had been fatal.
10-46 Sec. 16. NRS 616C.495 is hereby amended to read as follows:
10-47 616C.495 1. Except as otherwise provided in NRS 616C.380, an
10-48 award for a permanent partial disability may be paid in a lump sum under
10-49 the following conditions:
11-1 (a) A claimant injured on or after July 1, 1973, and before July 1, 1981,
11-2 who incurs a disability that does not exceed 12 percent may elect to receive
11-3 his compensation in a lump sum. A claimant injured on or after July 1,
11-4 1981, and before July 1, 1995, who incurs a disability that does not exceed
11-5 25 percent may elect to receive his compensation in a lump sum.
11-6 (b) The spouse, or in the absence of a spouse, any dependent child of a
11-7 deceased claimant injured on or after July 1, 1973, who is not entitled to
11-8 compensation in accordance with NRS 616C.505, is entitled to a lump sum
11-9 equal to the present value of the deceased claimant’s undisbursed award for
11-10 a permanent partial disability.
11-11 (c) Any claimant injured on or after July 1, 1981, and before July 1,
11-12 1995, who incurs a disability that exceeds 25 percent may elect to receive
11-13 his compensation in a lump sum equal to the present value of an award for
11-14 a disability of 25 percent. If the claimant elects to receive compensation
11-15 pursuant to this paragraph, the insurer shall pay in installments to the
11-16 claimant that portion of the claimant’s disability in excess of 25 percent.
11-17 (d) Any claimant injured on or after July 1, 1995, may elect to receive
11-18 his compensation in a lump sum in accordance with regulations adopted by
11-19 the administrator and approved by the governor. The administrator shall
11-20 adopt regulations for determining the eligibility of such a claimant to
11-21 receive all or any portion of his compensation in a lump sum. Such
11-22 regulations may include the manner in which an award for a permanent
11-23 partial disability may be paid to such a claimant in installments.
11-24 Notwithstanding the provisions of NRS 233B.070, any regulation adopted
11-25 pursuant to this paragraph does not become effective unless it is first
11-26 approved by the governor.
11-27 2. If the claimant elects to receive his payment for a permanent partial
11-28 disability in a lump sum pursuant to subsection 1, all of his benefits for
11-29 compensation terminate. His acceptance of that payment constitutes a final
11-30 settlement of all factual and legal issues in the case. By so accepting he
11-31 waives all of his rights regarding the claim, including the right to appeal
11-32 from the closure of the case or the percentage of his disability, except:
11-33 (a) His right to reopen his claim according to the provisions of NRS
11-34 616C.390; and
11-35 (b) Any counseling, training or other rehabilitative services provided by
11-36 the insurer.
11-37 The claimant must be advised in writing of the provisions of this
11-38 subsection when he demands his payment in a lump sum, and has 20 days
11-39 after the mailing or personal delivery of this notice within which to retract
11-40 or reaffirm his demand, before payment may be made and his election
11-41 becomes final.
11-42 3. Any lump-sum payment which has been paid on a claim incurred on
11-43 or after July 1, 1973, must be supplemented if necessary to conform to the
11-44 provisions of this section.
11-45 4. Except as otherwise provided in this subsection, the total lump-sum
11-46 payment for disablement must not be less than one-half the product of the
11-47 average monthly wage multiplied by the percentage of disability. If the
11-48 claimant received compensation in installment payments for his permanent
11-49 partial disability before electing to receive his payment for that disability in
12-1 a lump sum, the lump-sum payment must be calculated for the remaining
12-2 payment of compensation.
12-3 5. The lump sum payable must be equal to the present value of the
12-4 compensation awarded, less any advance payment or lump sum previously
12-5 paid. The present value must be calculated using monthly payments in the
12-6 amounts prescribed in subsection [6] 7 of NRS 616C.490 and actuarial
12-7 annuity tables adopted by the division. The tables must be reviewed
12-8 annually by a consulting actuary.
12-9 6. If a claimant would receive more money by electing to receive
12-10 compensation in a lump sum than he would if he receives installment
12-11 payments, he may elect to receive the lump-sum payment.
12-12 Sec. 17. NRS 616C.555 is hereby amended to read as follows:
12-13 616C.555 1. A vocational rehabilitation counselor shall develop a
12-14 plan for a program of vocational rehabilitation for each injured employee
12-15 who is eligible for vocational rehabilitation services pursuant to NRS
12-16 616C.590. The counselor shall work with the insurer and the injured
12-17 employee to develop a program that is compatible with the injured
12-18 employee’s age, sex and physical condition.
12-19 2. If the counselor determined in the written assessment developed
12-20 pursuant to NRS 616C.550 that the injured employee has existing
12-21 marketable skills, the plan must consist of job placement assistance only.
12-22 When practicable, the goal of job placement assistance must be to aid the
12-23 employee in finding a position which pays a gross wage that is equal to or
12-24 greater than 80 percent of the gross wage that he was earning at the time of
12-25 his injury. An injured employee must not receive job placement assistance
12-26 for more than 6 months after the date on which he was notified that he is
12-27 eligible only for job placement assistance because:
12-28 (a) He was physically capable of returning to work; or
12-29 (b) It was determined that he had existing marketable skills.
12-30 3. If the counselor determined in the written assessment developed
12-31 pursuant to NRS 616C.550 that the injured employee does not have
12-32 existing marketable skills, the plan must consist of a program which trains
12-33 or educates the injured employee and provides job placement assistance.
12-34 Except as otherwise provided in NRS 616C.560, such a program must not
12-35 exceed:
12-36 (a) If the injured employee has incurred a permanent disability as a
12-37 result of which permanent restrictions on his ability to work have been
12-38 imposed but no permanent physical impairment rating has been issued,
12-39 or a permanent disability with a permanent physical impairment of 1
12-40 percent or more but less than 6 percent, 9 months.
12-41 (b) If the injured employee has incurred a permanent physical
12-42 impairment of 6 percent or more, but less than 11 percent, 1 year.
12-43 (c) If the injured employee has incurred a permanent physical
12-44 impairment of 11 percent or more, 18 months.
12-45 The percentage of the injured employee’s permanent physical impairment
12-46 must be determined pursuant to NRS 616C.490.
12-47 4. A plan for a program of vocational rehabilitation must comply with
12-48 the requirements set forth in NRS 616C.585.
13-1 5. A plan created pursuant to subsection 2 or 3 must assist the
13-2 employee in finding a job or train or educate the employee and assist him
13-3 in finding a job that is a part of an employer’s regular business
13-4 operations and from which the employee will gain skills that would
13-5 generally be transferable to a job with another employer.
13-6 6. A program of vocational rehabilitation must not commence before
13-7 the treating physician or chiropractor, or an examining physician or
13-8 chiropractor determines that the injured employee is capable of safely
13-9 participating in the program.
13-10 [6.] 7. If, based upon the opinion of a treating or an examining
13-11 physician or chiropractor, the counselor determines that an injured
13-12 employee is not eligible for vocational rehabilitation services, the
13-13 counselor shall provide a copy of the opinion to the injured employee, the
13-14 injured employee’s employer and the insurer.
13-15 [7.] 8. A plan for a program of vocational rehabilitation must be
13-16 signed by a certified vocational rehabilitation counselor.
13-17 [8.] 9. If an initial program of vocational rehabilitation pursuant to this
13-18 section is unsuccessful, an injured employee may submit a written request
13-19 for the development of a second program of vocational rehabilitation which
13-20 relates to the same injury. An insurer shall authorize a second program for
13-21 an injured employee upon good cause shown.
13-22 [9.] 10. If a second program of vocational rehabilitation pursuant to
13-23 subsection [8] 9 is unsuccessful, an injured employee may submit a written
13-24 request for the development of a third program of vocational rehabilitation
13-25 which relates to the same injury. The insurer, with the approval of the
13-26 employer who was the injured employee’s employer at the time of his
13-27 injury, may authorize a third program for the injured employee. If such an
13-28 employer has terminated operations, his approval is not required for
13-29 authorization of a third program. An insurer’s determination to authorize or
13-30 deny a third program of vocational rehabilitation may not be appealed.
13-31 [10.] 11. The division shall adopt regulations to carry out the
13-32 provisions of this section. The regulations must specify the contents of a
13-33 plan for a program of vocational rehabilitation.
13-34 Sec. 18. NRS 616C.580 is hereby amended to read as follows:
13-35 616C.580 1. Except as otherwise provided in this section, vocational
13-36 rehabilitation services must not be provided outside of this state. An
13-37 injured employee who:
13-38 (a) Lives within 50 miles from any border of this state on the date of
13-39 injury; or
13-40 (b) Was injured while temporarily employed in this state by an
13-41 employer subject to the provisions of chapters 616A to 617, inclusive, of
13-42 NRS who can demonstrate that, on the date of injury, his permanent
13-43 residence was outside of this state,
13-44 may receive vocational rehabilitation services at a location within 50 miles
13-45 from his residence if such services are available at such location.
13-46 2. An injured employee, who:
13-47 (a) Is eligible for vocational rehabilitation services pursuant to NRS
13-48 616C.590; and
14-1 (b) Resides outside of this state but does not qualify to receive
14-2 vocational rehabilitation services outside of this state pursuant to
14-3 subsection 1,
14-4 may execute a written agreement with the insurer which provides for the
14-5 payment of compensation in a lump sum in lieu of the provision of
14-6 vocational rehabilitation services pursuant to NRS 616C.595. The amount
14-7 of the lump sum must not exceed [$15,000.] $20,000.
14-8 3. An injured employee who resides outside of this state but does not
14-9 qualify to receive vocational rehabilitation services outside of this state
14-10 pursuant to subsection 1 may receive the vocational rehabilitation services
14-11 to which he is entitled pursuant to NRS 616C.545 to 616C.575, inclusive,
14-12 and 616C.590 if he relocates to:
14-13 (a) This state; or
14-14 (b) A location within 50 miles from any border of this state,
14-15 at his own expense, if such services are available at such location.
14-16 Sec. 19. NRS 616C.590 is hereby amended to read as follows:
14-17 616C.590 1. Except as otherwise provided in this section, an injured
14-18 employee is not eligible for vocational rehabilitation services, unless:
14-19 (a) The treating physician or chiropractor approves the return of the
14-20 injured employee to work but imposes permanent restrictions that prevent
14-21 the injured employee from returning to the position that he held at the time
14-22 of his injury;
14-23 (b) The injured employee’s employer does not offer employment that
14-24 [the] :
14-25 (1) The employee is eligible for considering the restrictions imposed
14-26 pursuant to paragraph (a); and
14-27 (2) Provides a gross wage that is equal to or greater than 80 percent
14-28 of the gross wage that the employee was earning at the time of his injury;
14-29 and
14-30 (c) The injured employee is unable to return to gainful employment
14-31 with any other employer at a gross wage that is equal to or greater than 80
14-32 percent of the gross wage that [he] the employee was earning at the time of
14-33 his injury.
14-34 2. If the treating physician or chiropractor imposes permanent
14-35 restrictions on the injured employee for the purposes of paragraph (a) of
14-36 subsection 1, he shall specify in writing:
14-37 (a) The medically objective findings upon which his determination is
14-38 based; and
14-39 (b) A detailed description of the restrictions.
14-40 The treating physician or chiropractor shall deliver a copy of the findings
14-41 and the description of the restrictions to the insurer.
14-42 3. If there is a question as to whether the restrictions imposed upon the
14-43 injured employee are permanent, the employee may receive vocational
14-44 rehabilitation services until a final determination concerning the duration
14-45 of the restrictions is made.
14-46 4. Vocational rehabilitation services must cease as soon as the injured
14-47 employee is no longer eligible for the services pursuant to subsection 1.
15-1 5. An injured employee is not entitled to vocational rehabilitation
15-2 services solely because the position that he held at the time of his injury is
15-3 no longer available.
15-4 6. An injured employee or his dependents are not entitled to accrue or
15-5 be paid any money for vocational rehabilitation services during the time
15-6 the injured employee is incarcerated.
15-7 7. Any injured employee eligible for compensation other than accident
15-8 benefits may not be paid those benefits if he refuses counseling, training or
15-9 other vocational rehabilitation services offered by the insurer. Except as
15-10 otherwise provided in NRS 616B.028 and 616B.029, an injured employee
15-11 shall be deemed to have refused counseling, training and other vocational
15-12 rehabilitation services while he is incarcerated.
15-13 8. If an insurer cannot locate an injured employee for whom it has
15-14 ordered vocational rehabilitation services, the insurer may close his claim
15-15 21 days after the insurer determines that the employee cannot be located.
15-16 The insurer shall make a reasonable effort to locate the employee.
15-17 9. The reappearance of the injured employee after his claim has been
15-18 closed does not automatically reinstate his eligibility for vocational
15-19 rehabilitation benefits. If the employee wishes to reestablish his eligibility
15-20 for such benefits, he must file a written application with the insurer to
15-21 reinstate his claim. The insurer shall reinstate the employee’s claim if good
15-22 cause is shown for the employee’s absence.
15-23 Sec. 20. This act becomes effective on July 1, 2002.
15-24 H