Assembly Bill No. 46–Committee on Commerce and Labor

 

Prefiled January 26, 2001

 

(On Behalf of Legislative Committee on
Workers’ Compensation (NRS 218.5375))

 

____________

 

Referred to Committee on Commerce and Labor

 

SUMMARY—Makes various changes concerning workers’ compensation that affect eligibility, and amount and payment of benefits. (BDR 53‑773)

 

FISCAL NOTE:            Effect on Local Government: No.

                                    Effect on the State: 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 provision governing tests that are to be administered to certain police officers and firemen to determine if they have contagious diseases that qualify for workers’ compensation; requiring the administrator of the division of industrial relations of the department of business and industry to designate a vendor of certain data to assist the administrator in the establishment and revision of a schedule of reasonable fees for accident benefits; revising the provisions governing the circumstances under which a closed claim may be reopened; revising the provisions governing the effect on workers’ compensation if an employee’s injury is caused at least in part by the absence of a required safeguard or protection; providing a penalty; 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 616C.052 is hereby amended to read as follows:

1-2    616C.052  1.  If a police officer or a salaried or volunteer fireman is

1-3  exposed to a contagious disease:

1-4    (a) Upon battery by an offender; or

1-5    (b) While performing the duties of a police officer or fireman,

1-6  the employer of the police officer or fireman shall create and maintain a

1-7  report concerning the exposure that includes, without limitation, the name

1-8  of each police officer or fireman, as applicable, who was exposed to the

1-9  contagious disease and the name of each person, if any, to whom the police

1-10  officer or fireman was exposed.


2-1    2.  If the employment of a police officer or a salaried or volunteer

2-2  fireman is terminated, voluntarily or involuntarily, the employer of the

2-3  police officer or fireman shall, at the time of termination and at 6 and 12

2-4  months after the date of termination, provide to the police officer or

2-5  fireman [a blood] an appropriate test of the blood or skin to screen for

2-6  contagious diseases . [, including, without limitation, hepatitis A, hepatitis

2-7  B, hepatitis C, tuberculosis and human immunodeficiency virus.] The test

2-8  must be administered by a physician, a member of his staff, or an

2-9  employee of a medical laboratory in accordance with generally accepted

2-10  medical practices. If a [blood] test administered pursuant to this subsection

2-11  and provided to the employer reveals that a former police officer or a

2-12  former salaried or volunteer fireman has a contagious disease or the

2-13  antibodies associated with a contagious disease, the police officer or

2-14  fireman is eligible, during his lifetime, to receive compensation for such a

2-15  disease and any additional diseases or conditions that are associated with or

2-16  result from the contagious disease pursuant to chapters 616A to 617,

2-17  inclusive, of NRS. The former employer of a police officer or a salaried or

2-18  volunteer fireman shall pay all the costs associated with providing [blood]

2-19  tests required pursuant to this subsection.

2-20    3.  As used in this section, the term [“battery”] :

2-21    (a) “Battery” includes, without limitation, the intentional propelling or

2-22  placing, or the causing to be propelled or placed, of any human excrement

2-23  or bodily fluid upon the person of an employee.

2-24    (b) “Contagious diseases” includes, without limitation, hepatitis A,

2-25  hepatitis B, hepatitis C, tuberculosis and human immunodeficiency virus.

2-26    Sec. 2.  NRS 616C.260 is hereby amended to read as follows:

2-27    616C.260  1.  All fees and charges for accident benefits must not:

2-28    (a) Exceed the [fees and charges] amounts usually billed and paid in

2-29  the state for similar treatment.

2-30    (b) Be unfairly discriminatory as between persons legally qualified to

2-31  provide the particular service for which the fees or charges are asked.

2-32    2.  The administrator shall, giving consideration to the fees and charges

2-33  being billed and paid in the state, establish a schedule of reasonable fees

2-34  and charges allowable for accident benefits provided to injured employees

2-35  whose insurers have not contracted with an organization for managed care

2-36  or with providers of health care services pursuant to NRS 616B.527. The

2-37  administrator shall review and revise the schedule on or before [October]

2-38  February 1 of each year. [The administrator may increase or decrease ] In

2-39  the revision, the administrator shall adjust the schedule [, but shall not

2-40  increase the schedule by any factor greater than] by the corresponding

2-41  annual [increase] change in the Consumer Price Index, Medical Care

2-42  Component . [, unless the advisory council of the division approves such an

2-43  increase.]

2-44    3.  The administrator [may request] shall designate a vendor who

2-45  compiles data on a national basis concerning fees and charges that are

2-46  billed and paid for treatment or services similar to the treatment and

2-47  services that qualify as accident benefits in this state to provide him with

2-48  such information as he deems necessary to carry out the provisions of

2-49  subsection 2. The designation must be made pursuant to reasonable


3-1  competitive bidding procedures established by the administrator. In

3-2  addition, the administrator may request a health insurer, health

3-3  maintenance organization or provider of accident benefits, an agent or

3-4  employee of such a person, or an agency of the state [,] to provide the

3-5  administrator with [such] information concerning fees and charges that are

3-6  billed and paid in this state for similar services as he deems necessary to

3-7  carry out the provisions of subsection 2. The administrator shall require a

3-8  [person or entity providing] health insurer, health maintenance

3-9  organization or provider of accident benefits, an agent or employee of

3-10  such a person, or an agency of the state that provides records or reports of

3-11  fees [charged] and charges billed and paid pursuant to this section to

3-12  provide interpretation and identification concerning the information

3-13  delivered. The administrator may impose an administrative fine of $500 on

3-14  a health insurer, health maintenance organization or provider of

3-15  accident benefits, or an agent or employee of such a person for each

3-16  refusal to provide the information requested pursuant to this subsection.

3-17    4.  The division may adopt reasonable regulations necessary to carry

3-18  out the provisions of this section. The regulations must include provisions

3-19  concerning:

3-20    (a) Standards for the development of the schedule of fees and charges

3-21  [;] that are billed and paid;

3-22    (b) The periodic revision of the schedule; and

3-23    (c) The monitoring of compliance by providers of benefits with the

3-24  adopted schedule of fees and charges.

3-25    5.  The division shall adopt regulations requiring the [utilization] use of

3-26  a system of billing codes as recommended by the American Medical

3-27  Association.

3-28    Sec. 3.  NRS 616C.390 is hereby amended to read as follows:

3-29    616C.390  Except as otherwise provided in subsection 8 of NRS

3-30  617.457:

3-31    1.  If an application to reopen a claim to increase or rearrange

3-32  compensation is made in writing more than 1 year after the date on which

3-33  the claim was closed, the insurer shall reopen the claim if:

3-34    (a) The claimant was incapacitated from earning full wages for at

3-35  least 5 consecutive days or 5 cumulative days within a 20-day period;

3-36    (b) The claimant received benefits for a permanent partial disability;

3-37    (c) A change of circumstances now warrants an increase or

3-38  rearrangement of compensation during the life of the claimant;

3-39    [(b)] (d) The primary cause of the change of circumstances is the injury

3-40  or disease for which the claim was originally made; and

3-41    [(c)] (e) The application is accompanied by the certificate of a physician

3-42  or a chiropractor showing a change of circumstances which would warrant

3-43  an increase or rearrangement of compensation.

3-44    2.  After a claim has been closed, the insurer, upon receiving an

3-45  application and for good cause shown, may authorize the reopening of the

3-46  claim for medical investigation only. The application must be accompanied

3-47  by a written request for treatment from the physician or chiropractor

3-48  treating the claimant, certifying that the treatment is indicated by a change


4-1  in circumstances and is related to the industrial injury sustained or

4-2  occupational disease contracted by the claimant.

4-3    3.  If a claimant applies for a claim to be reopened pursuant to

4-4  subsection 1 or 2 and a final determination denying the reopening is issued,

4-5  the claimant [shall] may not reapply to reopen the claim until at least 1 year

4-6  after the date on which the final determination is issued.

4-7    4.  Except as otherwise provided in subsection 5, if an application to

4-8  reopen a claim is made in writing within 1 year after the date on which the

4-9  claim was closed, the insurer shall reopen the claim [only] if:

4-10    (a) The claimant either received benefits for a permanent partial

4-11  disability or did not receive benefits for a permanent partial disability but

4-12  was incapacitated from earning full wages for at least 5 consecutive days

4-13  or 5 cumulative days within a 20-day period;

4-14    (b) The application is supported by medical evidence demonstrating an

4-15  objective change in the medical condition of the claimant; and

4-16    [(b)] (c) There is clear and convincing evidence that the primary cause

4-17  of the change of circumstances is the injury or disease for which the claim

4-18  was originally made.

4-19    5.  [An application to reopen a claim must be made in writing within 1

4-20  year after the date on which the claim was closed if:

4-21    (a) The claimant was not off work] If the claimant:

4-22    (a) Was not incapacitated from earning full wages for at least 5

4-23  consecutive days or 5 cumulative days within a 20-day period as a result

4-24  of the injury [;] or disease; and

4-25    (b) [The claimant did] Did not receive benefits for a permanent partial

4-26  disability [.

4-27  If an application to reopen a claim to increase or rearrange compensation is

4-28  made pursuant to this subsection, the insurer shall reopen the claim if] , the

4-29  application to reopen the claim must be made in writing within 1 year

4-30  after the date on which the claim was closed and the claimant must

4-31  demonstrate that the requirements set forth in paragraphs [(a), (b) and] (c)

4-32  , (d) and (e) of subsection 1 are met. If the application is made in a timely

4-33  manner and the claimant meets the requirements of paragraphs (c), (d)

4-34  and (e) of subsection 1, the insurer shall reopen the claim.

4-35    6.  If an employee’s claim is reopened pursuant to this section, he is not

4-36  entitled to vocational rehabilitation services or benefits for a temporary

4-37  total disability if, before his claim was reopened, he:

4-38    (a) Retired; or

4-39    (b) Otherwise voluntarily removed himself from the work force,

4-40  for reasons unrelated to the injury or disease for which the claim was

4-41  originally made.

4-42    7.  One year after the date on which the claim was closed, an insurer

4-43  may dispose of the file of a claim authorized to be reopened pursuant to

4-44  subsection 5, unless an application to reopen the claim has been filed

4-45  pursuant to that subsection.

4-46    8.  An increase or rearrangement of compensation is not effective

4-47  before an application for reopening a claim is made unless good cause is

4-48  shown. The insurer shall, upon good cause shown, allow the cost of


5-1  emergency treatment the necessity for which has been certified by a

5-2  physician or a chiropractor.

5-3    9.  A claim that closes pursuant to subsection 2 of NRS 616C.235 and

5-4  is not appealed or is unsuccessfully appealed pursuant to the provisions of

5-5  NRS 616C.305 and 616C.315 to 616C.385, inclusive, may not be reopened

5-6  pursuant to this section.

5-7    10.  The provisions of this section apply to any claim for which an

5-8  application to reopen the claim or to increase or rearrange compensation is

5-9  made pursuant to this section, regardless of the date of the injury or

5-10  accident or the date of disablement to the claimant. If a claim is reopened

5-11  pursuant to this section, the amount of any compensation or benefits

5-12  provided must be determined in accordance with the provisions of NRS

5-13  616C.425 [.] or 617.445, as appropriate.

5-14    Sec. 4.  NRS 616D.270 is hereby amended to read as follows:

5-15    616D.270  Any employer who fails:

5-16    1.  To post the notice required by NRS 616A.490 , [and] 616B.650 and

5-17  616D.280 in a place that is readily accessible and visible to employees is

5-18  guilty of a misdemeanor.

5-19    2.  To maintain the notice or notices required by NRS 616A.490 , [and]

5-20  616B.650 and 616D.280 is guilty of a misdemeanor.

5-21    Sec. 5.  NRS 616D.280 is hereby amended to read as follows:

5-22    616D.280  1.  If any [workman] employee is injured because of the

5-23  absence of any safeguard or protection required to be provided or

5-24  maintained [by, or] pursuant to [,] any statute, ordinance [, or any

5-25  divisional regulation under any statute, the] or regulation, and the absence

5-26  is caused by the failure of the employer to provide and make the

5-27  safeguard or protection available for use, or the absence is caused by the

5-28  removal of the safeguard or protection by the employee in compliance

5-29  with a deliberate order or direction by the employer, superintendent or

5-30  foreman to do so:

5-31    (a) The employer is liable to the division for a penalty of not less than

5-32  $300 nor more than $2,000, to be collected in a civil action at law by the

5-33  division.

5-34    (b) The compensation of the injured employee as provided for by NRS

5-35  616C.405, 616C.425, 616C.435, 616C.440, 616C.445 and 616C.475 to

5-36  616C.505, inclusive, must be increased by 25 percent.

5-37    2.  [The provisions of subsection 1 do not apply if the absence of the

5-38  safeguard or protection is due to the removal thereof by the injured

5-39  workman himself, or with his knowledge by any fellow workman, unless

5-40  the removal is by order or direction of the employer or superintendent or

5-41  foreman of the employer.

5-42    3. ] If any employee is injured because of the absence of any

5-43  safeguard or protection required to be provided or maintained pursuant

5-44  to any statute, ordinance or regulation, and the absence is caused by the

5-45  employee, on the date of injury:

5-46    (a) Failing to use the safeguard or protection that was provided by his

5-47  employer;

5-48    (b) Using the provided safeguard or protection for a period but

5-49  subsequently and voluntarily removing it himself; or


6-1    (c) Using the provided safeguard or protection [is removed by the

6-2  workman himself, or] for a period but subsequently and voluntarily

6-3  allowing the safeguard or protection to be removed, with his consent , [is

6-4  removed] by any of his fellow [workmen, unless done by order or direction

6-5  of the employer or superintendent or foreman of the employer,]
employees,

6-6  the compensation of the injured [workman,] employee, as provided for by

6-7  NRS 616C.405, 616C.425, 616C.435, 616C.440, 616C.445 and 616C.475

6-8  to 616C.505, inclusive, must be reduced by 25 percent.

6-9    3.  The employer shall ensure that a notice containing the contents of

6-10  subsection 2 is printed in English and Spanish and posted in an area that

6-11  is conspicuous, readily accessible and visible to employees at the

6-12  employer’s place of business.

6-13    Sec. 6.  Notwithstanding the amendatory provisions of section 2 of this

6-14  act, the administrator of the division of industrial relations of the

6-15  department of business and industry is not required to designate a vendor

6-16  that compiles data on a national basis concerning fees and charges that are

6-17  billed and paid for certain treatment and services pursuant to section 2 of

6-18  this act in sufficient time to ensure that the schedule of reasonable fees and

6-19  charges allowable for accident benefits that must be revised on or before

6-20  February 1, 2002, includes the data obtained from that vendor, but shall use

6-21  his best efforts to do so.

6-22    Sec. 7.  1.  Section 2 of this act becomes effective:

6-23    (a) Upon passage and approval for the purpose of requiring the

6-24  administrator to designate a vendor who compiles data on a national basis

6-25  concerning fees and charges that are billed and paid for treatment or

6-26  services similar to the treatment and services that qualify as accident

6-27  benefits in this state to provide the administrator with such information as

6-28  he deems necessary to carry out the provisions of subsection 2 of section 2

6-29  of this act.

6-30    (b) On July 1, 2001, for all other purposes.

6-31    2.  Section 6 of this act becomes effective upon passage and approval.

6-32    3.  This section and sections 1, 3, 4 and 5 of this act become effective

6-33  on July 1, 2001.

 

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