Assembly Bill No. 495–Committee on Commerce and Labor

 

(On Behalf of the Department of Business
and Industry, Attorney for Injured Workers)

 

March 24, 2003

____________

 

Referred to Committee on Commerce and Labor

 

SUMMARY—Makes various changes relating to industrial insurance. (BDR 53‑468)

 

FISCAL NOTE:  Effect on Local Government: No.

                           Effect on the State: Yes.

 

~

 

EXPLANATION – Matter in bolded italics is new; matter between brackets [omitted material] is material to be omitted.

 

AN ACT relating to industrial insurance; requiring the establishment of a repository for records of closed claims; authorizing an employee to select any willing provider under certain circumstances; revising distribution of death benefits; expanding the period during which an injured employee may request an extension of his program for vocational rehabilitation; authorizing an injured employee to appeal an insurer’s refusal to execute an agreement providing for the payment of compensation in a lump sum in lieu of providing vocational rehabilitation services under certain circumstances; revising provisions governing a compensable injury or disease caused by stress; repealing the limitation of liability of an insurer or third-party administrator for any violation of the provisions relating to 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:

 

 

 

2-1  Section 1. NRS 616A.465 is hereby amended to read as

2-2  follows:

2-3  616A.465  1.  Except as otherwise provided in this section, the

2-4  Division shall:

2-5  (a) Regulate insurers pursuant to chapters 616A to 617,

2-6  inclusive, of NRS;

2-7  (b) Investigate insurers regarding compliance with statutes and

2-8  the Division’s regulations;

2-9  (c) Determine whether an employee leasing company is entitled

2-10  to a certificate of registration pursuant to NRS 616B.673; and

2-11      (d) Regulate employee leasing companies pursuant to the

2-12  provisions of NRS 616B.670 to 616B.697, inclusive.

2-13      2.  The Commissioner is responsible for reviewing rates,

2-14  investigating the solvency of insurers, authorizing private carriers

2-15  pursuant to chapter 680A of NRS and certifying:

2-16      (a) Self-insured employers pursuant to NRS 616B.300 to

2-17  616B.330, inclusive, and 616B.336;

2-18      (b) Associations of self-insured public or private employers

2-19  pursuant to NRS 616B.350 to 616B.446, inclusive; and

2-20      (c) Third-party administrators pursuant to chapter 683A of NRS.

2-21      3.  The Department of Administration is responsible for

2-22  contested claims relating to industrial insurance pursuant to NRS

2-23  616C.310 to 616C.385, inclusive. The Administrator is responsible

2-24  for administrative appeals pursuant to NRS 616B.215.

2-25      4.  The Nevada Attorney for Injured Workers is responsible for

2-26  legal representation of claimants pursuant to NRS 616A.435 to

2-27  616A.460, inclusive, and 616D.120.

2-28      5.  The Division is responsible for the investigation of

2-29  complaints. If a complaint is filed with the Division, the

2-30  Administrator shall cause to be conducted an investigation which

2-31  includes a review of relevant records and interviews of affected

2-32  persons. If the Administrator determines that a violation may have

2-33  occurred, the Administrator shall proceed in accordance with the

2-34  provisions of NRS 616D.120 and 616D.130.

2-35      6.  The Division shall establish and maintain a repository for

2-36  records relating to claims that are closed. The Nevada Attorney for

2-37  Injured Workers may obtain information from the repository. The

2-38  Division shall adopt regulations as needed to carry out the

2-39  provisions of this subsection.

2-40      7.  As used in this section, “employee leasing company” has the

2-41  meaning ascribed to it in NRS 616B.670.

2-42      Sec. 2.  NRS 616C.070 is hereby amended to read as follows:

2-43      616C.070  1.  A person is conclusively presumed to be totally

2-44  dependent upon an injured or deceased employee if the person is a

2-45  natural, posthumous or adopted child, whether legitimate or

3-1  illegitimate, under the age of 18 years, or over that age if physically

3-2  or mentally incapacitated from wage earning[,] and there is no

3-3  surviving parent[.] , or over 18 years of age and enrolled as a full-

3-4  time student in an accredited vocational or educational institution,

3-5  until he reaches the age of 22 years. Stepparents may be regarded

3-6  in chapters 616A to 616D, inclusive, or chapter 617 of NRS as

3-7  parents if the fact of dependency is shown, and a stepchild or

3-8  stepchildren may be regarded in chapters 616A to 616D, inclusive,

3-9  or chapter 617 of NRS as a natural child or children if the existence

3-10  and fact of dependency are shown.

3-11      2.  Except as otherwise provided in subsection 13 of NRS

3-12  616C.505, questions as to who constitute dependents and the extent

3-13  of their dependency must be determined as of the date of the

3-14  accident or injury to the employee, and their right to any benefit

3-15  becomes fixed at that time, irrespective of any subsequent change in

3-16  conditions, and the benefits are directly recoverable by and payable

3-17  to the dependent or dependents entitled thereto or to their legal

3-18  guardians or trustees.

3-19      3.  The presumptions of this section do not apply in favor of

3-20  aliens who are nonresidents of the United States at the time of the

3-21  accident, injury to, or death of the employee.

3-22      Sec. 3.  NRS 616C.090 is hereby amended to read as follows:

3-23      616C.090  1.  The Administrator shall establish a panel of

3-24  physicians and chiropractors who have demonstrated special

3-25  competence and interest in industrial health to treat injured

3-26  employees under chapters 616A to 616D, inclusive, or chapter 617

3-27  of NRS. Every employer whose insurer has not entered into a

3-28  contract with an organization for managed care or with providers of

3-29  health care services pursuant to NRS 616B.527 shall maintain a list

3-30  of those physicians and chiropractors on the panel who are

3-31  reasonably accessible to his employees.

3-32      2.  An injured employee whose employer’s insurer has not

3-33  entered into a contract with an organization for managed care or

3-34  with providers of health care services pursuant to NRS 616B.527

3-35  may choose his treating physician or chiropractor from the panel of

3-36  physicians and chiropractors. If the injured employee is not satisfied

3-37  with the first physician or chiropractor he so chooses, he may make

3-38  an alternative choice of physician or chiropractor from the panel if

3-39  the choice is made within 90 days after his injury. The insurer shall

3-40  notify the first physician or chiropractor in writing. The notice must

3-41  be postmarked within 3 working days after the insurer receives

3-42  knowledge of the change. The first physician or chiropractor must

3-43  be reimbursed only for the services he rendered to the injured

3-44  employee up to and including the date of notification. Except as

3-45  otherwise provided in this subsection, any further change is subject

4-1  to the approval of the insurer, which must be granted or denied

4-2  within 10 days after a written request for such a change is received

4-3  from the injured employee. If no action is taken on the request

4-4  within 10 days, the request shall be deemed granted. Any request for

4-5  a change of physician or chiropractor must include the name of the

4-6  new physician or chiropractor chosen by the injured employee. If

4-7  the treating physician or chiropractor refers the injured employee to

4-8  a specialist for treatment, the treating physician or chiropractor shall

4-9  provide to the injured employee a list that includes the name of each

4-10  physician or chiropractor with that specialization who is on the

4-11  panel. After receiving the list, the injured employee shall, at the time

4-12  the referral is made, select a physician or chiropractor from the list.

4-13      3.  [An] Except as otherwise provided in this subsection, an

4-14  injured employee whose employer’s insurer has entered into a

4-15  contract with an organization for managed care or with providers of

4-16  health care services pursuant to NRS 616B.527 must choose his

4-17  treating physician or chiropractor pursuant to the terms of that

4-18  contract. If the injured employee is not satisfied with the first

4-19  physician or chiropractor he so chooses, he may make an alternative

4-20  choice of physician or chiropractor pursuant to the terms of the

4-21  contract if the choice is made within 90 days after his injury. If the

4-22  injured employee, after choosing his treating physician or

4-23  chiropractor, moves to a county which is not served by the

4-24  organization for managed care or providers of health care services

4-25  named in the contract and the insurer determines that it is

4-26  impractical for the injured employee to continue treatment with the

4-27  physician or chiropractor, the injured employee must choose a

4-28  treating physician or chiropractor who has agreed to the terms of

4-29  that contract unless the insurer authorizes the injured employee to

4-30  choose another physician or chiropractor. If the treating physician or

4-31  chiropractor refers the injured employee to a specialist for treatment,

4-32  the treating physician or chiropractor shall provide to the injured

4-33  employee a list that includes the name of each physician or

4-34  chiropractor with that specialization who is available pursuant to the

4-35  terms of the contract with the organization for managed care or with

4-36  providers of health care services pursuant to NRS 616B.527, as

4-37  appropriate. After receiving the list, the injured employee shall,

4-38  at the time the referral is made, select a physician or chiropractor

4-39  from the list. If the employee fails to select a physician or

4-40  chiropractor, the insurer may select a physician or chiropractor with

4-41  that specialization. If a physician or chiropractor with that

4-42  specialization is not available pursuant to the terms of the contract[,

4-43  the organization for managed care or the provider of health care

4-44  services] :

5-1  (a) The employee may select [a] any physician or chiropractor

5-2  with that specialization[.] who is willing to accept the applicable

5-3  fees and charges established pursuant to NRS 616C.260; and

5-4  (b) The insurer shall pay the physician or chiropractor

5-5  selected pursuant to paragraph (a) in accordance with the

5-6  applicable fees and charges established pursuant to

5-7  NRS 616C.260.

5-8  4.  Except when emergency medical care is required and except

5-9  as otherwise provided in NRS 616C.055, the insurer is not

5-10  responsible for any charges for medical treatment or other accident

5-11  benefits furnished or ordered by any physician, chiropractor or other

5-12  person selected by the injured employee in disregard of the

5-13  provisions of this section or for any compensation for any

5-14  aggravation of the injured employee’s injury attributable to

5-15  improper treatments by such physician, chiropractor or other person.

5-16      5.  The Administrator may order necessary changes in a panel

5-17  of physicians and chiropractors and shall suspend or remove any

5-18  physician or chiropractor from a panel for good cause shown.

5-19      6.  An injured employee may receive treatment by more than

5-20  one physician or chiropractor if the insurer provides written

5-21  authorization for such treatment.

5-22      7.  The Administrator shall design a form that notifies injured

5-23  employees of their right pursuant to subsections 2 and 3 to select an

5-24  alternative treating physician or chiropractor and make the form

5-25  available to insurers for distribution pursuant to subsection 2 of

5-26  NRS 616C.050.

5-27      Sec. 4.  NRS 616C.180 is hereby amended to read as follows:

5-28      616C.180  1.  Except as otherwise provided in this section, an

5-29  injury or disease sustained by an employee that is caused by stress is

5-30  compensable pursuant to the provisions of chapters 616A to 616D,

5-31  inclusive, or chapter 617 of NRS if it arose out of and in the course

5-32  of his employment[.

5-33      2.  Any ailment or disorder caused by any gradual mental

5-34  stimulus, and any death or disability ensuing therefrom, shall be

5-35  deemed not to be an injury or disease arising out of and in the

5-36  course of employment.

5-37      3.  An injury or disease caused by stress shall be deemed to

5-38  arise out of and in the course of employment only if the employee

5-39  proves by clear and convincing medical or psychiatric evidence that:

5-40      (a) He has a mental injury caused by extreme stress in time of

5-41  danger;

5-42      (b) The primary cause of the injury was an event that arose out

5-43  of and during the course of his employment; and

6-1  (c) The] and the stress was not caused by his layoff, the

6-2  termination of his employment or any disciplinary action taken

6-3  against him.

6-4  [4.] 2. The provisions of this section do not apply to a person

6-5  who is claiming compensation pursuant to NRS 617.457.

6-6  Sec. 5.  NRS 616C.230 is hereby amended to read as follows:

6-7  616C.230  1.  Compensation is not payable pursuant to the

6-8  provisions of chapters 616A to 616D, inclusive, or chapter 617 of

6-9  NRS for an injury:

6-10      (a) Caused by the employee’s willful intention to injure himself.

6-11      (b) Caused by the employee’s willful intention to injure another.

6-12      (c) Proximately caused by the employee’s intoxication. If the

6-13  employee was intoxicated at the time of his injury, intoxication must

6-14  be presumed to be a proximate cause unless rebutted by evidence to

6-15  the contrary.

6-16      (d) Proximately caused by the employee’s use of a controlled

6-17  substance. If the employee had any amount of a controlled substance

6-18  in his system at the time of his injury for which the employee did

6-19  not have a current and lawful prescription issued in his name or that

6-20  he was not using in accordance with the provisions of chapter 453A

6-21  of NRS, the controlled substance must be presumed to be a

6-22  proximate cause unless rebutted by evidence to the contrary.

6-23      2.  For the purposes of paragraphs (c) and (d) of subsection 1:

6-24      (a) The affidavit or declaration of an expert or other person

6-25  described in NRS 50.310, 50.315 or 50.320 is admissible to prove

6-26  the existence of any alcohol or the existence, quantity or identity of

6-27  a controlled substance in an employee’s system. If the affidavit or

6-28  declaration is to be so used, it must be submitted in the manner

6-29  prescribed in NRS 616C.355.

6-30      (b) When an examination requested or ordered includes testing

6-31  for the use of alcohol or a controlled substance, the laboratory that

6-32  conducts the testing must be licensed pursuant to the provisions of

6-33  chapter 652 of NRS.

6-34      3.  No compensation is payable for the death, disability or

6-35  treatment of an employee if his death is caused by, or insofar as his

6-36  disability is aggravated, caused or continued by, an unreasonable

6-37  refusal or neglect to submit to or to follow any competent and

6-38  reasonable surgical treatment or medical aid.

6-39      4.  If any employee persists in an unsanitary or injurious

6-40  practice that imperils or retards his recovery, or refuses to submit to

6-41  such medical or surgical treatment as is necessary to promote his

6-42  recovery, his compensation may be reduced or suspended.

6-43      5.  An injured employee’s compensation, other than accident

6-44  benefits, must be suspended if:

7-1  (a) A physician or chiropractor determines that the employee is

7-2  unable to undergo treatment, testing or examination for the

7-3  industrial injury solely because of a condition or injury that did not

7-4  arise out of and in the course of his employment; and

7-5  (b) It is within the ability of the employee to correct the

7-6  nonindustrial condition or injury.

7-7  The compensation must be suspended until the injured employee is

7-8  able to resume treatment, testing or examination for the industrial

7-9  injury. The insurer may elect to pay for the treatment of the

7-10  nonindustrial condition or injury.

7-11      Sec. 6.  NRS 616C.235 is hereby amended to read as follows:

7-12      616C.235  1.  Except as otherwise provided in subsections 2, 3

7-13  and 4:

7-14      (a) When the insurer determines that a claim should be closed

7-15  before all benefits to which the claimant may be entitled have been

7-16  paid, the insurer shall send a written notice of its intention to close

7-17  the claim to the claimant by first-class mail addressed to the last

7-18  known address of the claimant. The notice must include [a] :

7-19          (1) A statement that sets forth the effect the proposed

7-20  closure of the claim will have on the claimant’s right to receive

7-21  benefits and on any other issues relating to the claim;

7-22          (2) A statement printed in at least 10-point bold type that if

7-23  the claimant does not agree with the determination, he has a right to

7-24  request a resolution of the dispute pursuant to NRS 616C.305 and

7-25  616C.315 to 616C.385, inclusive[.] , and the time within which the

7-26  claimant may request a resolution of the dispute; and

7-27          (3) A suitable form for requesting a resolution of the dispute

7-28  . [must be enclosed with the notice.]

7-29  The closure of a claim pursuant to this subsection is not effective

7-30  unless notice is given as required by this [subsection.] paragraph.

7-31      (b) If the insurer does not receive a request for the resolution of

7-32  the dispute, it may close the claim.

7-33      (c) Notwithstanding the provisions of NRS 233B.125, if a

7-34  hearing is conducted to resolve the dispute, the decision of the

7-35  hearing officer may be served by first-class mail.

7-36      2.  If, during the first 12 months after a claim is opened, the

7-37  medical benefits required to be paid for a claim are less than $300,

7-38  the insurer may close the claim at any time after he sends, by first-

7-39  class mail addressed to the last known address of the claimant,

7-40  written notice printed in at least 10-point bold type that:

7-41      (a) The claim is being closed pursuant to this subsection;

7-42      (b) The injured employee may appeal the closure of the claim

7-43  pursuant to the provisions of NRS 616C. 305 and 616C.315 to

7-44  616C.385, inclusive; and

8-1  (c) If the injured employee does not appeal the closure of the

8-2  claim or appeals the closure of the claim but is not successful, the

8-3  claim cannot be reopened.

8-4  3.  In addition to the notice described in subsection 2, an insurer

8-5  shall send to each claimant who receives less than $300 in medical

8-6  benefits within 6 months after the claim is opened a written notice

8-7  that explains the circumstances under which a claim may be closed

8-8  pursuant to subsection 2. The written notice provided pursuant to

8-9  this subsection does not create any right to appeal the contents of

8-10  that notice. The written notice must be:

8-11      (a) Sent by first-class mail addressed to the last known address

8-12  of the claimant; and

8-13      (b) A document that is separate from any other document or

8-14  form that is used by the insurer.

8-15      4.  The closure of a claim pursuant to subsection 2 is not

8-16  effective unless notice is given as required by subsections 2 and 3.

8-17      Sec. 7.  NRS 616C.315 is hereby amended to read as follows:

8-18      616C.315  1.  Any person who is subject to the jurisdiction of

8-19  the hearing officers pursuant to chapters 616A to 616D, inclusive, or

8-20  chapter 617 of NRS may request a hearing before a hearing officer

8-21  of any matter within the hearing officer’s authority. The insurer

8-22  shall provide, without cost, the forms necessary to request a hearing

8-23  to any person who requests them.

8-24      2.  Except as otherwise provided in NRS 616B.772, 616B.775,

8-25  616B.787 and 616C.305, a person who is aggrieved by:

8-26      (a) A written determination of an insurer; or

8-27      (b) The failure of an insurer to respond within 30 days to a

8-28  written request mailed to the insurer by the person who is

8-29  aggrieved,

8-30  may appeal from the determination or failure to respond by filing a

8-31  request for a hearing before a hearing officer. Such a request must

8-32  be filed within 70 days after the date on which the notice of the

8-33  insurer’s determination was mailed by the insurer or the unanswered

8-34  written request was mailed to the insurer, as applicable. The failure

8-35  of an insurer to respond to a written request for a determination

8-36  within 30 days after receipt of such a request shall be deemed by the

8-37  hearing officer to be a denial of the request.

8-38      3.  Failure to file a request for a hearing within the period

8-39  specified in subsection 2 may be excused if the person aggrieved

8-40  shows by a preponderance of the evidence that he did not receive

8-41  the notice of the determination and the forms necessary to request a

8-42  hearing[.] or for any other reason the hearing officer deems

8-43  appropriate, including, without limitation, the death or diagnosis

8-44  of a terminal disease of a spouse, parent or child. The claimant or

8-45  employer shall notify the insurer of a change of address.

9-1  4.  The hearing before the hearing officer must be conducted as

9-2  expeditiously and informally as is practicable.

9-3  5.  The parties to a contested claim may, if the claimant is

9-4  represented by legal counsel, agree to forego a hearing before a

9-5  hearing officer and submit the contested claim directly to an appeals

9-6  officer.

9-7  Sec. 8.  NRS 616C.345 is hereby amended to read as follows:

9-8  616C.345  1.  Any party aggrieved by a decision of the

9-9  hearing officer relating to a claim for compensation may appeal

9-10  from the decision by filing a notice of appeal with an appeals officer

9-11  within 30 days after the date of the decision.

9-12      2.  If a dispute is required to be submitted to a procedure for

9-13  resolving complaints pursuant to NRS 616C.305 and:

9-14      (a) A final determination was rendered pursuant to that

9-15  procedure; or

9-16      (b) The dispute was not resolved pursuant to that procedure

9-17  within 14 days after it was submitted,

9-18  any party to the dispute may file a notice of appeal within 70 days

9-19  after the date on which the final determination was mailed to the

9-20  employee, or his dependent, or the unanswered request for

9-21  resolution was submitted. Failure to render a written determination

9-22  within 30 days after receipt of such a request shall be deemed by the

9-23  appeals officer to be a denial of the request.

9-24      3.  Except as otherwise provided in NRS 616C.380, the filing of

9-25  a notice of appeal does not automatically stay the enforcement of the

9-26  decision of a hearing officer or a determination rendered pursuant to

9-27  NRS 616C.305. The appeals officer may order a stay, when

9-28  appropriate, upon the application of a party. If such an application is

9-29  submitted, the decision is automatically stayed until a determination

9-30  is made concerning the application. A determination on the

9-31  application must be made within 30 days after the filing of

9-32  the application. If a stay is not granted by the officer after reviewing

9-33  the application, the decision must be complied with within 10 days

9-34  after the date of the refusal to grant a stay.

9-35      4.  Except as otherwise provided in this subsection, the appeals

9-36  officer shall, within 10 days after receiving a notice of appeal

9-37  pursuant to this section or a contested claim pursuant to subsection 5

9-38  of NRS 616C.315, schedule a hearing on the merits of the appeal or

9-39  contested claim for a date and time within 90 days after his receipt

9-40  of the notice and give notice by mail or by personal service to all

9-41  parties to the matter and their attorneys or agents at least 30 days

9-42  before the date and time scheduled. A request to schedule the

9-43  hearing for a date and time which is:

9-44      (a) Within 60 days after the receipt of the notice of appeal or

9-45  contested claim; or

10-1      (b) More than 90 days after the receipt of the notice or

10-2  claim,

10-3  may be submitted to the appeals officer only if all parties to the

10-4  appeal or contested claim agree to the request.

10-5      5.  An appeal or contested claim may be continued upon written

10-6  stipulation of all parties, or upon good cause shown.

10-7      6.  Failure to file a notice of appeal within the period specified

10-8  in subsection 1 or 2 may be excused if the party aggrieved shows by

10-9  a preponderance of the evidence that he did not receive the notice of

10-10  the determination and the forms necessary to appeal the

10-11  determination[.] or for any other reason the appeals officer deems

10-12  appropriate, including, without limitation, the death or diagnosis

10-13  of a terminal disease of a spouse, parent or child. The claimant,

10-14  employer or insurer shall notify the hearing officer of a change of

10-15  address.

10-16     Sec. 9.  NRS 616C.390 is hereby amended to read as follows:

10-17     616C.390  1.  If an application to reopen a claim to increase or

10-18  rearrange compensation is made in writing more than 1 year after

10-19  the date on which the claim was closed, the insurer shall reopen the

10-20  claim if:

10-21     (a) A change of circumstances warrants an increase or

10-22  rearrangement of compensation during the life of the claimant;

10-23     (b) The [primary] substantial contributing cause of the change

10-24  of circumstances is the injury for which the claim was originally

10-25  made; and

10-26     (c) The application is accompanied by the certificate of a

10-27  physician or a chiropractor showing a change of circumstances

10-28  which would warrant an increase or rearrangement of compensation.

10-29     2.  After a claim has been closed, the insurer, upon receiving an

10-30  application and for good cause shown, may authorize the reopening

10-31  of the claim for medical investigation only. The application must be

10-32  accompanied by a written request for treatment from the physician

10-33  or chiropractor treating the claimant, certifying that the treatment is

10-34  indicated by a change in circumstances and is related to the

10-35  industrial injury sustained by the claimant.

10-36     3.  If a claimant applies for a claim to be reopened pursuant to

10-37  subsection 1 or 2 and a final determination denying the reopening is

10-38  issued, the claimant shall not reapply to reopen the claim until at

10-39  least 1 year after the date on which the final determination is issued.

10-40     4.  Except as otherwise provided in subsection 5, if an

10-41  application to reopen a claim is made in writing within 1 year after

10-42  the date on which the claim was closed, the insurer shall reopen the

10-43  claim only if:

11-1      (a) The application is supported by medical evidence

11-2  demonstrating an objective change in the medical condition of the

11-3  claimant; and

11-4      (b) There is clear and convincing evidence that the [primary]

11-5  substantial contributing cause of the change of circumstances is the

11-6  injury for which the claim was originally made.

11-7      5.  An application to reopen a claim must be made in writing

11-8  within 1 year after the date on which the claim was closed if:

11-9      (a) The claimant was not off work as a result of the injury; and

11-10     (b) The claimant did not receive benefits for a permanent partial

11-11  disability.

11-12  If an application to reopen a claim to increase or rearrange

11-13  compensation is made pursuant to this subsection, the insurer shall

11-14  reopen the claim if the requirements set forth in paragraphs (a), (b)

11-15  and (c) of subsection 1 are met.

11-16     6.  If an employee’s claim is reopened pursuant to this section,

11-17  he is not entitled to vocational rehabilitation services or benefits for

11-18  a temporary total disability if, before his claim was reopened, he:

11-19     (a) Retired; or

11-20     (b) Otherwise voluntarily removed himself from the

11-21  workforce,

11-22  for reasons unrelated to the injury for which the claim was originally

11-23  made.

11-24     7.  One year after the date on which the claim was closed, an

11-25  insurer may dispose of the file of a claim authorized to be reopened

11-26  pursuant to subsection 5, unless an application to reopen the claim

11-27  has been filed pursuant to that subsection.

11-28     8.  An increase or rearrangement of compensation is not

11-29  effective before an application for reopening a claim is made unless

11-30  good cause is shown. The insurer shall, upon good cause shown,

11-31  allow the cost of emergency treatment the necessity for which has

11-32  been certified by a physician or a chiropractor.

11-33     9.  A claim that closes pursuant to subsection 2 of NRS

11-34  616C.235 and is not appealed or is unsuccessfully appealed pursuant

11-35  to the provisions of NRS 616C.305 and 616C.315 to 616C.385,

11-36  inclusive, may not be reopened pursuant to this section.

11-37     10.  The provisions of this section apply to any claim for which

11-38  an application to reopen the claim or to increase or rearrange

11-39  compensation is made pursuant to this section, regardless of the date

11-40  of the injury or accident to the claimant. If a claim is reopened

11-41  pursuant to this section, the amount of any compensation or benefits

11-42  provided must be determined in accordance with the provisions of

11-43  NRS 616C.425.

 

 

12-1      Sec. 10.  NRS 616C.440 is hereby amended to read as follows:

12-2      616C.440  1.  Except as otherwise provided in this section and

12-3  NRS 616C.175, every employee in the employ of an employer,

12-4  within the provisions of chapters 616A to 616D, inclusive, of NRS,

12-5  who is injured by accident arising out of and in the course of

12-6  employment, or his dependents as defined in chapters 616A to

12-7  616D, inclusive, of NRS, is entitled to receive the following

12-8  compensation for permanent total disability:

12-9      (a) In cases of total disability adjudged to be permanent,

12-10  compensation per month of 66 2/3 percent of the average monthly

12-11  wage.

12-12     (b) If there is a previous disability, as the loss of one eye, one

12-13  hand, one foot or any other previous permanent disability, the

12-14  percentage of disability for a subsequent injury must be determined

12-15  by computing the percentage of the entire disability and deducting

12-16  therefrom the percentage of the previous disability as it existed at

12-17  the time of the subsequent injury, but such a deduction for a

12-18  previous award for permanent partial disability must be made in a

12-19  reasonable manner and must not be more than the total amount

12-20  which was paid for the previous award for permanent partial

12-21  disability. The total amount of the allowable deduction includes,

12-22  without limitation, any compensation for a permanent partial

12-23  disability which is deducted from the compensation the employee

12-24  receives for a temporary total disability, and any compensation for

12-25  a temporary partial disability, permanent partial disability or

12-26  vocational rehabilitation maintenance.

12-27     (c) If the character of the injury is such as to render the

12-28  employee so physically helpless as to require the service of a

12-29  constant attendant, an additional allowance may be made so long as

12-30  such requirements continue, but the allowance may not be made

12-31  while the employee is receiving benefits for care in a hospital or

12-32  facility for intermediate care pursuant to the provisions of

12-33  NRS 616C.265.

12-34     2.  Except as otherwise provided in NRS 616B.028 and

12-35  616B.029, an injured employee or his dependents are not entitled to

12-36  accrue or be paid any benefits for a permanent total disability during

12-37  the time the injured employee is incarcerated. The injured employee

12-38  or his dependents are entitled to receive such benefits when the

12-39  injured employee is released from incarceration if he is certified as

12-40  permanently totally disabled by a physician or chiropractor.

12-41     3.  An employee is entitled to receive compensation for a

12-42  permanent total disability only so long as the permanent total

12-43  disability continues to exist. The insurer has the burden of proving

12-44  that the permanent total disability no longer exists.

13-1      4.  If an employee who has received compensation in a lump

13-2  sum for a permanent partial disability pursuant to NRS 616C.495 is

13-3  subsequently determined to be permanently and totally disabled, the

13-4  compensation for the permanent total disability must be reduced [as

13-5  follows:

13-6      (a) If the employee has not received a minimum lump sum, the

13-7  insurer of the employee’s employer shall deduct from the

13-8  compensation for the permanent total disability an amount equal to

13-9  the monthly installment rate for awards for permanent partial

13-10  disability until the insurer has deducted an amount that equals the

13-11  amount it has already paid out as a lump sum; or

13-12     (b) If the employee received a minimum lump sum,] by the

13-13  insurer of the employee’s employer [shall deduct from the

13-14  compensation for the permanent total disability] by an amount of not

13-15  more than 10 percent of the rate of compensation for a permanent

13-16  total disability until the lump sum is recovered. The provisions of

13-17  this subsection are retroactive for all claims for compensation for a

13-18  permanent total disability remaining open on January 1, 2000.

13-19     Sec. 11.  NRS 616C.495 is hereby amended to read as follows:

13-20     616C.495  1.  Except as otherwise provided in NRS 616C.380,

13-21  an award for a permanent partial disability may be paid in a lump

13-22  sum under the following conditions:

13-23     (a) A claimant injured on or after July 1, 1973, and before

13-24  July 1, 1981, who incurs a disability that does not exceed 12 percent

13-25  may elect to receive his compensation in a lump sum. A claimant

13-26  injured on or after July 1, 1981, and before July 1, 1995, who incurs

13-27  a disability that does not exceed 25 percent may elect to receive his

13-28  compensation in a lump sum.

13-29     (b) [The spouse, or in the absence of a spouse, any dependent

13-30  child of] If a deceased claimant was injured on or after July 1, 1973,

13-31  any person who [is not] would have been entitled to compensation

13-32  in accordance with NRS 616C.505[,] if the death of the claimant

13-33  had been caused by an injury by accident arising out of and in the

13-34  course of employment is entitled to a proportionate share of a lump

13-35  sum equal to the present value of the deceased claimant’s

13-36  undisbursed award for a permanent partial disability. Each person

13-37  entitled to receive payment pursuant to this paragraph must

13-38  receive a share of the lump sum that is proportionate to the share

13-39  of the compensation pursuant to NRS 616C.505 that the person

13-40  would have been entitled to receive.

13-41     (c) Any claimant injured on or after July 1, 1981, and before

13-42  July 1, 1995, who incurs a disability that exceeds 25 percent may

13-43  elect to receive his compensation in a lump sum equal to the present

13-44  value of an award for a disability of 25 percent. If the claimant

13-45  elects to receive compensation pursuant to this paragraph, the

14-1  insurer shall pay in installments to the claimant that portion of the

14-2  claimant’s disability in excess of 25 percent.

14-3      (d) Any claimant injured on or after July 1, 1995, may elect to

14-4  receive his compensation in a lump sum in accordance with

14-5  regulations adopted by the Administrator and approved by the

14-6  Governor. The Administrator shall adopt regulations for

14-7  determining the eligibility of such a claimant to receive all or any

14-8  portion of his compensation in a lump sum. Such regulations may

14-9  include the manner in which an award for a permanent partial

14-10  disability may be paid to such a claimant in installments.

14-11  Notwithstanding the provisions of NRS 233B.070, any regulation

14-12  adopted pursuant to this paragraph does not become effective unless

14-13  it is first approved by the Governor.

14-14     2.  If the claimant elects to receive his payment for a permanent

14-15  partial disability in a lump sum pursuant to subsection 1, all of his

14-16  benefits for compensation terminate. His acceptance of that payment

14-17  constitutes a final settlement of all factual and legal issues in the

14-18  case. By so accepting he waives all of his rights regarding the claim,

14-19  including the right to appeal from the closure of the case or the

14-20  percentage of his disability, except:

14-21     (a) His right to reopen his claim according to the provisions of

14-22  NRS 616C.390; and

14-23     (b) Any counseling, training or other rehabilitative services

14-24  provided by the insurer.

14-25  The claimant must be [advised in writing] provided written notice

14-26  of the provisions of this subsection when he demands his payment

14-27  in a lump sum . [, and] The notice must indicate that the claimant

14-28  has 20 days after the mailing or personal delivery of this notice

14-29  within which to retract or reaffirm his demand, before payment may

14-30  be made and his election becomes final[.] , and must explain in

14-31  plain language the effect of accepting a lump sum pursuant to this

14-32  section. The notice must be printed in at least 10-point bold type.

14-33     3.  Any lump-sum payment which has been paid on a claim

14-34  incurred on or after July 1, 1973, must be supplemented if necessary

14-35  to conform to the provisions of this section.

14-36     4.  Except as otherwise provided in this subsection, the total

14-37  lump-sum payment for disablement must not be less than one-half

14-38  the product of the average monthly wage multiplied by the

14-39  percentage of disability. If the claimant received compensation in

14-40  installment payments for his permanent partial disability before

14-41  electing to receive his payment for that disability in a lump sum, the

14-42  lump-sum payment must be calculated for the remaining payment of

14-43  compensation.

14-44     5.  The lump sum payable must be equal to the present value of

14-45  the compensation awarded, less any advance payment or lump sum

15-1  previously paid. The present value must be calculated using monthly

15-2  payments in the amounts prescribed in subsection 7 of NRS

15-3  616C.490 and actuarial annuity tables adopted by the Division. The

15-4  tables must be reviewed annually by a consulting actuary.

15-5      6.  If a claimant would receive more money by electing to

15-6  receive compensation in a lump sum than he would if he receives

15-7  installment payments, he may elect to receive the lump-sum

15-8  payment.

15-9      Sec. 12.  NRS 616C.505 is hereby amended to read as follows:

15-10     616C.505  If an injury by accident arising out of and in the

15-11  course of employment causes the death of an employee in the

15-12  employ of an employer, within the provisions of chapters 616A to

15-13  616D, inclusive, of NRS, the compensation is known as a death

15-14  benefit, and is payable as follows:

15-15     1.  In addition to any other compensation payable pursuant to

15-16  chapters 616A to 616D, inclusive, of NRS, burial expenses are

15-17  payable in an amount not to exceed $5,000. When the remains of the

15-18  deceased employee and the person accompanying the remains are to

15-19  be transported to a mortuary or mortuaries, the charge of

15-20  transportation must be borne by the insurer.

15-21     2.  [To] Except as otherwise provided in subsection 3, the

15-22  surviving spouse of the deceased employee, if any, must receive 66

15-23  2/3 percent of the average monthly wage [is payable until his] of the

15-24  deceased employee until the death or remarriage[, with 2 years’

15-25  compensation payable in one lump sum upon remarriage.] of the

15-26  surviving spouse.

15-27     3.  Except as otherwise provided in subsection 6, if there is a

15-28  child of the deceased employee who is entitled to compensation

15-29  pursuant to subsection 13 and who is not the child of the surviving

15-30  spouse:

15-31     (a) Each such child must receive an equal share of 33 1/3

15-32  percent of the average monthly wage of the deceased employee

15-33  until that child is not entitled to receive compensation pursuant to

15-34  subsection 13, at which time the share of that child must be

15-35  divided equally among the remaining children to whom this

15-36  paragraph applies; and

15-37     (b) The surviving spouse of the deceased employee is entitled

15-38  to 33 1/3 percent of the average monthly wage of the deceased

15-39  employee until the death or remarriage of the surviving spouse.

15-40     4.  In the event of the subsequent death of [the] a surviving

15-41  spouse[:

15-42     (a) Each] before the surviving spouse remarries, each surviving

15-43  child of the deceased employee who is entitled to compensation

15-44  pursuant to subsection 13, if any, must receive an equal share

15-45  [equally] of the total compensation theretofore paid to the surviving

16-1  spouse [but not in excess thereof, and it is payable until the youngest

16-2  child reaches the age of 18 years.

16-3      (b) Except as otherwise provided in subsection 11, if the

16-4  children have a guardian, the compensation they are entitled to

16-5  receive may be paid to the guardian.

16-6      4.] and any children pursuant to subsection 2 or 3, as

16-7  applicable. A child to whom this subsection applies must receive

16-8  payment until that child is not entitled to receive compensation

16-9  pursuant to subsection 13, at which time the share of that child

16-10  must be divided equally among the remaining children to whom

16-11  this subsection applies.

16-12     5. Upon the remarriage of a surviving spouse : [with children:]

16-13     (a) The surviving spouse must be paid 2 years’ compensation in

16-14  one lump sum and further benefits must cease; and

16-15     (b) Each surviving child of the deceased employee who is

16-16  entitled to compensation pursuant to subsection 13, if any, must

16-17  [be paid 15 percent of the average monthly wage, up to a maximum

16-18  family benefit of 66 2/3 percent of the average monthly wage.

16-19     5.] receive an equal share of the total compensation theretofore

16-20  paid to the surviving spouse and any children pursuant to

16-21  subsection 2 or 3, as applicable. A child to whom this paragraph

16-22  applies must receive payment until that child is not entitled to

16-23  receive compensation pursuant to subsection 13, at which time the

16-24  share of that child must be divided equally among the remaining

16-25  children to whom this paragraph applies.

16-26     6. If there are any surviving children of the deceased employee

16-27  [under the age of 18 years,] entitled to compensation pursuant to

16-28  subsection 13, but no surviving spouse, then each such child is

16-29  entitled to [his proportionate] an equal share of 66 2/3 percent of

16-30  the average monthly wage of the deceased employee for his support.

16-31     [6.] A child to whom this subsection applies must receive

16-32  payment until that child is not entitled to receive compensation

16-33  pursuant to subsection 13, at which time the share of that child

16-34  must be divided equally among the remaining children to whom

16-35  this subsection applies.

16-36     7. Except as otherwise provided in subsection [7,] 8, if there is

16-37  no surviving spouse or child [under the age of 18 years,] entitled to

16-38  compensation pursuant to subsection 13, there must be paid:

16-39     (a) To a parent, if wholly dependent for support upon the

16-40  deceased employee at the time of the injury causing his death, 33

16-41  1/3 percent of the average monthly wage.

16-42     (b) To both parents, if wholly dependent for support upon the

16-43  deceased employee at the time of the injury causing his death, 66

16-44  2/3 percent of the average monthly wage.

17-1      (c) To each brother or sister until he or she reaches the age of 18

17-2  years, if wholly dependent for support upon the deceased employee

17-3  at the time of the injury causing his death, his proportionate share of

17-4  66 2/3 percent of the average monthly wage.

17-5      [7.] 8. The aggregate compensation payable pursuant to

17-6  subsection [6] 7 must not exceed 66 2/3 percent of the average

17-7  monthly wage.

17-8      [8.] 9. In all other cases involving a question of total or partial

17-9  dependency:

17-10     (a) The extent of the dependency must be determined in

17-11  accordance with the facts existing at the time of the injury.

17-12     (b) If the deceased employee leaves dependents only partially

17-13  dependent upon his earnings for support at the time of the injury

17-14  causing his death, the monthly compensation to be paid must be

17-15  equal to the same proportion of the monthly payments for the

17-16  benefit of persons totally dependent as the amount contributed by

17-17  the deceased employee to the partial dependents bears to the average

17-18  monthly wage of the deceased employee at the time of the injury

17-19  resulting in his death.

17-20     (c) The duration of compensation to partial dependents must be

17-21  fixed in accordance with the facts shown, but may not exceed

17-22  compensation for 100 months.

17-23     [9.] 10. Compensation payable to a surviving spouse is for the

17-24  use and benefit of the surviving spouse and the dependent children,

17-25  and the insurer may, from time to time, apportion such

17-26  compensation between them in such a way as it deems best for the

17-27  interest of all dependents.

17-28     [10.] 11. In the event of the death of any dependent specified in

17-29  this section before the expiration of the time during which

17-30  compensation is payable to him, funeral expenses are payable in an

17-31  amount not to exceed $5,000.

17-32     [11.] 12. If a dependent is entitled to receive a death benefit

17-33  pursuant to this section , does not have a parent or guardian, and is

17-34  less than 18 years of age or incompetent, the legal representative of

17-35  the dependent shall petition for a guardian to be appointed for that

17-36  dependent pursuant to NRS 159.044. An insurer shall not pay any

17-37  compensation in excess of $3,000, other than burial expenses, to the

17-38  dependent until a guardian is appointed and legally qualified. Upon

17-39  receipt of a certified letter of guardianship, the insurer shall make all

17-40  payments required by this section to the guardian of the dependent

17-41  until the dependent is emancipated, the guardianship terminates or

17-42  the dependent reaches the age of 18 years, whichever occurs first,

17-43  unless paragraph (a) of subsection [12] 13 is applicable. The fees

17-44  and costs related to the guardianship must be paid from the estate of

17-45  the dependent. A guardianship established pursuant to this

18-1  subsection must be administered in accordance with chapter 159 of

18-2  NRS, except that after the first annual review required pursuant to

18-3  NRS 159.176, a court may elect not to review the guardianship

18-4  annually. The court shall review the guardianship at least once every

18-5  3 years. As used in this subsection, “incompetent” has the meaning

18-6  ascribed to it in NRS 159.019.

18-7      [12.] 13. Except as otherwise provided in paragraphs (a) and

18-8  (b), the entitlement of any child to receive his proportionate share of

18-9  compensation pursuant to this section ceases when he dies, marries

18-10  or reaches the age of 18 years. A child is entitled to continue to

18-11  receive compensation pursuant to this section if he is:

18-12     (a) Over 18 years of age and incapable of supporting himself,

18-13  until such time as he becomes capable of supporting himself; or

18-14     (b) Over 18 years of age and enrolled as a full-time student in an

18-15  accredited vocational or educational institution, until he reaches the

18-16  age of 22 years.

18-17     [13.] 14. As used in this section, “surviving spouse” means a

18-18  surviving husband or wife who was married to the employee at the

18-19  time of the employee’s death.

18-20     Sec. 13.  NRS 616C.560 is hereby amended to read as follows:

18-21     616C.560  1.  A program for vocational rehabilitation

18-22  developed pursuant to subsection 3 of NRS 616C.555 may be

18-23  extended:

18-24     (a) Without condition or limitation, by the insurer at his sole

18-25  discretion; or

18-26     (b) In accordance with this section if:

18-27         (1) The injured employee makes a written request to extend

18-28  the program within 30 days after he receives written notification that

18-29  he [is eligible] has completed his program for vocational

18-30  rehabilitation services; and

18-31         (2) There are exceptional circumstances which make it

18-32  unlikely that the injured employee will obtain suitable gainful

18-33  employment as a result of vocational rehabilitation which is limited

18-34  to the period for which he is eligible.

18-35  An insurer’s determination to grant or deny an extension pursuant to

18-36  paragraph (a) may not be appealed.

18-37     2.  If an injured employee has incurred a permanent physical

18-38  impairment of less than 11 percent:

18-39     (a) The total length of the program, including any extension,

18-40  must not exceed 2 years.

18-41     (b) “Exceptional circumstances” shall be deemed to exist for the

18-42  purposes of paragraph (b) of subsection 1, if:

18-43         (1) The injured employee lacks work experience, training,

18-44  education or other transferable skills for an occupation which he is

18-45  physically capable of performing; or

19-1          (2) Severe physical restrictions as a result of the industrial

19-2  injury have been imposed by a physician which significantly limit

19-3  the employee’s occupational opportunities.

19-4      3.  If an injured employee has incurred a permanent physical

19-5  impairment of 11 percent or more:

19-6      (a) The total length of the program, including any extension,

19-7  must not exceed 2 1/2 years.

19-8      (b) “Exceptional circumstances” shall be deemed to exist for the

19-9  purposes of paragraph (b) of subsection 1, if the injured employee

19-10  has suffered:

19-11         (1) The total and permanent loss of sight of both eyes;

19-12         (2) The loss by separation of a leg at or above the knee;

19-13         (3) The loss by separation of a hand at or above the wrist;

19-14         (4) An injury to the head or spine which results in permanent

19-15  and complete paralysis of both legs, both arms or a leg and an arm;

19-16         (5) An injury to the head which results in a severe cognitive

19-17  functional impairment which may be established by a nationally

19-18  recognized form of objective psychological testing;

19-19         (6) The loss by separation of an arm at or above the elbow

19-20  and the loss by separation of a leg at or above the knee;

19-21         (7) An injury consisting of second or third degree burns on

19-22  50 percent or more of the body, both hands or the face;

19-23         (8) A total bilateral loss of hearing;

19-24         (9) The total loss or significant and permanent impairment of

19-25  speech; or

19-26         (10) A permanent physical impairment of 50 percent or more

19-27  determined pursuant to NRS 616C.490, if the severity of the

19-28  impairment limits the injured employee’s gainful employment to

19-29  vocations that are primarily intellectual and require a longer

19-30  program of education.

19-31     4.  The insurer shall deliver a copy of its decision granting or

19-32  denying an extension to the injured employee and the employer.

19-33  Except as otherwise provided in this section, the decision shall be

19-34  deemed to be a final determination of the insurer for the purposes of

19-35  NRS 616C.315.

19-36     Sec. 14.  NRS 616C.580 is hereby amended to read as follows:

19-37     616C.580  1.  Except as otherwise provided in this section,

19-38  vocational rehabilitation services must not be provided outside of

19-39  this state. An injured employee who:

19-40     (a) Lives within 50 miles from any border of this state on the

19-41  date of injury; [or]

19-42     (b) Was injured while temporarily employed in this state by an

19-43  employer subject to the provisions of chapters 616A to 617,

19-44  inclusive, of NRS who can demonstrate that, on the date of injury,

19-45  his permanent residence was outside of this state[,] ; or

20-1      (c) Was moved outside of this state by the insurer,

20-2  may receive vocational rehabilitation services at a location within 50

20-3  miles from his residence if such services are available at such

20-4  location.

20-5      2.  If the injured employee was moved outside of this state by

20-6  the insurer, the insurer shall, upon the request of the injured

20-7  employee:

20-8      (a) Provide vocational rehabilitation services to the injured

20-9  employee outside of this state; or

20-10     (b) Move the injured employee to this state at the expense of

20-11  the insurer.

20-12     3.  An injured employee, who:

20-13     (a) Is eligible for vocational rehabilitation services pursuant to

20-14  NRS 616C.590; and

20-15     (b) Resides outside of this state but does not qualify to receive

20-16  vocational rehabilitation services outside of this state pursuant to

20-17  subsection 1,

20-18  may execute a written agreement with the insurer which provides

20-19  for the payment of compensation in a lump sum in lieu of the

20-20  provision of vocational rehabilitation services pursuant to NRS

20-21  616C.595. The amount of the lump sum must not exceed $20,000.

20-22     [3.] 4. An injured employee who resides outside of this state

20-23  but does not qualify to receive vocational rehabilitation services

20-24  outside of this state pursuant to subsection 1 may receive the

20-25  vocational rehabilitation services to which he is entitled pursuant to

20-26  NRS 616C.545 to 616C.575, inclusive, and 616C.590 if he relocates

20-27  to:

20-28     (a) This state; or

20-29     (b) A location within 50 miles from any border of this

20-30  state,

20-31  at his own expense, if such services are available at such location.

20-32     Sec. 15.  NRS 616C.595 is hereby amended to read as follows:

20-33     616C.595  1.  If an injured employee is eligible for vocational

20-34  rehabilitation services pursuant to NRS 616C.590, the insurer and

20-35  the injured employee may, at any time during the employee’s

20-36  eligibility for [such] those services, execute a written agreement

20-37  providing for the payment of compensation in a lump sum in lieu of

20-38  the provision of vocational rehabilitation services. An insurer’s

20-39  refusal to execute such an agreement may not be appealed[.] unless

20-40  the payment of compensation in a lump sum in lieu of the

20-41  provision of vocational rehabilitation services is the only

20-42  vocational rehabilitation benefit the injured employee is entitled to

20-43  receive.

20-44     2.  If the insurer and the injured employee execute an agreement

20-45  pursuant to subsection 1, the acceptance of the payment of

21-1  compensation in a lump sum by the injured employee extinguishes

21-2  his right to receive vocational rehabilitation services under his

21-3  claim. Except as otherwise required by federal law, an injured

21-4  employee shall not receive vocational rehabilitation services from

21-5  any state agency after he accepts payment of compensation in a

21-6  lump sum pursuant to this section.

21-7      3.  Before executing an agreement pursuant to subsection 1, an

21-8  insurer shall:

21-9      (a) Order an assessment of and counseling concerning the

21-10  vocational skills of the injured employee, unless the provisions of

21-11  NRS 616C.580 are applicable;

21-12     (b) Consult with the employer of the injured employee; and

21-13     (c) Provide a written notice to the injured employee that

21-14  contains the following statements:

21-15         (1) That the injured employee is urged to seek assistance and

21-16  advice from the Nevada Attorney for Injured Workers or to consult

21-17  with a private attorney before signing the agreement.

21-18         (2) That the injured employee may rescind the agreement

21-19  within 20 days after he signs it.

21-20         (3) That the 20-day period pursuant to subparagraph (2) may

21-21  not be waived.

21-22         (4) That acceptance by the injured employee of payment of

21-23  compensation in a lump sum in lieu of the provision of vocational

21-24  rehabilitation services extinguishes his right to receive [such] those

21-25  services.

21-26     4.  No payment of compensation in a lump sum may be made

21-27  pursuant to this section until the 20-day period provided for the

21-28  rescission of the agreement has expired. The amount of the

21-29  payment is equal to the cost of vocational rehabilitation

21-30  maintenance and the cost of rehabilitation for the period for

21-31  which the employee is entitled to receive vocational rehabilitation

21-32  services pursuant to NRS 616C.555 and 616C.560.

21-33     Sec. 16.  NRS 616C.430 and 616D.030 are hereby repealed.

21-34     Sec. 17.  This act becomes effective on July 1, 2003.

 

21-35  TEXT OF REPEALED SECTIONS

 

21-36     616C.430  Reduction of compensation by amount of federal

21-37   disability insurance benefits received by employee.

21-38     1.  Ifan employee who is entitled to compensation under

21-39   chapters 616A to 616D, inclusive, of NRS for temporary total

21-40   disability, permanent partial disability or permanent total disability

22-1  becomes entitled to federal disability insurance benefits under

22-2  section 202 or 223 of the Social Security Act, as amended (42 U.S.C

22-3   §§ 402 and 423, respectively), the employee’s compensation under

22-4   chapters 616A to 616D, inclusive, of NRS must be reduced by the

22-5   amount of the federal benefits being received by him.

22-6      2.  This section must not be applied to reduce the employee’s

22-7   compensation under chapters 616A to 616D, inclusive, of NRS to

22-8   any greater extent than his federal benefits would have otherwise

22-9   been reduced by the Social Security Administration under section

22-10   224 of the Social Security Act, as amended (42 U.S.C. § 424a).

22-11   After any reduction pursuant to this section, the combination of his

22-12   state compensation and federal benefits must be at least as much as

22-13   the greater of:

22-14     (a) The benefits payable pursuant to chapters 616A to 616D,

22-15   inclusive, of NRS (without the reduction); or

22-16     (b) The benefits payable under the Social Security Act (without

22-17   any reduction).

22-18     3.  After a reduced amount of compensation for an employee

22-19   has been established pursuant to this section, no further reduction in

22-20   his compensation may be made because he receives an increase in

22-21   his benefits under the Social Security Act as the result of an

22-22   adjustment based on an increase in the cost of living.

22-23     4.  No compensation may be reduced pursuant to this section

22-24   until the Social Security Administration has determined the amount

22-25   of benefits payable to the employee under section 202 or 223 of the

22-26   Social Security Act and he has begun to receive those benefits.

22-27     5.  If an employee:

22-28     (a) Fails to report the amount of benefits which he is receiving

22-29   under section 202 or 223 of the Social Security Act, within 30 days

22-30   after he is requested in writing by the insurer to make that report; or

22-31     (b) Fails to provide the insurer with a written authorization for

22-32   the Social Security Administration to release information on the

22-33   employee’s average current earnings and the amount of benefits to

22-34   which he is entitled, within 30 days after he is requested to provide

22-35   that authorization,

22-36  the insurer may reduce by 50 percent the compensation which the

22-37   employee would otherwise receive pursuant to chapters 616A to

22-38   616D, inclusive, of NRS. Any compensation which is withheld

22-39   pursuant to this subsection must be paid to the employee when he

22-40   has furnished the report or authorization as requested.

22-41     6.  If the provisions of section 224 of the Social Security Act

22-42   are amended:

22-43     (a) To allow an employee to receive more compensation under

22-44   chapters 616A to 616D, inclusive, of NRS without any reduction in

23-1  benefits payable under section 202 or 223 of the Social Security

23-2  Act; or

23-3      (b) To lower the maximum sum of compensation payable under

23-4   chapters 616A to 616D, inclusive, of NRS and benefits payable

23-5   under section 202 or 223 of the Social Security Act,

23-6  the reduction imposed by this section must be increased or

23-7   decreased correspondingly.

23-8      7.  No reduction in compensation may be made under this

23-9   section for any period of entitlement which:

23-10     (a) Occurs before January 1, 1982;

23-11     (b) Occurs before the employee has been given a written notice

23-12   by mail of the intended reduction; or

23-13     (c) Includes any week after the week in which the employee

23-14   becomes 62 years of age.

23-15     616D.030  Limitation of liability of insurer or third-party

23-16   administrator; administrative fines are exclusive remedies.

23-17     1.  No cause of action may be brought or maintained against an

23-18   insurer or a third-party administrator who violates any provision of

23-19   this chapter or chapter 616A, 616B, 616C or 617 of NRS.

23-20     2.  The administrative fines provided for in NRS 616B.318 and

23-21   616D.120 are the exclusive remedies for any violation of this

23-22   chapter or chapter 616A, 616B, 616C or 617 of NRS committed by

23-23   an insurer or a third-party administrator.

 

23-24  H