Senate Bill No. 292–Senator Schneider

 

March 14, 2003

____________

 

Referred to Committee on Commerce and Labor

 

SUMMARY—Revises circumstances under which Nevada Attorney for Injured Workers is required to represent injured workers. (BDR 53‑784)

 

FISCAL NOTE:  Effect on Local Government: Yes.

                           Effect on the State: Yes.

 

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

 

AN ACT relating to industrial insurance; revising the circumstances under which the Nevada Attorney for Injured Workers is required to represent injured workers; 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 616A.450 is hereby amended to read as

1-2  follows:

1-3  616A.450  1.  Any claimant may request [the appointment of]

1-4  the Nevada Attorney for Injured Workers to represent [him.] the

1-5  claimant with regard to a claim or an appeal concerning a claim

1-6  arising under chapters 616A to 617, inclusive, of NRS. The request

1-7  must be made in writing.

1-8  2.  [The appeals officer or Administrator, as the case may be,

1-9  shall consider each request within a reasonable time and shall make

1-10  any inquiry as he deems necessary. If he finds that the claimant

1-11  would be better served by legal representation in the case, he shall

1-12  appoint the Nevada Attorney for Injured Workers to represent the

1-13  claimant. Once the Nevada Attorney for Injured Workers has been

1-14  appointed to represent a claimant,] Upon receipt of the request, the

1-15  Nevada Attorney for Injured Workers [is authorized to] shall

1-16  represent the claimant [at any level of proceedings if, in the opinion

1-17  of the Nevada Attorney for Injured Workers, the representation is

2-1  necessary.] with regard to the claim or the appeal concerning the

2-2  claim in accordance with the provisions of NRS 616A.455.

2-3  Sec. 2.  NRS 616A.455 is hereby amended to read as follows:

2-4  616A.455  1.  [Except as otherwise provided in subsection 3,]

2-5  If a claimant requests the Nevada Attorney for Injured Workers to

2-6  represent the claimant with regard to a claim or an appeal

2-7  concerning a claim arising under chapters 616A to 617, inclusive,

2-8  of NRS, the Nevada Attorney for Injured Workers shall[, when

2-9  appointed by an appeals officer or the Administrator,] represent the

2-10  claimant, without charge [a claimant before the] , before any

2-11  hearing officer, any appeals officer, the Administrator, any district

2-12  court or the Supreme Court[. In addition, the Nevada Attorney for

2-13  Injured Workers may give advice regarding a claimant’s rights

2-14  before a hearing officer and the procedure for enforcing those rights.

2-15      2.  When representing a claimant, the Nevada Attorney for

2-16  Injured Workers shall:

2-17      (a) Advise the claimant and present his case to the appeals

2-18  officer or Administrator; and

2-19      (b) Present in the district court or Supreme Court an appeal from

2-20  the decision of the appeals officer or Administrator if, in the opinion

2-21  of the Nevada Attorney for Injured Workers, the appeal is merited.

2-22      3.  If] , with regard to the claim or the appeal concerning the

2-23  claim, unless the Nevada Attorney for Injured Workers determines,

2-24  in accordance with the guidelines adopted pursuant to [subsection 4,

2-25  that a] this section, that the claim or the appeal concerning the

2-26  claim is frivolous or lacks merit . [, he may refuse to represent a

2-27  claimant.

2-28      4.] 2. The Nevada Attorney for Injured Workers shall establish

2-29  the policies to be followed in determining whether a claim or an

2-30  appeal concerning a claim is frivolous or lacks merit.

2-31      Sec. 3.  NRS 616C.050 is hereby amended to read as follows:

2-32      616C.050  1.  An insurer shall provide to each claimant:

2-33      (a) Upon written request, one copy of any medical information

2-34  concerning his injury or illness.

2-35      (b) A statement which contains information concerning the

2-36  claimant’s right to:

2-37          (1) Receive the information and forms necessary to file a

2-38  claim;

2-39          (2) Select a treating physician or chiropractor and an

2-40  alternative treating physician or chiropractor in accordance with the

2-41  provisions of NRS 616C.090;

2-42          (3) [Request the appointment of] Have the Nevada Attorney

2-43  for Injured Workers [to represent him before the appeals officer;]

2-44  represent the claimant in accordance with NRS 616A.450 and

2-45  616A.455;

3-1       (4) File a complaint with the Administrator;

3-2       (5) When applicable, receive compensation for:

3-3          (I) Permanent total disability;

3-4          (II) Temporary total disability;

3-5          (III) Permanent partial disability;

3-6          (IV) Temporary partial disability; or

3-7          (V) All medical costs related to his injury or disease;

3-8       (6) Receive services for rehabilitation if his injury prevents

3-9  him from returning to gainful employment;

3-10          (7) Review by a hearing officer of any determination or

3-11  rejection of a claim by the insurer within the time specified by

3-12  statute; and

3-13          (8) Judicial review of any final decision within the time

3-14  specified by statute.

3-15      2.  The insurer’s statement must include a copy of the form

3-16  designed by the Administrator pursuant to subsection 7 of NRS

3-17  616C.090 that notifies injured employees of their right to select an

3-18  alternative treating physician or chiropractor. The Administrator

3-19  shall adopt regulations for the manner of compliance by an insurer

3-20  with the other provisions of subsection 1.

3-21      Sec. 4.  NRS 616C.330 is hereby amended to read as follows:

3-22      616C.330  1.  The hearing officer shall:

3-23      (a) Within 5 days after receiving a request for a hearing, set the

3-24  hearing for a date and time within 30 days after his receipt of the

3-25  request;

3-26      (b) Give notice by mail or by personal service to all interested

3-27  parties to the hearing at least 15 days before the date and time

3-28  scheduled; and

3-29      (c) Conduct hearings expeditiously and informally.

3-30      2.  The notice must include a statement that the injured

3-31  employee may be represented by a private attorney or [seek

3-32  assistance and advice from] may request the Nevada Attorney for

3-33  Injured Workers[.] to represent the injured employee.

3-34      3.  If necessary to resolve a medical question concerning an

3-35  injured employee’s condition or to determine the necessity of

3-36  treatment for which authorization for payment has been denied, the

3-37  hearing officer may refer the employee to a physician or

3-38  chiropractor of his choice who has demonstrated special competence

3-39  to treat the particular medical condition of the employee. If the

3-40  medical question concerns the rating of a permanent disability, the

3-41  hearing officer may refer the employee to a rating physician or

3-42  chiropractor. The rating physician or chiropractor must be selected

3-43  in rotation from the list of qualified physicians and chiropractors

3-44  maintained by the Administrator pursuant to subsection 2 of NRS

3-45  616C.490, unless the insurer and injured employee otherwise agree

4-1  to a rating physician or chiropractor. The insurer shall pay the costs

4-2  of any medical examination requested by the hearing officer.

4-3  4.  If an injured employee has requested payment for the cost of

4-4  obtaining a second determination of his percentage of disability

4-5  pursuant to NRS 616C.100, the hearing officer shall decide whether

4-6  the determination of the higher percentage of disability made

4-7  pursuant to NRS 616C.100 is appropriate and, if so, may order the

4-8  insurer to pay to the employee an amount equal to the maximum

4-9  allowable fee established by the Administrator pursuant to NRS

4-10  616C.260 for the type of service performed, or the usual fee of that

4-11  physician or chiropractor for such service, whichever is less.

4-12      5.  The hearing officer shall order an insurer, organization for

4-13  managed care or employer who provides accident benefits for

4-14  injured employees pursuant to NRS 616C.265 to pay the charges of

4-15  a provider of health care if the conditions of NRS 616C.138 are

4-16  satisfied.

4-17      6.  The hearing officer may allow or forbid the presence of a

4-18  court reporter and the use of a tape recorder in a hearing.

4-19      7.  The hearing officer shall render his decision within 15 days

4-20  after:

4-21      (a) The hearing; or

4-22      (b) He receives a copy of the report from the medical

4-23  examination he requested.

4-24      8.  The hearing officer shall render his decision in the most

4-25  efficient format developed by the Chief of the Hearings Division of

4-26  the Department of Administration.

4-27      9.  The hearing officer shall give notice of his decision to each

4-28  party by mail. He shall include with the notice of his decision the

4-29  necessary forms for appealing from the decision.

4-30      10.  Except as otherwise provided in NRS 616C.380, the

4-31  decision of the hearing officer is not stayed if an appeal from that

4-32  decision is taken unless an application for a stay is submitted by a

4-33  party. If such an application is submitted, the decision is

4-34  automatically stayed until a determination is made on the

4-35  application. A determination on the application must be made within

4-36  30 days after the filing of the application. If, after reviewing the

4-37  application, a stay is not granted by the hearing officer or an appeals

4-38  officer, the decision must be complied with within 10 days after the

4-39  refusal to grant a stay.

4-40      Sec. 5.  NRS 616C.595 is hereby amended to read as follows:

4-41      616C.595  1.  If an injured employee is eligible for vocational

4-42  rehabilitation services pursuant to NRS 616C.590, the insurer and

4-43  the injured employee may, at any time during the employee’s

4-44  eligibility for such services, execute a written agreement providing

4-45  for the payment of compensation in a lump sum in lieu of the

5-1  provision of vocational rehabilitation services. An insurer’s refusal

5-2  to execute such an agreement may not be appealed.

5-3  2.  If the insurer and the injured employee execute an agreement

5-4  pursuant to subsection 1, the acceptance of the payment of

5-5  compensation in a lump sum by the injured employee extinguishes

5-6  his right to receive vocational rehabilitation services under his

5-7  claim. Except as otherwise required by federal law, an injured

5-8  employee shall not receive vocational rehabilitation services from

5-9  any state agency after he accepts payment of compensation in a

5-10  lump sum pursuant to this section.

5-11      3.  Before executing an agreement pursuant to subsection 1, an

5-12  insurer shall:

5-13      (a) Order an assessment of and counseling concerning the

5-14  vocational skills of the injured employee, unless the provisions of

5-15  NRS 616C.580 are applicable;

5-16      (b) Consult with the employer of the injured employee; and

5-17      (c) Provide a written notice to the injured employee that

5-18  contains the following statements:

5-19          (1) That the injured employee is urged to seek [assistance

5-20  and] representation or advice from the Nevada Attorney for Injured

5-21  Workers or to consult with a private attorney before signing the

5-22  agreement.

5-23          (2) That the injured employee may rescind the agreement

5-24  within 20 days after he signs it.

5-25          (3) That the 20-day period pursuant to subparagraph (2) may

5-26  not be waived.

5-27          (4) That acceptance by the injured employee of payment of

5-28  compensation in a lump sum in lieu of the provision of vocational

5-29  rehabilitation services extinguishes his right to receive such

5-30  services.

5-31      4.  No payment of compensation in a lump sum may be made

5-32  pursuant to this section until the 20‑day period provided for the

5-33  rescission of the agreement has expired.

5-34      Sec. 6.  This act becomes effective on July 1, 2003.

 

5-35  H