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H.B. 222 Enrolled
AN ACT RELATING TO WORKFORCE SERVICES; AMENDING ATTORNEY FEE
PROVISIONS; AMENDING DEPARTMENT'S JURISDICTION ON
COMPENSABILITY OF HEALTH CARE PROVIDER SERVICES; MAKING
TECHNICAL CORRECTIONS; AND PROVIDING AN EFFECTIVE DATE.
This act affects sections of Utah Code Annotated 1953 as follows:
AMENDS:
35A-3-407 (Effective 07/01/97), as renumbered and amended by Chapter 240, Laws of
Utah 1996
35A-3-805 (Effective 07/01/97), as renumbered and amended by Chapter 240, Laws of
Utah 1996
35A-3a-108 (Effective 07/01/97), as renumbered and amended by Chapter 240, Laws of
Utah 1996
Be it enacted by the Legislature of the state of Utah:
Section 1. Section 35A-3-407 (Effective 07/01/97) is amended to read:
35A-3-407 (Effective 07/01/97). Reporting of industrial injuries -- Regulation of
health care providers.
(1) Any employee sustaining an injury arising out of and in the course of employment
shall provide notification to the employee's employer promptly of the injury. If the employee is
unable to provide notification, the employee's next-of-kin or attorney may provide notification of
the injury to the employee's employer.
(2) Any employee who fails to notify [
within 180 days of an injury is barred for any claim of benefits arising from the injury.
(3) An employer's or physician's injury report filed with the department, employer, or
insurance carrier or the payment of any medical or disability benefits by the employer or the
employer's insurance carrier, constitutes notification of an injury.
(4) (a) On forms or by methods prescribed by the department, each employer shall file a
report with the department of any work-related fatality or any work-related injury resulting in
medical treatment, loss of consciousness, loss of work, restriction of work, or transfer to another job
within seven days after:
(i) the occurrence of a fatality or injury;
(ii) the employer's first knowledge of the fatality or injury; or
(iii) the employee's notification of the fatality or injury.
(b) Each employer shall file a subsequent report with the department of any previously
reported injury that later resulted in death. The subsequent report shall be filed with the department
within seven days following the death or the employer's first knowledge or notification of the death.
(c) No report is required for minor injuries, such as cuts or scratches that require first-aid
treatment only, unless a treating physician files, or is required to file, the Physician's Initial Report
of Work Injury or Occupational Disease with the department.
(5) Each employer shall provide the employee with:
(a) a copy of the report submitted to the department[
(b) a statement, as prepared by the department, of the employee's rights and responsibilities
related to the industrial injury.
(6) Each employer shall maintain a record in a manner prescribed by the department of all
work-related fatalities or work-related injuries resulting in:
(a) medical treatment[
(b) loss of consciousness[
(c) loss of work[
(d) restriction of work[
(e) transfer to another job.
(7) Any employer who refuses or neglects to make reports, to maintain records, or to file
reports with the department as required by this section is guilty of a class C misdemeanor and subject
to citation under Section 35A-6-302 and a civil assessment as provided under Section 35A-6-307,
unless the department finds that the employer has shown good cause for submitting a report later
than required by this section.
(8) (a) Except as provided in Subsection (8)(c) all physicians, surgeons, and other health
providers attending injured employees shall:
(i) comply with all the rules, including the schedule of fees, for their services as adopted by
the department; and
(ii) make reports to the department at any and all times as required as to the condition and
treatment of an injured employee or as to any other matter concerning industrial cases they are
treating.
(b) A physician, as defined in Subsection 35A-3-117(2), who is associated with, employed
by, or bills through a hospital is subject to Subsection (8)(a).
(c) A hospital is not subject to the requirements of Subsection (8)(a).
(d) The department's schedule of fees may reasonably differentiate remuneration to be paid
to providers of health services based on:
(i) the severity of the employee's condition[
(ii) the nature of the treatment necessary[
(iii) the facilities or equipment specially required to deliver that treatment.
(e) Subsection (8) does not modify contracts with providers of health services relating to the
pricing of goods and services existing on May 1, 1995.
(9) A copy of the physician's initial report shall be furnished to:
(a) the department[
(b) the employee[
(c) the employer or its insurance carrier.
(10) Any physician, surgeon, or other health provider, excluding any hospital, who refuses
or neglects to make any report or comply with this section is guilty of a class C misdemeanor for
each offense, unless the department finds that there is good cause for submitting a late report.
(11) (a) Subject to appellate review under Section 35A-1-302, the department has exclusive
jurisdiction to hear and determine whether the treatment or services rendered to employees by
physicians, surgeons, or other health providers are:
(i) reasonably related to industrial injuries or occupational diseases; and
(ii) compensable pursuant to this chapter or Chapter 3a, Utah Occupational Disease Act.
(b) Except as provided in Subsection (11)(a), Subsection 35A-3-204(7), or Section
35A-3-211, a person may not maintain a cause of action in any forum within this state other than the
department for collection or payment of a physician's, surgeon's, or other health provider's billing
for treatment or services that are compensable under this chapter or Chapter 3a, Utah Occupational
Disease Act.
Section 2. Section 35A-3-805 (Effective 07/01/97) is amended to read:
35A-3-805 (Effective 07/01/97). Attorneys' fees.
(1) In all cases coming before the department in which attorneys have been employed, the
department is vested with full power to regulate and fix the fees of the attorneys.
(2) (a) The department may award reasonable attorneys' fees on a contingency basis when
disability or death benefits or interest on disability or death benefits are generated.
(b) Attorney fees awarded under Subsection (2)(a) shall be paid by the employer or its
insurance carrier out of the award of disability or death benefits, or interest on disability or death
benefits.
(3) (a) If the department orders that only medical benefits be paid, the department may award
reasonable attorneys' fee on a contingency basis for medical benefits ordered paid if:
(i) the department's informal dispute resolution mechanisms were fully used by the parties
prior to adjudication; and
(ii) at no time were disability or death benefits or interest on disability or death benefits at
issue in the adjudication of the medical benefit claim.
(b) Attorneys' fees awarded under Subsection (3)(a) shall be paid by the employer or its
insurance carrier in addition to the payment of medical benefits ordered.
Section 3. Section 35A-3a-108 (Effective 07/01/97) is amended to read:
35A-3a-108 (Effective 07/01/97). Reporting of occupational diseases -- Regulation of
health care providers.
(1) Any employee sustaining an occupational disease, as defined in this chapter, arising out
of and in the course of employment shall provide notification to the employee's employer promptly
of the occupational disease. If the employee is unable to provide notification, the employee's
next-of-kin or attorney may provide notification of the occupational disease to the employee's
employer.
(2) Any employee who fails to notify the employee's employer or the department within 180
days after the cause of action arises is barred from any claim of benefits arising from the
occupational disease. The cause of action is considered to arise on the date the employee first
suffered disability from the occupational disease and knew, or in the exercise of reasonable diligence
should have known, that the occupational disease was caused by employment.
(3) An employer's or physician's injury report filed with the department, employer, or
insurance carrier, or the payment of any medical or disability benefits by the employer or the
employer's insurance carrier, constitutes notification of an occupational disease.
(4) (a) On forms or by methods prescribed by the department, each employer shall file a
report with the department of any occupational disease resulting in medical treatment, loss of
consciousness, loss of work, restriction of work, or transfer to another job within seven days after:
(i) the occurrence of an occupational disease;
(ii) the employer's first knowledge of the occupational disease; or
(iii) the employee's notification of the occupational disease.
(b) Each employer shall file a subsequent report with the department of any previously
reported occupational disease that later resulted in death. The subsequent report shall be filed with
the department within seven days following the death or the employer's first knowledge or
notification of the death.
(c) No report is required for minor injuries that require first-aid treatment only, unless a
treating physician files, or is required to file, the Physician's Initial Report of Work Injury or
Occupational Disease with the department.
(d) No report is required for occupational diseases that manifest after the employee is no
longer employed by the employer with which the exposure occurred, or when the employer is not
aware of an exposure occasioned by the employment that results in an occupational disease as
defined by Section 35A-3a-103.
(5) Each employer shall provide the employee with:
(a) a copy of the report submitted to the department[
(b) a statement, as prepared by the department, of the employee's rights and responsibilities
related to the occupational disease.
(6) Each employer shall maintain a record in a manner prescribed by the department of all
occupational diseases resulting in:
(a) medical treatment[
(b) loss of consciousness[
(c) loss of work[
(d) restriction of work[
(e) transfer to another job.
(7) Any employer who refuses or neglects to make reports, to maintain records, or to file
reports with the department as required by this section is guilty of a class C misdemeanor and subject
to citation under Section 35A-6-302 and a civil assessment as provided under Section 35A-6-307,
unless the department finds that the employer has shown good cause for submitting a report later
than required by this section.
(8) (a) Except as provided in Subsection (8)(c), all physicians, surgeons, and other health
providers attending occupationally diseased employees shall:
(i) comply with all the rules, including the schedule of fees, for their services as adopted by
the department; and
(ii) make reports to the department at any and all times as required as to the condition and
treatment of an occupationally diseased employee or as to any other matter concerning industrial
cases they are treating.
(b) A physician, as defined in Subsection 35A-3-117(2), who is associated with, employed
by, or bills through a hospital is subject to Subsection (8)(a).
(c) A hospital is not subject to the requirements of Subsection (8)(a).
(d) The department's schedule of fees may reasonably differentiate remuneration to be paid
to providers of health services based on:
(i) the severity of the employee's condition[
(ii) the nature of the treatment necessary[
(iii) the facilities or equipment specially required to deliver that treatment.
(e) Subsection (8) does not modify contracts with providers of health services relating to the
pricing of goods and services existing on May 1, 1995.
(9) A copy of the physician's initial report shall be furnished to:
(a) the department[
(b) the employee[
(c) the employer or its insurance carrier.
(10) Any physician, surgeon, or other health provider, excluding any hospital, who refuses
or neglects to make any report or comply with this section is guilty of a class C misdemeanor for
each offense, unless the department finds that there is good cause for submitting a late report.
(11) Applications for a hearing to resolve disputes regarding occupational disease claims
shall be filed with the department. After the filing, a copy shall be forwarded by mail to the
employer or to the employer's insurance carrier, to the applicant, and to the attorneys for the parties.
(12) (a) Subject to appellate review under Section 35A-1-302, the department has exclusive
jurisdiction to hear and determine whether the treatment or services rendered to employees by
physicians, surgeons, or other health providers are:
(i) reasonably related to industrial injuries or occupational diseases; and
(ii) compensable pursuant to this chapter and Chapter 3, Workers' Compensation Act.
(b) Except as provided in Subsection (12)(a), Subsection 35A-3-204(7), or Section
35A-3-211, a person may not maintain a cause of action in any forum within this state other than the
department for collection or payment of a physician's, surgeon's, or other health provider's billing
for treatment or services that are compensable under this chapter or Chapter 3, Workers'
Compensation Act.
Section 4. Effective date.
This act takes effect on July 1, 1997.
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