H.B. 222

1

POWERS OF THE DEPARTMENT OF
2 WORKFORCE SERVICES
3 1997 GENERAL SESSION
4 STATE OF UTAH
5 Sponsor: Gerry A. Adair
6 AN ACT RELATING TO WORKFORCE SERVICES; AMENDING ATTORNEY FEE
7 PROVISIONS; AMENDING DEPARTMENTS JURISDICTION ON COMPENSABILITY
8 OF HEALTH CARE PROVIDER SERVICES; MAKING TECHNICAL CORRECTIONS;
9 AND PROVIDING AN EFFECTIVE DATE.
10 This act affects sections of Utah Code Annotated 1953 as follows:
11 AMENDS:
12 35A-3-407 (Effective 07/01/97), as renumbered and amended by Chapter 240, Laws of Utah
13 1996
14 35A-3-805 (Effective 07/01/97), as renumbered and amended by Chapter 240, Laws of Utah
15 1996
16 35A-3a-108 (Effective 07/01/97), as renumbered and amended by Chapter 240, Laws of Utah
17 1996
18 Be it enacted by the Legislature of the state of Utah:
19 Section 1. Section 35A-3-407 (Effective 07/01/97) is amended to read:
20 35A-3-407 (Effective 07/01/97). Reporting of industrial injuries -- Regulation of
21 health care providers.
22 (1) Any employee sustaining an injury arising out of and in the course of employment
23 shall provide notification to the employee's employer promptly of the injury. If the employee is
24 unable to provide notification, the employee's next-of-kin or attorney may provide notification of
25 the injury to the employee's employer.
26 (2) Any employee who fails to notify [his] the employee's employer or the department
27 within 180 days of an injury is barred for any claim of benefits arising from the injury.

1 (3) An employer's or physician's injury report filed with the department, employer, or
2 insurance carrier or the payment of any medical or disability benefits by the employer or the
3 employer's insurance carrier, constitutes notification of an injury.
4 (4) (a) On forms or by methods prescribed by the department, each employer shall file a
5 report with the department of any work-related fatality or any work-related injury resulting in
6 medical treatment, loss of consciousness, loss of work, restriction of work, or transfer to another
7 job within seven days after:
8 (i) the occurrence of a fatality or injury;
9 (ii) the employer's first knowledge of the fatality or injury; or
10 (iii) the employee's notification of the fatality or injury.
11 (b) Each employer shall file a subsequent report with the department of any previously
12 reported injury that later resulted in death. The subsequent report shall be filed with the
13 department within seven days following the death or the employer's first knowledge or notification
14 of the death.
15 (c) No report is required for minor injuries, such as cuts or scratches that require first-aid
16 treatment only, unless a treating physician files, or is required to file, the Physician's Initial Report
17 of Work Injury or Occupational Disease with the department.
18 (5) Each employer shall provide the employee with:
19 (a) a copy of the report submitted to the department[. The employer shall also provide
20 the employee with]; and
21 (b) a statement, as prepared by the department, of the employee's rights and
22 responsibilities related to the industrial injury.
23 (6) Each employer shall maintain a record in a manner prescribed by the department of all
24 work-related fatalities or work-related injuries resulting in:
25 (a) medical treatment[,];
26 (b) loss of consciousness[,];
27 (c) loss of work[,];
28 (d) restriction of work[,]; or
29 (e) transfer to another job.
30 (7) Any employer who refuses or neglects to make reports, to maintain records, or to file
31 reports with the department as required by this section is guilty of a class C misdemeanor and

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1 subject to citation under Section 35A-6-302 and a civil assessment as provided under Section
2 35A-6-307, unless the department finds that the employer has shown good cause for submitting
3 a report later than required by this section.
4 (8) (a) Except as provided in Subsection (8)(c) all physicians, surgeons, and other health
5 providers attending injured employees shall:
6 (i) comply with all the rules, including the schedule of fees, for their services as adopted
7 by the department; and
8 (ii) make reports to the department at any and all times as required as to the condition and
9 treatment of an injured employee or as to any other matter concerning industrial cases they are
10 treating.
11 (b) A physician, as defined in Subsection 35A-3-117(2), who is associated with, employed
12 by, or bills through a hospital is subject to Subsection (8)(a).
13 (c) A hospital is not subject to the requirements of Subsection (8)(a).
14 (d) The department's schedule of fees may reasonably differentiate remuneration to be paid
15 to providers of health services based on:
16 (i) the severity of the employee's condition[,];
17 (ii) the nature of the treatment necessary[,]; and
18 (iii) the facilities or equipment specially required to deliver that treatment.
19 (e) Subsection (8) does not modify contracts with providers of health services relating to
20 the pricing of goods and services existing on May 1, 1995.
21 (9) A copy of the physician's initial report shall be furnished to:
22 (a) the department[,]:
23 (b) the employee[,]; and
24 (c) the employer or its insurance carrier.
25 (10) Any physician, surgeon, or other health provider, excluding any hospital, who refuses
26 or neglects to make any report or comply with this section is guilty of a class C misdemeanor for
27 each offense, unless the department finds that there is good cause for submitting a late report.
28 (11) (a) Subject to appellate review under Section 35A-1-302, the department has
29 exclusive jurisdiction to hear and determine whether the treatment or services rendered to
30 employees by physicians, surgeons, or other health providers are:
31 (i) reasonably related to industrial injuries or occupational diseases; and

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1 (ii) compensable pursuant to this chapter or Chapter 3a, Utah Occupational Disease Act.
2 (b) Except as provided in Subsection (11)(a), Subsection 35A-3-204(7), or Section
3 35A-3-211, a person may not maintain a cause of action in any forum within this state other than
4 the department for collection or payment of a physician's, surgeon's, or other health provider's
5 billing for treatment or services that are compensable under this chapter or Chapter 3a, Utah
6 Occupational Disease Act.
6a h (c) (i) A HOSPITAL IS NOT SUBJECT TO THE REQUIREMENTS OF THIS SUBSECTION (11).
6b (ii) A PHYSICIAN, AS DEFINED IN SUBSECTION 35A-3-117(2), WHO IS ASSOCIATED WITH,
6c EMPLOYED BY, OR BILLS THROUGH A HOSPITAL IS SUBJECT TO THIS SUBSECTION (11). h
7 Section 2. Section 35A-3-805 (Effective 07/01/97) is amended to read:
8 35A-3-805 (Effective 07/01/97). Attorneys' fees.
9 (1) In all cases coming before the department in which attorneys have been employed, the
10 department is vested with full power to regulate and fix the fees of the attorneys.
11 (2) (a) The department may award reasonable attorneys' fees on a contingency basis when
12 disability or death benefits or interest on disability or death benefits are generated.
13 (b) Attorney fees awarded under Subsection (2)(a) shall be paid by the employer or its
14 insurance carrier out of the award of disability or death benefits, or interest on disability or death
15 benefits.
16 (3) (a) If the department orders that only medical benefits be paid, the department may
17 award a reasonable attorney's fee on a contingency basis for medical benefits ordered paid if:
18 (i) the department's informal dispute resolution mechanisms were fully used by the parties
19 prior to adjudication; and
20 (ii) at no time were disability or death benefits or interest on disability or death benefits at
21 issue in the adjudication of the medical benefit claim.
22 (b) Attorney's fees awarded under Subsection (3)(a) shall be paid by the employer or its
23 insurance carrier in addition to the payment of medical benefits ordered.
24 Section 3. Section 35A-3a-108 (Effective 07/01/97) is amended to read:
25 35A-3a-108 (Effective 07/01/97). Reporting of occupational diseases -- Regulation of
26 health care providers.
27 (1) Any employee sustaining an occupational disease, as defined in this chapter, arising
28 out of and in the course of employment shall provide notification to the employee's employer
29 promptly of the occupational disease. If the employee is unable to provide notification, the
30 employee's next-of-kin or attorney may provide notification of the occupational disease to the
31 employee's employer.

lilac-February 3, 1997

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1 (2) Any employee who fails to notify the employee's employer or the department within
2 180 days after the cause of action arises is barred from any claim of benefits arising from the
3 occupational disease. The cause of action is considered to arise on the date the employee first
4 suffered disability from the occupational disease and knew, or in the exercise of reasonable
5 diligence should have known, that the occupational disease was caused by employment.
6 (3) An employer's or physician's injury report filed with the department, employer, or
7 insurance carrier, or the payment of any medical or disability benefits by the employer or the
8 employer's insurance carrier, constitutes notification of an occupational disease.
9 (4) (a) On forms or by methods prescribed by the department, each employer shall file a
10 report with the department of any occupational disease resulting in medical treatment, loss of
11 consciousness, loss of work, restriction of work, or transfer to another job within seven days after:
12 (i) the occurrence of an occupational disease;
13 (ii) the employer's first knowledge of the occupational disease; or
14 (iii) the employee's notification of the occupational disease.
15 (b) Each employer shall file a subsequent report with the department of any previously
16 reported occupational disease that later resulted in death. The subsequent report shall be filed with
17 the department within seven days following the death or the employer's first knowledge or
18 notification of the death.
19 (c) No report is required for minor injuries that require first-aid treatment only, unless a
20 treating physician files, or is required to file, the Physician's Initial Report of Work Injury or
21 Occupational Disease with the department.
22 (d) No report is required for occupational diseases that manifest after the employee is no
23 longer employed by the employer with which the exposure occurred, or when the employer is not
24 aware of an exposure occasioned by the employment that results in an occupational disease as
25 defined by Section 35A-3a-103.
26 (5) Each employer shall provide the employee with:
27 (a) a copy of the report submitted to the department[. The employer shall also provide
28 the employee with]; and
29 (b) a statement, as prepared by the department, of the employee's rights and
30 responsibilities related to the occupational disease.
31 (6) Each employer shall maintain a record in a manner prescribed by the department of all

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1 occupational diseases resulting in:
2 (a) medical treatment[,];
3 (b) loss of consciousness[,];
4 (c) loss of work[,];
5 (d) restriction of work[,]; or
6 (e) transfer to another job.
7 (7) Any employer who refuses or neglects to make reports, to maintain records, or to file
8 reports with the department as required by this section is guilty of a class C misdemeanor and
9 subject to citation under Section 35A-6-302 and a civil assessment as provided under Section
10 35A-6-307, unless the department finds that the employer has shown good cause for submitting
11 a report later than required by this section.
12 (8) (a) Except as provided in Subsection (8)(c), all physicians, surgeons, and other health
13 providers attending occupationally diseased employees shall:
14 (i) comply with all the rules, including the schedule of fees, for their services as adopted
15 by the department; and
16 (ii) make reports to the department at any and all times as required as to the condition and
17 treatment of an occupationally diseased employee or as to any other matter concerning industrial
18 cases they are treating.
19 (b) A physician, as defined in Subsection 35A-3-117(2), who is associated with, employed
20 by, or bills through a hospital is subject to Subsection (8)(a).
21 (c) A hospital is not subject to the requirements of Subsection (8)(a).
22 (d) The department's schedule of fees may reasonably differentiate remuneration to be paid
23 to providers of health services based on:
24 (i) the severity of the employee's condition[,];
25 (ii) the nature of the treatment necessary[,]; and
26 (iii) the facilities or equipment specially required to deliver that treatment.
27 (e) Subsection (8) does not modify contracts with providers of health services relating to
28 the pricing of goods and services existing on May 1, 1995.
29 (9) A copy of the physician's initial report shall be furnished to:
30 (a) the department[,];
31 (b) the employee[,]; and

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1 (c) the employer or its insurance carrier.
2 (10) Any physician, surgeon, or other health provider, excluding any hospital, who refuses
3 or neglects to make any report or comply with this section is guilty of a class C misdemeanor for
4 each offense, unless the department finds that there is good cause for submitting a late report.
5 (11) Applications for a hearing to resolve disputes regarding occupational disease claims
6 shall be filed with the department. After the filing, a copy shall be forwarded by mail to the
7 employer or to the employer's insurance carrier, to the applicant, and to the attorneys for the
8 parties.
9 (12) (a) Subject to appellate review under Section 35A-1-302, the department has
10 exclusive jurisdiction to hear and determine whether the treatment or services rendered to
11 employees by physicians, surgeons, or other health providers are:
12 (i) reasonably related to industrial injuries or occupational diseases; and
13 (ii) compensable pursuant to this chapter and Chapter 3, Workers Compensation Act.
14 (b) Except as provided in Subsection (12)(a), Subsection 35A-3-204(7), or Section
15 35A-3-211, a person may not maintain a cause of action in any forum within this state other than
16 the department for collection or payment of a physician's, surgeon's, or other health provider's
17 billing for treatment or services that are compensable under this chapter or Chapter 3, Workers'
18 Compensation Act.
18a h (c) (i) A HOSPITAL IS NOT SUBJECT TO THE REQUIREMENTS OF THIS SUBSECTION (12).
18b (ii) A PHYSICIAN, AS DEFINED IN SUBSECTION 35A-3-117(2), WHO IS ASSOCIATED WITH,
18c EMPLOYED BY , OR BILLS THROUGH A HOSPITAL IS SUBJECT TO THIS SUBSECTION (12). h
19 Section 4. Effective date.
20 This act takes effect on July 1, 1997.




Legislative Review Note
as of 12-12-96 2:27 PM

A limited legal review of this bill raises no obvious constitutional or statutory concerns.

Office of Legislative Research and General Counsel

lilac-February 3, 1997

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