H.B. 238 Enrolled

WORKERS' COMPENSATION ACCESS TO
MEDICAL RECORDS
2004 GENERAL SESSION
STATE OF UTAH
Sponsor: Jeff Alexander

LONG TITLE
General Description:
This bill amends the Workers' Compensation Laws to clarify that the Labor Commission
has rulemaking authority regarding a physician's disclosure of medical records relevant
to an employee's industrial accident or occupational disease claim.
Highlighted Provisions:
This bill:
. requires an injured employee and a physician to comply with commission rules
regarding disclosure of medical records relevant to the employee's industrial accident
or occupational disease; and
. makes technical changes.
Monies Appropriated in this Bill:
None
Other Special Clauses:
None
Utah Code Sections Affected:
AMENDS:
34A-2-407, as last amended by Chapter 67, Laws of Utah 2003

Be it enacted by the Legislature of the state of Utah:
Section 1. Section 34A-2-407 is amended to read:
34A-2-407. Reporting of industrial injuries -- Regulation of health care
providers.

(1) As used in this section, "physician" is as defined in Section 34A-2-111 .
(2) (a) 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.
(b) If the employee is unable to provide the notification required by Subsection (2)(a), the
following may provide notification of the injury to the employee's employer:
(i) the employee's next-of-kin; or
(ii) the employee's attorney.
(c) An employee claiming benefits under this chapter, or Chapter 3, Utah Occupational
Disease Act, shall comply with rules adopted by the commission regarding disclosure of medical
records of the employee medically relevant to the industrial accident or occupational disease
claim.
(3) (a) An employee is barred for any claim of benefits arising from an injury if the
employee fails to notify within the time period described in Subsection (3)(b):
(i) the employee's employer in accordance with Subsection (2); or
(ii) the division.
(b) The notice required by Subsection (3)(a) shall be made within:
(i) 180 days of the day on which the injury occurs; or
(ii) in the case of an occupational hearing loss, the time period specified in Section
34A-2-506 .
(4) The following constitute notification of injury required by Subsection (2):
(a) an employer's or physician's injury report filed with:
(i) the division;
(ii) the employer; or
(iii) the employer's insurance carrier; or
(b) the payment of any medical or disability benefits by:
(i) the employer; or
(ii) the employer's insurance carrier.
(5) (a) In the form prescribed by the division, each employer shall file a report with the

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division of any:
(i) work-related fatality; or
(ii) work-related injury resulting in:
(A) medical treatment;
(B) loss of consciousness;
(C) loss of work;
(D) restriction of work; or
(E) transfer to another job.
(b) The employer shall file the report required by Subsection (5)(a) 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.
(c) (i) An employer shall file a subsequent report with the division of any previously
reported injury that later results in death.
(ii) The subsequent report required by this Subsection (5)(c) shall be filed with the
division within seven days following:
(A) the death; or
(B) the employer's first knowledge or notification of the death.
(d) A report is not required to be filed under this Subsection (5) for minor injuries, such
as cuts or scratches that require first-aid treatment only, unless:
(i) a treating physician files a report with the division in accordance with Subsection (9);
or
(ii) a treating physician is required to file a report with the division in accordance with
Subsection (9).
(6) An employer required to file a report under Subsection (5) shall provide the employee
with:
(a) a copy of the report submitted to the division; and

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(b) a statement, as prepared by the division, of the employee's rights and responsibilities
related to the industrial injury.
(7) Each employer shall maintain a record in a manner prescribed by the division of all:
(a) work-related fatalities; or
(b) work-related injuries resulting in:
(i) medical treatment;
(ii) loss of consciousness;
(iii) loss of work;
(iv) restriction of work; or
(v) transfer to another job.
(8) (a) Except as provided in Subsection (8)(b), an employer who refuses or neglects to
make reports, to maintain records, or to file reports with the division as required by this section is:
(i) guilty of a class C misdemeanor; and
(ii) subject to a civil assessment:
(A) imposed by the division, subject to the requirements of Title 63, Chapter 46b,
Administrative Procedures Act; and
(B) that may not exceed $500.
(b) An employer is not subject to the civil assessment or guilty of a class C misdemeanor
under this Subsection (8) if:
(i) the employer submits a report later than required by this section; and
(ii) the division finds that the employer has shown good cause for submitting a report
later than required by this section.
(c) A civil assessment collected under this Subsection (8) shall be deposited into the
Uninsured Employers' Fund created in Section 34A-2-704 .
(9) (a) Except as provided in Subsection (9)(c), a physician attending an injured employee
shall[: (i)] comply with [all the] rules[, including the schedule of] established by the commission
regarding:
(i) fees[,] for [the] physician's services [as adopted by the commission; and (ii) make];

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(ii) disclosure of medical records of the employee medically relevant to the employee's
industrial accident, or occupational disease claim; and
(iii) reports to the division [at any and all times as required as to] regarding:
(A) the condition and treatment of an injured employee; or
(B) any other matter concerning industrial cases that the physician is treating.
(b) A physician who is associated with, employed by, or bills through a hospital is subject
to Subsection (9)(a).
(c) A hospital is not subject to the requirements of Subsection (9)(a).
(d) The commission'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; and
(iii) the facilities or equipment specially required to deliver that treatment.
(e) This Subsection (9) does not modify contracts with providers of health services
relating to the pricing of goods and services existing on May 1, 1995.
(f) In accordance with Title 63, Chapter 46b, Administrative Procedures Act, a physician
may file with the Division of Adjudication an application for hearing to appeal a decision or final
order to the extent a decision or final order concerns the fees charged by the physician in
accordance with this section.
(10) A copy of the initial report filed under Subsection (9)(a)(iii) shall be furnished to:
(a) the division;
(b) the employee; and
(c) (i) the employer; or
(ii) the employer's insurance carrier.
(11) (a) Except as provided in Subsection (11)(b), a physician, excluding any hospital,
who fails to comply with [this section] Subsection (9)(a)(iii) is guilty of a class C misdemeanor for
each offense.
(b) A physician is not guilty of a class C misdemeanor under this Subsection (11), if:

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(i) the physician files a late report; and
(ii) the division finds that there is good cause for submitting a late report.
(12) (a) Subject to appellate review under Section 34A-1-303 , the commission has
exclusive jurisdiction to hear and determine whether the treatment or services rendered to an
employee by a physician are:
(i) reasonably related to industrial injuries or occupational diseases; and
(ii) compensable pursuant to this chapter or Chapter 3, Utah Occupational Disease Act.
(b) Except as provided in Subsection (12)(a), Subsection 34A-2-211 (7), or Section
34A-2-212 , a person may not maintain a cause of action in any forum within this state other than
the commission for collection or payment of a physician's billing for treatment or services that are
compensable under this chapter or Chapter 3, Utah Occupational Disease Act.

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