1     
LABOR COMMISSION AMENDMENTS

2     
2016 GENERAL SESSION

3     
STATE OF UTAH

4     
Chief Sponsor: Karen Mayne

5     
House Sponsor: James A. Dunnigan

6     

7     LONG TITLE
8     General Description:
9          This bill modifies provisions related to payment of workers' compensation benefits.
10     Highlighted Provisions:
11          This bill:
12          ▸     repeals language related to liability for extended benefits;
13          ▸     imposes time frames within which claims for reimbursement from the Employer's
14     Reinsurance Fund may be submitted; and
15          ▸     makes technical changes.
16     Money Appropriated in this Bill:
17          None
18     Other Special Clauses:
19          None
20     Utah Code Sections Affected:
21     AMENDS:
22          34A-2-416, as last amended by Laws of Utah 2008, Chapter 90
23          34A-2-703, as last amended by Laws of Utah 2011, Chapter 366
24     

25     Be it enacted by the Legislature of the state of Utah:
26          Section 1. Section 34A-2-416 is amended to read:
27          34A-2-416. Additional benefits in special cases.
28          [(1)] Benefits received by a wholly dependent person under this chapter or Chapter 3,
29     Utah Occupational Disease Act, extend indefinitely if at the termination of the benefits:
30          [(a)] (1) the wholly dependent person is still in a dependent condition; and
31          [(b)] (2) under all reasonable circumstances the wholly dependent person should be
32     entitled to additional benefits.
33          [(2) If benefits are extended under Subsection (1):]
34          [(a) the liability of the employer or insurance carrier involved may not be extended;
35     and]
36          [(b) the additional benefits allowed shall be paid out of the Employers' Reinsurance
37     Fund created in Subsection 34A-2-702(1).]
38          Section 2. Section 34A-2-703 is amended to read:
39          34A-2-703. Payments from Employers' Reinsurance Fund.
40          If an employee, who has at least a 10% whole person permanent impairment from any
41     cause or origin, subsequently incurs an additional impairment by an accident arising out of and
42     in the course of the employee's employment during the period of July 1, 1988, to June 30,
43     1994, inclusive, and if the additional impairment results in permanent total disability, the
44     employer or its insurance carrier and the Employers' Reinsurance Fund are liable for the
45     payment of benefits as follows:
46          (1) The employer or its insurance carrier is liable for the first $20,000 of medical
47     benefits and the initial 156 weeks of permanent total disability compensation as provided in
48     this chapter or Chapter 3, Utah Occupational Disease Act.
49          (2) Reasonable medical benefits in excess of the first $20,000 shall be paid in the first
50     instance by the employer or its insurance carrier. Then, as provided in Subsection (5), the
51     Employers' Reinsurance Fund shall reimburse the employer or its insurance carrier for 50% of
52     those expenses.
53          (3) After the initial 156-week period under Subsection (1), permanent total disability
54     compensation payable to an employee under this chapter or Chapter 3, Utah Occupational
55     Disease Act, becomes the liability of and shall be paid by the Employers' Reinsurance Fund.
56          (4) If it is determined that the employee is permanently and totally disabled, the
57     employer or its insurance carrier shall be given credit for all prior payments of temporary total,
58     temporary partial, and permanent partial disability compensation made as a result of the
59     industrial accident. [Any] An overpayment by the employer or its insurance carrier shall be
60     reimbursed by the Employers' Reinsurance Fund under Subsection (5).
61          (5) (a) (i) Upon receipt of a duly verified petition, the Employers' Reinsurance Fund
62     shall reimburse the employer or its insurance carrier for the Employers' Reinsurance Fund's
63     share of medical benefits and compensation paid to or on behalf of an employee.
64          (ii) A request for Employers' Reinsurance Fund reimbursements shall be accompanied
65     by satisfactory evidence of payment of the medical or disability compensation for which the
66     reimbursement is requested. [Each]
67          (iii) A request is subject to review as to reasonableness by the administrator. The
68     administrator may determine the manner of reimbursement.
69          (b) A decision of the administrator under Subsection (5)(a) may be appealed in
70     accordance with Part 8, Adjudication.
71          (c) An employer or its insurance carrier shall submit to the Employers' Reinsurance
72     Fund, by June 30, 2018, a request for reimbursement related to medical benefits or
73     compensation paid on or before July 1, 2016.
74          (d) An employer or its insurance carrier shall submit to the Employers' Reinsurance
75     Fund a request for reimbursement related to medical benefits or compensation paid after July 1,
76     2016, within 24 months of the later of:
77          (i) the date the benefits or compensation are paid by the employer or its insurance
78     carrier; or
79          (ii) the date the Employers' Reinsurance Fund is determined to be liable.
80          (e) Requests for reimbursement not submitted in accordance with Subsection (5)(c) or
81     (5)(d) are considered untimely and the Employers' Reinsurance Fund may not reimburse the
82     benefits or compensation paid.
83          (6) If, at the time an employee is determined to have a permanent, total disability, the
84     employee has other actionable workers' compensation claims, the employer or insurance carrier
85     that is liable for the last industrial accident resulting in permanent total disability shall be liable
86     for the benefits payable by the employer as provided in this section and Section 34A-2-413.
87     The employee's entitlement to benefits for prior actionable claims shall then be determined
88     separately on the facts of those claims. [Any] A previous permanent partial disability arising
89     out of those claims shall then be considered to be impairments that may give rise to Employers'
90     Reinsurance Fund liability under this section.




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