Chief Sponsor: Karen Mayne

House Sponsor: James A. Dunnigan


8     General Description:
9          This bill enacts provisions related to add-on fees in workers' compensation cases.
10     Highlighted Provisions:
11          This bill:
12          ▸     repeals provisions authorizing the Labor Commission to award attorney fees;
13          ▸     defines terms;
14          ▸     in certain workers' compensation cases, authorizes the Labor Commission to award
15     an add-on fee to a claimant to be paid by the workers' compensation insurance
16     carrier; and
17          ▸     if the Labor Commission awards an add-on fee, establishes the amount of the
18     add-on fee.
19     Money Appropriated in this Bill:
20          None
21     Other Special Clauses:
22          This bill provides a special effective date.
23     Utah Code Sections Affected:
25          34A-1-309, as repealed and reenacted by Laws of Utah 2018, Chapter 273

27     Be it enacted by the Legislature of the state of Utah:
28          Section 1. Section 34A-1-309 is repealed and reenacted to read:
29          34A-1-309. Add-on fees.

30          (1) As used in this section:
31          (a) "Carrier" means a workers' compensation insurance carrier, the Uninsured
32     Employers' Fund, an employer that does not carry workers' compensation insurance, or a
33     self-insured employer as defined in Section 34A-2-201.5.
34          (b) "Indemnity compensation" means a workers' compensation claim for indemnity
35     benefits that arises from or may arise from a denial of a medical claim.
36          (c) "Medical claim" means a workers' compensation claim for medical expenses or
37     recommended medical care.
38          (d) "Unconditional denial" means a carrier's denial of a medical claim:
39          (i) after the carrier completes an investigation; or
40          (ii) 90 days after the day on which the claim was submitted to the carrier.
41          (2) (a) The commission may award an add-on fee to a claimant to be paid by the carrier
42     if:
43          (i) a medical claim is at issue;
44          (ii) the carrier issues an unconditional denial of the medical claim;
45          (iii) the claimant hires an attorney to represent the claimant during the formal
46     adjudicative process before the commission;
47          (iv) after the carrier issues the unconditional denial, the commission orders the carrier
48     or the carrier agrees to pay the medical claim; and
49          (v) any award of indemnity compensation in the case is less than $5,000.
50          (b) An award of an add-on fee under this section is in addition to:
51          (i) the amount awarded for the medical claim or indemnity compensation; and
52          (ii) any amount for attorney fees agreed upon between the claimant and the claimant's
53     attorney.
54          (c) An award under this section is governed by the law in effect at the time the claimant
55     files an application for hearing with the Division of Adjudication.
56          (3) If the commission awards an add-on fee under this section, the commission shall
57     award the add-on fee in the following amount:

58          (a) the lesser of 25% of the medical expenses the commission awards to the claimant or
59     $25,000, for a case that is resolved at the commission level;
60          (b) the lesser of 30% of the medical expenses the Utah Court of Appeals awards to the
61     claimant or $30,000, for a case that is resolved on appeal before the Utah Court of Appeals; or
62          (c) the lesser of 35% of the medical expenses that the Utah Supreme Court awards to
63     the claimant or $35,000, for a case that is resolved on appeal before the Utah Supreme Court.
64          (4) If a court invalidates any portion of this section, the entire section is invalid.
65          Section 2. Effective date.
66          If approved by two-thirds of all the members elected to each house, this bill takes effect
67     upon approval by the governor, or the day following the constitutional time limit of Utah
68     Constitution, Article VII, Section 8, without the governor's signature, or in case of a veto, the
69     date of veto override.