Senator Curtis S. Bramble proposes the following substitute bill:


1     
OCCUPATIONAL INJURIES AMENDMENTS

2     
2023 GENERAL SESSION

3     
STATE OF UTAH

4     
Chief Sponsor: Curtis S. Bramble

5     
House Sponsor: Casey Snider

6     

7     LONG TITLE
8     General Description:
9          This bill addresses provisions related to occupational injuries and diseases.
10     Highlighted Provisions:
11          This bill:
12          ▸     modifies requirements for calculating add-on fees under a medical workers'
13     compensation claim;
14          ▸     modifies the circumstances under which a firefighter is presumed to have contracted
15     certain cancers during the course of the firefighter's employment;
16          ▸     requires the Division of Industrial Accidents to conduct a study regarding cancers
17     commonly caused in the course of a firefighter's employment;
18          ▸     includes a sunset date and reporting requirements for the study; and
19          ▸     makes technical changes.
20     Money Appropriated in this Bill:
21          None
22     Other Special Clauses:
23          None
24     Utah Code Sections Affected:
25     AMENDS:

26          34A-1-309, as repealed and reenacted by Laws of Utah 2019, Chapter 15
27          34A-3-113, as last amended by Laws of Utah 2022, Chapter 346
28          63I-2-234, as last amended by Laws of Utah 2021, Chapter 82
29     

30     Be it enacted by the Legislature of the state of Utah:
31          Section 1. Section 34A-1-309 is amended to read:
32          34A-1-309. Add-on fees.
33          (1) As used in this section:
34          (a) "Carrier" means:
35          (i) a workers' compensation insurance carrier[,];
36          (ii) the Uninsured Employers' Fund, an employer that does not carry workers'
37     compensation insurance[,]; or
38          (iii) a self-insured employer as defined in Section 34A-2-201.5.
39          (b) "Indemnity compensation" means a workers' compensation claim for indemnity
40     benefits that arises from or may arise from a denial of a medical claim.
41          (c) "Medical claim" means a workers' compensation claim for medical expenses or
42     recommended medical care.
43          (d) "Unconditional denial" means a carrier's denial of a medical claim:
44          (i) after the carrier completes an investigation; or
45          (ii) 90 days after the day on which the claim was submitted to the carrier.
46          (2) (a) The commission may award an add-on fee to a claimant to be paid by the carrier
47     if:
48          (i) a medical claim is at issue;
49          (ii) the carrier issues an unconditional denial of the medical claim;
50          (iii) the claimant hires an attorney to represent the claimant during the formal
51     adjudicative process before the commission;
52          (iv) after the carrier issues the unconditional denial, the commission orders the carrier
53     or the carrier agrees to pay the medical claim; and
54          (v) any award of indemnity compensation in the case is less than $5,000.
55          (b) An award of an add-on fee under this section is in addition to:
56          (i) the amount awarded for the medical claim or indemnity compensation; and

57          (ii) any amount for attorney fees agreed upon between the claimant and the claimant's
58     attorney.
59          (c) An award under this section is governed by the law in effect at the time the claimant
60     files an application for hearing with the Division of Adjudication.
61          (d) (i) Medical expenses awarded as part of a medical claim under this section shall be
62     calculated in accordance with the amount the carrier is required to pay under the rules
63     established by the commission under Subsection 34A-2-407(9).
64          (ii) If the medical expenses awarded under this section are not set forth in the rules
65     described in Subsection 34A-2-407(9), the medical expenses shall be calculated based on the
66     amount the carrier paid or is contractually required to pay to the medical provider, whichever is
67     greater.
68          (3) If the commission awards an add-on fee under this section, the commission shall
69     award the add-on fee in the following amount:
70          (a) the lesser of 25% of the medical expenses the commission awards to the claimant or
71     $25,000, for a case that is resolved at the commission level;
72          (b) the lesser of 30% of the medical expenses the Utah Court of Appeals awards to the
73     claimant or $30,000, for a case that is resolved on appeal before the Utah Court of Appeals; or
74          (c) the lesser of 35% of the medical expenses that the Utah Supreme Court awards to
75     the claimant or $35,000, for a case that is resolved on appeal before the Utah Supreme Court.
76          (4) If a court invalidates any portion of this section, the entire section is invalid.
77          Section 2. Section 34A-3-113 is amended to read:
78          34A-3-113. Presumption of workers' compensation benefits for firefighters --
79     Study.
80          (1) As used in this section:
81          (a) (i) "Firefighter" means a member, including a volunteer member, as described in
82     Subsection 67-20-2(7)(b)(ii), or a member paid on call, of a fire department or other
83     organization that provides fire suppression and other fire-related service who is responsible for
84     or is in a capacity that includes responsibility for the extinguishment of fires.
85          (ii) "Firefighter" does not include a person whose job description, duties, or
86     responsibilities do not include direct involvement in fire suppression.
87          (b) "Presumptive cancer" means one or more of the following cancers:

88          (i) pharynx;
89          (ii) esophagus;
90          (iii) lung; and
91          (iv) mesothelioma.
92          (2) If a firefighter who contracts a presumptive cancer meets the requirements of
93     Subsection (3), there is a rebuttable presumption that:
94          (a) the presumptive cancer was contracted arising out of and in the course of
95     employment; and
96          (b) the presumptive cancer was not contracted by a willful act of the firefighter.
97          (3) To be entitled to the rebuttable presumption described in Subsection (2), the
98     firefighter shall:
99          (a) during the time of employment as a firefighter, [the firefighter undergoes] undergo
100     annual physical examinations;
101          (b) [the firefighter shall] have been employed as a firefighter for eight years or more
102     and regularly responded to firefighting or emergency calls within the eight-year period; and
103          (c) if [a] the firefighter has used tobacco, [the firefighter provides] provide
104     documentation from a physician that indicates that the firefighter has not used tobacco for the
105     eight years preceding reporting the presumptive cancer to the employer or division.
106          (4) A presumption established under this section may be rebutted by a preponderance
107     of the evidence.
108          (5) If a firefighter who contracts a presumptive cancer is employed as a firefighter by
109     more than one employer and qualifies for the presumption under Subsection (2), and that
110     presumption has not been rebutted, the employer and insurer at the time of the last substantial
111     exposure to risk of the presumptive cancer are liable under this chapter [pursuant to] under
112     Section 34A-3-105.
113          (6) A cause of action subject to the presumption under this section is considered to
114     arise on the date [after May 12, 2015,] that the employee:
115          (a) suffers disability from the occupational disease;
116          (b) knows, or in the exercise of reasonable diligence should have known, that the
117     occupational disease is caused by employment; and
118          (c) files a claim as provided in Section 34A-3-108.

119          (7) (a) The division shall conduct a study to determine whether cancers other than the
120     cancers listed in Subsection (1)(b) are commonly contracted in the course of a firefighter's
121     employment.
122          (b) In conducting the study, the division shall:
123          (i) consider cancer latency periods; and
124          (ii) consult with:
125          (A) associations representing firefighters;
126          (B) fire departments; and
127          (C) the Rocky Mountain Center for Occupational and Environmental Health created in
128     Section 53B-30-203.
129          (c) Before November 30, 2024, the division shall provide a report to the Business and
130     Labor Interim Committee summarizing the results of the study and any recommendations for
131     legislation.
132          Section 3. Section 63I-2-234 is amended to read:
133          63I-2-234. Repeal dates: Title 34A.
134          (1) Section 34A-2-107.3 is repealed May 15, 2025.
135          (2) Subsection 34A-3-113(7) relating to a study is repealed on January 1, 2025.